Dr. B Website Matches People with Leftover COVID-19 Vaccine Doses

More than one in five Americans have received at least one dose of the COVID-19 vaccine and the numbers are steadily increasing as more people become eligible for the shot. But the vaccine remains a hot commodity and people seeking appointments continue to flood sign-up sites. Yet, due to no-shows or appointment cancellations, some vaccine providers are still left with extra doses at the end of the day.

Once thawed, the vaccines made by Pfizer-BioNTech and Moderna must be used within hours. Some providers are scrambling to figure out how to best distribute these doses before they expire. In some places, people queue for hours outside of distribution sites, waiting for extra doses at the end of the day. In others, people who happen to be by a pharmacy at the right time may snag a shot along with their potato chips.

Cyrus Massoumi, the founder of ZocDoc and board member at the Mailman School of Public Health at Columbia University, estimates that up to 30% of vaccine doses are left unaccounted for to be distributed essentially by chance. To make the process more equitable, Massoumi proposed a new COVID-19 vaccine waiting list which may bring a bit of method to the madness.

“I thought there had to be a better solution for how the excess vaccine was getting allocated,” Massoumi tells Verywell.

The company, called Dr. B, acts as a nationwide standby system. People who are eligible for vaccination can sign up to join and are placed on the list based on the prioritization groups outlined by their local and state governments. Vaccine providers in their area indicate how many extra doses they have and when they are set to expire, and the system pings people nearby who sit high on the list.

How Dr. B Works

Anyone in the U.S. over the age of 18 who is eligible for the vaccine can sign up on Dr. B to receive notifications. Because all notifications come via text message, users must also have access to a phone.

People can sign up for the service online for free through the website. To join, users complete a personal profile with information like their name, ZIP code, phone number, and information to help determine their eligibility, like medical risk factors and occupation. Then, users are placed on a list of those waiting for the vaccine based on their eligibility criteria.

When an extra dose becomes available for someone on the list, they will get a text message notification. Once pinged, users have a short period of time to respond indicating their interest. They then have a limited window of time to travel to the clinic to receive the shot. If someone receives a notification and declines or does not respond, they will have to indicate their desire to remain on the list.

The service is currently available in New York and Arkansas. Nearly 2 million people had signed up as of March 16, 2021, and hundreds of providers have applied to participate.

Providers only need a cell phone to report their extra doses and how much time is left until they expire. “It’s designed to be super simple,” Massoumi says.

Ensuring Equity of Access

In the first few weeks of its pilot program, the company opted to lay low. It refused major media requests and instead launched its service on a Zoom call with leaders of communities that “have been most ravaged by the coronavirus,” Massoumi says. The represented organizations included the NAACP, Unidos, and the U.S. Indian Health Service. By first spreading the word to these community leaders, Dr. B aimed to give people with the greatest need a head start on sign-ups.

Now that the service is open to the general public, Dr. B is referring to state and local guidelines for group prioritization. As states across the country open up access to the vaccine, people who were prioritized in earlier groups may face greater competition for vaccine appointment sites.

“The advantage of a queueing-based model is that they don’t have to compete with people who can hit that refresh 1000 times a second,” Massoumi says. People who fall under Phase 1B categorization, for example, will be higher on Dr. B’s list than those in Phase 1C. “They immediately go to the front of the line like having a first-class ticket.”

Harald Schmidt, MD, PhD, an assistant professor of medical ethics and health policy at the University of Pennsylvania, tells Verywell that in the complex process of distributing COVID-19 vaccines, avoiding vaccine waste is the most important goal.

But as companies that connect people to vaccines create their models, he says they should not only consider the priority groups laid out by local and state governments but also how disadvantaged populations factor into those groups.

Initiatives like Dr. B exist “to deal with sub-optimal allocation,” Schmidt says. “We should use them to then also prioritize more disadvantaged communities because both public health and equity are served by that.”

In a pre-print study, Schmidt and his colleagues write that 29 states have adopted a “disadvantage index” to inform how vaccine doses should be allocated within priority groups. This allows more doses to be guaranteed for people with relatively less access to resources than others in their priority group. For example, an elderly person living in a high-density urban area in a household with essential workers can be prioritized over another elderly person with access to more space and fewer personal contacts.

“This doesn’t mean that you don’t give anything to better-off people, but you simply increase the shares of vaccines that are offered to more disadvantaged groups,” Schmidt says.

What Can Organizations Do?

To determine where a person falls on this index, groups or companies like Dr. B may only need to collect a user’s nine-digit zip code since location is so often tied to socioeconomic status and other relevant factors.

In terms of Dr. B’s current model, because people need to have internet access to sign up and a phone to receive a notification, there may be technological barriers for some people.

“We’ve seen already in vaccine uptake that many people who don’t have access to the internet are, and increasingly so, disadvantaged people or communities of color,” Schmidt says.

Since users must be able to quickly respond when they are notified, people who are able to drop what they’re doing and travel to the vaccination site have a higher chance of making use of the service. This poses a challenge for people without much control over their work or other duties.

Though Dr. B does not facilitate sign-ups, the company allows people to sign up for others. This way, people who have difficulty accessing or navigating technology can seek help from community organizations or others.

Fighting a Global Pandemic

For Massoumi, this effort intends to bring together several groups to combat the pandemic. The company’s name is a “tip of the hat” to Massoumi’s grandfather, who worked as a physician in France during the 1918 Spanish flu pandemic.

“My view is that everyone’s been so focused on the Plan A—which is how the majority of people are getting vaccinated through regular scheduling and these portals, etc. What we’re building is Plan B,” Massoumi says. “And given that we’ve never done Plan A, it’s hard to even imagine that you need to spend the resources planning for Plan B when Plan A still needs resources.”

The company has only been operational for a few weeks. But already, Dr. B is poised to expand the service to help allocate vaccine doses to people all across the U.S. and the world.

“Right now, we’re heads down to get to all 50 states,” Massoumi says. “We know that there’s a need for what we’ve built across the globe—this problem of patients canceling, and no showing is going to be systemic everywhere.”

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