How texts, Twitter and close-knit communities are helping to fuel West Virginia’s COVID vaccine success story

By Lauren Peace and Lucas Manfield, Mountain State Spotlight

“This story was originally published by Mountain State Spotlight. For more stories from Mountain State Spotlight, visit www.mountainstatespotlight.org.” 

A line of cars wrapped around the Teays Valley Baptist Church, stretching back toward the interstate. It was a weekend in mid-March, but the Saturday crowd wasn’t there for services; it was hundreds of hopeful West Virginians trying their luck for an unclaimed dose of vaccine.

Earlier that afternoon, Jamie Miller had gotten a text from a friend who knew somebody working at the vaccination event in Putnam County. She was told that the parking-lot clinic had an abundance of unclaimed doses. So the Charleston-based artist took to Twitter and Facebook to spread the news.

“Giving to anyone, not just 50 and over! Get there if ya need it and pass along to folks who are close,” Miller wrote.

West Virginians responded. People piled into cars with hopes of snagging a coveted dose, while others placed calls to neighbors, parents and grandparents, hoping to get their loved ones a step closer to safety.

It was the work of an old-fashioned gossip chain with the power of the internet’s reach. In less than an hour, the extra doses were gone.

“It’s not because of me,” Miller said of the filled appointments. “It’s because of somebody, who told somebody, who told somebody, who told me. It’s like there’s an underground vaccine hotline. It’s a dang lottery.”

While there’s still a centralized statewide vaccine program in West Virginia, as the doses become more readily available, secondary networks have swooped in to fill the gaps.

These networks rely on close-knit communities, where looped-in residents like Miller can play matchmaker between neighbors and unclaimed vaccine appointments. They include local health care providers, who are keeping community-based lists of people nearby who need and want the vaccine.

They range from places like Grant County, where the health department has administered 4,500 doses of vaccine — more than a third of the county’s population — to Cabin Creek in eastern Kanawha County, which has administered another 9,000. Neither used the state’s list. Down in McDowell County, a physician estimated only about one out of every eight vaccine appointments is scheduled from the state’s system. In  Marion County, a health official said they haven’t used the state’s automated system at all. 

Dr. Clay Marsh, the state’s coronavirus czar, acknowledged that the state’s official system is “not perfect and that it was maybe not as functional as some may have liked.”

“But West Virginians are doing a great job rallying together, which is making a difference,” Marsh said.

Still, this lack of clear communication from the state has created inequity in who gets the vaccine and when. Those in the know, who call their health departments or scour social media for their own appointments, are bypassing those who are waiting for a call from the state.

A workable system

West Virginia’s vaccine rollout has been widely praised by national media. These accolades are for good reason: as of March 17, nearly 15% of West Virginians had been fully vaccinated, one of the highest percentages in the United States.

That success has been partially attributed to the use of a centralized registration tool West Virginia bought for $760,000 from a publicly traded, Massachusetts-based company called Everbridge.

The goal was to take the load off local health authorities whose phones had been ringing off the hook as West Virginians hunted for vaccines in the early days of distribution. People could sign up with the Everbridge system, which could prioritize them based on factors like age, race and pre-existing conditions. Then the system would call people to schedule vaccine appointments when they became available. No more frantic daily calls to the health department, no more searching the web trying to figure out how to make appointments; just sit back, relax and wait. 

State officials say they do not track how many vaccination appointments are actually scheduled through Everbridge, so there isn’t any hard data to indicate how well the system is or isn’t working. But Everbridge has been touted by the companythe media and state administrators as a major reason for West Virginia’s high vaccination rates. 

“This implementation of [our product] with our partners in West Virginia has been widely recognized as a poster child for successful vaccine distribution,” Everbridge CEO David Meredith said on a Feb. 18 earnings call with investors, taking credit for the state’s leading vaccination rate.

In some places, particularly West Virginia’s larger counties, the system has worked: health departments in Kanawha, Monongalia and Putnam counties have relied on the system since the beginning to fill their vaccination slots. But West Virginia University Medicine, the state’s largest health care provider, puts many of its appointments up on its own online portal and people can sign up directly for them. The Walgreens pharmacy chain now has its own scheduling system, and thus, a separate list of potential vaccine recipients.

