3 Ways Technology Can Improve Adherence to the COVID-19 Vaccine Booster Shot
Tashfeen Ekram, MD
When the Pfizer and Moderna vaccines for COVID-19 were first approved, it was a celebratory moment. But for healthcare providers, it was followed by some trepidation: not only were there hundreds of millions of Americans to vaccinate, but they’d have to be vaccinated twice, since this vaccine requires a second dose.
In an interview with The Washington Post, Kelly Moore of the Immunization Action Coalition reminded the healthcare community of the logistical challenge this would invite, saying, “This is the only time we’ve faced a serious, immediate threat to the entire population that requires a two-dose vaccine.”
Two-dose vaccines don’t have a great track record when it comes to adherence. In a study that examined the success of the two-dose Hepatitis B vaccination regimens in the U.S. and U.K., nearly 50% of patients never got their second shot; HPV vaccinations had an equally dismal completion rate. This problem may be even more prevalent in rural areas, where access to healthcare and higher poverty rates result in a 20% higher vaccine attrition rate. Whether it’s a failure to schedule a return visit or an overwhelming number of no-shows, such a low adherence rate could cause a never-ending effort to quelch the COVID-19 pandemic.
Aside from slowing down our path to herd immunity to COVID-19, providers will have to make quick decisions about how they can salvage vaccine supply so it’s not wasted when patients don’t keep their booster appointments.
Healthcare providers can tackle this task the same way so many people get more things done these days: with technology. In this post, we explain how three types of technology — all part of our COVID-19 solutions — will help those administering the COVID-19 vaccine get patients to show up for round two.
“This is the only time we’ve faced a serious, immediate threat to teh entire population that requires a two-dose vaccine.”
Web Scheduling and Smart Waitlists Will Lead Patients to Get — and Stay — on Schedule
Adherence to the second shot will start with scheduling. Ideally, providers should schedule patients for their booster shot at the time of their first vaccination, but there may be instances where that’s not possible (the patient doesn’t want to commit, the system is down, or staff is too overwhelmed to get everyone scheduled then and there). Scheduling is complicated by the fact that the Pfizer and Moderna vaccines have different (but strict) time lapse requirements between doses, leaving no room for scheduling errors.
Each patient will get an immunization card on which providers will write the due date for their second COVID-19 vaccination — but that doesn’t equal a scheduled appointment or guarantee they’ll remember.
Even when a patient does schedule a second dose appointment, they may end up having a time conflict (something comes up, or they can’t wait in line for hours.) The Cleveland Department of Health is sending a letter to eligible residents with a phone number to call if they want to reschedule — but other jurisdictions have struggled with keeping phone lines open and running amidst the high demand for COVID-19 vaccine services. If residents lose that piece of paper, they won’t know who to call, provided they can even get through. Since different regions are handling the COVID-19 vaccination process in different ways, there’s no common resource for patients who need to re-schedule.
Another potential scheduling problem is policy around the second dose. The slow vaccination has some leaders in the US and the UK discussing whether to delay second doses in order to issue more initial vaccines (though this is unlikely, as the FDA and WHO has advised against it). But if the situation grew more dire and such a policy were set in motion, providers would have to cancel and later reschedule a large number of patients awaiting their second dose.
Providers can overcome any and all of these challenges using Luma Health’s web-based self-scheduling solution paired with our Smart Waitlist, which syncs with their EHR. The technology sends a web link directly to patients’ devices so they can see where the openings are in real-time and schedule at their convenience. Smart waitlist technology will trigger a link sent to those next in line to receive the vaccine (vs. them having to repeatedly call for status updates), as well as alerts patients when an earlier slot has become available on their appointment day, if they want it.
In less exceptional situations, boosting second dose adherence rates would seem like an easy fix — just give them a reminder call. But mass vaccinations mean huge volumes of patients coming and going every day (as well as the inevitable reschedulers), and juggling reminders (and then initiating new ones) using more traditional methods like phone calls and paper slips won’t be scalable.
Another useful tech tool providers can use is mobile intake for day-of check-ins. While your reminder system will successfully get patients to show up, you also want them to stay there — even if there are long wait times. Mobile intake allows providers to trigger messages directly to patients’ mobiles with directions and status updates so that they don’t get frustrated and leave (30% of patients leave if they encounter longer wait times than they expected).
Because the vast majority of side effects won’t be cause for concern, it isn’t efficient to have every worried patient come in or call the office. Providers who opt for virtual visits via telehealth platforms can offer the same standard of care with added convenience — at more volume. A five-minute Q&A on whether side effects are worth seeking additional care is much more achievable (and safer) than scheduling in-person visits when, in most scenarios, providers will just need to confirm that what the patient is experiencing is normal.
Another useful technology for addressing COVID-19 vaccine side effects at scale is secure, two-way messaging. Providers can rapidly respond to patient questions, and Luma Health’s collaboration hub allows any added team member to respond so that fielding inquiries doesn’t fall on one person. Additionally, providers can automatically generate post-first dose check-in surveys via SMS so that patients can report any bothersome side effects. This will also give providers valuable data about how their patient pool is faring as a whole.