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The first Pfizer-BioNTech COVID-19 vaccine dose in Canada sits ready for use at The Michener Institute in Toronto on Dec. 14, 2020.

Frank Gunn/The Canadian Press

The federal government says a vaccine-tracking system it acquired from Deloitte is up and running – and officials are confident it won’t face the same problems as a similar platform launched by the accounting firm in the United States.

Ottawa has refused to release many details of the new system, including explaining what it will do or what gaps it will address in Canada’s inconsistent vaccine-tracking protocols.

Good information technology systems will be crucial for the next phase of the COVID-19 vaccine distribution campaign, as hundreds of thousands of doses will be arriving in the country and administered in the span of just weeks. Ineffective technology, however, can serve to compound problems and cause steep delays, as health authorities south of the border have learned the hard way.

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Canada’s last-minute technology solution was purchased, via a private tendering process that began in late November, to help track vaccine shipments, monitor their storage, count the vaccinations and keep tabs on any adverse reactions. Getting this system online was dubbed “mission critical” by the government, in a request for proposals sent to industry and shared with The Globe and Mail in December.

The “enhanced national vaccine management IT platform,” or NVMIP, as the Public Health Agency of Canada (PHAC) calls it, was purchased to “build further functionality into PHAC’s current operational and well-developed surveillance and coverage information technology systems.” The NVMIP system came online on Feb. 2.

Beyond that, the department would not elaborate, citing security concerns. It remains unclear whether this technology will immediately allow provinces and territories to place orders for vaccines and track the short shelf life of the doses, as an early draft of the request for proposals sought. Health Canada has also not responded as to how this new technology will work with existing provincial systems.

Deloitte Canada, which won the $16-million NVMIP contract, referred questions about the system to the federal government.

The only direct question PHAC or Deloitte would answer was regarding the international accounting firm’s American vaccine-tracking platform.

“The solution that Deloitte Canada is implementing for PHAC is not the same as what has been rolled out in the U.S., and they have advised us that no issues are anticipated at this stage,” PHAC said in a statement. Deloitte confirmed that detail in an e-mail.

The U.S. awarded Deloitte a US$16-million contract last May to design a new suite of vaccination-management software, but the system has been beset by problems. The final product, known as the Vaccine Administration Management System (VAMS), was billed as an “easy-to-use, secure online tool to manage vaccine administration from the time the vaccine arrives at a clinic to when it is administered to a recipient,” per a Centers for Disease Control and Prevention fact sheet. It was designed to do everything from book vaccination appointments to track doses and surveil immunity levels in the population.

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Software bugs and usability issues have plagued its release. Fewer than a dozen states have opted to use the system, and even some of those have announced plans to drop it.

“We have not been able to successfully … export all the data of those who we have vaccinated,” Maritza Bond, director of public health for New Haven, Conn. – one of the states still using VAMS – told The Globe.

While Ms. Bond stressed there were positive aspects to VAMS, she said the system failed to adequately collect demographic information about patients, and was cumbersome for those who struggle with technology, posing equity issues. Another troubling aspect of the platform, Ms. Bond said, is that VAMS is available only in English – despite federal requirements that health authorities provide service in the patient’s native language.

Even though the U.S. federal government provided VAMS at no charge to all states, the problems were so endemic that most have opted to pay for their own systems instead. New Hampshire initially adopted VAMS, for instance, but has announced plans to scrap it, after a slew of problems.

The U.S. experience offers a stark warning about what can go wrong if technology procurement doesn’t go right. For years, health care experts have warned that Canada’s fractured national vaccine-tracking efforts were woefully outdated.

A 2016 paper published in the Canadian Journal of Public Health analyzed all the provincial, territorial and federal immunization information technology and found that “systems ranged from newly implemented information technology applications to paper-based methods and spreadsheets.” The study found that, when compared against functional standards written in 2002, “several of these standards have not been achieved by all [provinces and territories].”

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The study found that at the time, only two provinces could “assess vaccine effectiveness using coverage data.” The request for proposals for the new NVMIP specifically sought out a system to “provide reporting and analytics on vaccine immunization coverage at the population level.”

Many of the gaps in the provincial and territorial systems have been long-standing. Canada, for example, has long prioritized systems that can scan vaccines’ unique barcodes. Multiple provinces still lack that capability, and it does not seem the new federal system will rectify that, leaving many provinces to continue tracking vaccines with pen and paper and doing manual data entry.

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