And in some rural counties, physicians say Everbridge has caused more problems than it’s solved, producing unreliable information and snarling the process of getting community members appointments. Complicating the situation are factors like access and trust: many patients don’t want to sign up through an online portal and want to exchange information directly with their primary doctor or local health department instead. 

“I think [Everbridge] was designed to make everything easier,” said Bonnie Woodrum, an infectious disease specialist at the Randolph-Elkins Health Department. “But I don’t think it was a workable program when we got it.” 

Woodrum said a major problem has been that Everbridge isn’t automatically updated after people get a vaccine. As a result, the department gets a list each week with names of people, some of whom have already been vaccinated. Staff spend hours each week removing those names. 

She estimated that fewer than half of the vaccine appointments made by the county health department had actually come from the Everbridge list.

‘Game on’

Mountain State Spotlight heard from health departments in Randolph, Boone, McDowell, Clay, Braxton, Grant and Marion counties. All said they are either using their own lists to supplement Everbridge’s system, or bypassing the system entirely. 

But an Everbridge executive stood by the system. Brian Toolan said in an interview that the tool met the goal of alleviating the burden on West Virginia’s state-run call center, and that Everbridge was working with the state to continue to improve the system.

Toolan also said that for the system  to be most effective, people need to use it  in the way it was designed to be. In Teays Valley earlier this month, for example — where leftover doses were being given to anyone, first-come, first-serve — Toolan said Everbridge’s system could have helped clinic organizers find nearby people who fit the state’s prioritization criteria instead. 

“That’s exactly why we built our platform: to solve part of that problem,” he said.

But in many cases, the reality is different than the ideal. Some counties have few people who have signed up through the official state system: state Department of Health and Human Resources Secretary Bill Crouch said on March 11 that in 13 West Virginia counties, there were fewer than 100 people over age 65 registered on the official list.

And when resources are stretched and the clock is ticking, local vaccine distributors say if they have extra doses, there just isn’t enough time to call people from Everbridge. The lists aren’t always reliable, and there’s no guarantee people will be available at a moment’s notice. That’s why health officials turn to social media or reach out to people on their own local lists to avoid any waste. It’s how several Mountain State Spotlight employees were recently vaccinated: by hopping in the car and driving to a clinic with available doses, nearby.

Instead of helping streamline appointments in Clay County, a family physician said the Everbridge system added complications.

“It just got really messy,” said Dr. Kimberly Becher, who has been working with the local health department to get vaccines to West Virginians.

First, patients registered with Everbridge, but then the system crashed and Becher couldn’t reach those people for a few weeks. Then, when the system began working again, Becher said, there were huge discrepancies between the number of people who registered through the state’s system and the number of vaccinations her county got in a week. 

“We don’t know how many shots we’re getting until the day before the vaccine event. But we don’t get an updated list from the system until a couple days before, so there’s a huge scramble trying to sign people up so we don’t waste any shots,” Becher said.

And so far they haven’t. Becher said every shot available through the clinics in Clay County has gone to a West Virginian who wanted it. But that’s been the result of work done at the ground level, calling to find local community members who will come in to get the vaccine.

“Somebody says we’re getting 20 extra doses and I’m like ‘OK, game on,’” Becher said. “Next thing you know, I’m walking through the clinic trying to get patients in for appointments signed up for shots. And if somebody has a grandma or a cousin or a church friend, we get them an appointment, too.”

She wants to keep the vaccines coming. The ways local health officials are adapting to fill the gaps have been highly effective, and she wants to continue to see these counties getting their supply.

Marsh said he understands that the system is imperfect, and it served more of a critical purpose in the beginning of West Virginia’s vaccine rollout — when demand for the vaccine was really high, but supply was really low — by working to prioritize the most vulnerable West Virginians.

But Marsh said supply and demand are now getting closer together  — making the Everbridge system even less effective, but resulting in more West Virginians getting the vaccine.

“The Everbridge system was never really meant to be a scheduling system, it was meant to be an emergency response system,” Marsh said. “Eventually, and I think soon, COVID-19 shots are going to be available like flu shots. People are going to be able to get them at grocery stores and local pharmacies and we won’t need this centralized queue. That’s the goal.” 

As more vaccine doses come into West Virginia and vaccine distribution is decentralized, pharmacies, clinics and local health departments will need  to fill appointments more quickly, which could make the Everbridge system more obsolete — if people who are eligible see an appointment available for self-schedule, they should take it, Marsh said.

‘I worry about who we’re missing’

Vaccines are getting into arms, despite the complications. But these mixed messages — which list should you be on? How many lists? — are resulting in confusion and inequity. 

Take the Kadylaks: a Wheeling couple who are both in their 70s, and signed up on the Everbridge system as soon as it was unveiled. 

Kerry Kadylak, who is 74, got a call to schedule an appointment in early February. Her husband John, 76, never did.

“He kept waiting, and waiting and the call never came,” said John and Kerry’s son, Nick Kadylak. “It was frustrating because the state kept opening appointments to younger groups but my dad still hadn’t been scheduled.”

It wasn’t until a family friend reached out about available appointments in Morgantown that John got the vaccine.

“We would call and get told, well you’re on the list so we don’t know what’s going on,” Nick said. “It was a real lack of communication.”

In Cabell County, Chris Mays has pre-existing conditions that made him eligible for an earlier dose of the vaccine. He waited for a call from Everbridge that never came, and was ultimately vaccinated after his partner, Olivia Qualls, called the local health department. 

“People think that if you put your name on the [state’s] list then you’re good. But that’s not the case,” Qualls said. “It’s like you have to be proactive or you get left out.”

In Monongalia County, Micah Weglinski said the same. Once he realized he didn’t have to wait for the state’s call, he let his neighbors know too, and began working to get local residents scheduled.

“I helped multiple people over 50 register for a vaccine time on the WVU site. They all registered through the DHHR site. All were eligible and none were called. I honestly don’t know one person who was,” Weglinski said. “Some of them I registered [through WVU] on the spot, using my phone.”

Kanawha County resident Crystal Good likened the approach to getting information from friends about a sale at a store — but with much higher stakes.

“WV bootleg vaccine network be like… ‘Call this number you can get a vaccine!!’ All casual and urgent. Like Big Lots is having a sale,” Good wrote on Twitter. “Get over there now! And then you go. Sold out! So you go to the other Big Lots. Generations of inside discount info network at play!”

But Good, who is the founder of Black by God, a multimedia platform that elevates the voices of Black people in and from West Virginia, said that while it’s nice to celebrate West Virginians coming together to get people vaccinated, she’s disappointed with how the state has left some of the most vulnerable residents behind. The pandemic has further heightened racial health and communication disparities in an already disadvantaged state.

“Everbridge was sold to me as a way that Black residents were going to get vaccinated,” Good said. “But I have gotten six calls from various people telling me that they know where I can get vaccinated, and not one has come from the state.”

Good said that state leaders were asked to prioritize Black West Virginians because of the disparities, but she hasn’t seen it happen effectively. 

“Most of my family has been vaccinated,” she said. “But not through any of the state initiatives. It’s been through these underground communication networks.”

Good’s appointment came through Jamie Miller, who echoed the same.

“I worry about who we’re missing,” Miller said. “But this is the best I can do to help my community, is just share information when I have it, and I’m seeing so many others are doing the same.”

One of her latest shares was Wednesday, when she tweeted information about vaccine availability at the Walgreens in Charleston. After a friend mentioned that appointments were available, Miller called the pharmacy to confirm and then took to Twitter to spread the news. In the week since she’s begun posting appointments, Miller’s Twitter profile has had more than 15,000 visits. Her tweets have been viewed more than a quarter million times.

Less than an hour after sharing the post, she updated her followers that a line of people waiting for vaccines had wrapped around the building.

“I can’t wait for the day this valuable service isn’t needed anymore,” one user responded.

“God. Same!” Miller replied.

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