Algorithms match vaccine seekers with soon-to-be-wasted doses

ZocDoc Inc. founder Cyrus Massoumi has been frustrated by the imbalance in U.S. vaccine supply and demand — with providers tossing out doses they can't use, even as many people desperately seek shots.

So the former CEO of the doctor appointment-booking company has quietly launched an online platform to match providers with those willing to be on standby for covid-19 vaccines. More than 200 sites in 30 states are being connected through the platform, called Dr. B, with half a million Americans requesting to be notified when doses become available nearby. And that number continues to grow.

With vials of Pfizer Inc.'s and Moderna Inc.'s two-shot vaccines susceptible to expiring given temperature restrictions, Massoumi decided in early January that he wanted to help make the U.S. immunization campaign more efficient and equitable by playing matchmaker.
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"The scarcest resource in the country was going to waste," he said. "I had this idea, reading all the articles: Why is there not a nationwide standby system that any provider could use that would effectively reallocate the vaccine?"

The platform works like this: Providers plug in the number of leftover vaccines they have and the time frame in which they can be administered. Dr. B's algorithm sifts through a list of people who have signed up for the free service, and prioritizes them based on state and local criteria.

For instance, a 66-year-old firefighter will have first dibs on a spare dose over a 25-year-old law student with asthma. In government speak, priority group 1B will come before 1C. For those in the same priority group, it's first-come, first-serve.

Those tapped by Dr. B are sent text messages notifying them they've secured a vaccine dose, and must respond quickly or relinquish their spot. Dr. B spits out more messages than doses available.

On. Feb 25, Brittany Marsh of Little Rock, Arkansas, became the first vaccine provider to use the tool. The drugstore owner had encountered plenty of hurdles in using up supply before it spoiled, including the 22 inches of snow that made it hard to drive to her Cornerstone Pharmacy in early February for shots.

"The biggest challenge is getting the doses to the correct people before they expire," Marsh said.

The pace of U.S. vaccinations is picking up, with as many as 2.17 million doses being administered a day in the past week. But many front-line workers, people older than 65 and those with underlying health conditions still are searching for appointments. The pandemic has also disproportionately affected Black and Hispanic people, but states have vaccinated a much greater proportion of their White populations, according to Bloomberg's Vaccine Tracker.

For the rollout to be successful, those soon-to-spoil doses must go to the most vulnerable, said Massoumi, a 44-year-old entrepreneur who sees algorithms as helping solve what he calls "suboptimal allocation."

Front-line workers who were initially hesitant about the vaccine shouldn't be punished for not getting a shot when it was first offered, he said. With this tool, they will still have priority status and won't have to compete with a wide pool of candidates.

"People were waiting in lines — a deli-counter-style system — and hopping between pharmacies over multiple days to find vaccines," said Jimmy Chion, the head of product at Dr. B. "But It should truly go to those who need it most."

Dr. B's origin was prompted by conversations between Massoumi and one of the world's top epidemiologists. As the first few million shots were deployed, Massoumi, who sits on the board of Columbia University's Mailman School of Public Health, frequently spoke with Ian Lipkin, director of the school's Center for Infection and Immunity. The duo were worried by reports that significant supply of vaccine was being wasted.

Encouraged by Lipkin, Massoumi brought his network of Silicon Valley tech executives, public health experts and political contacts into the fold of discussions. Funding the project himself, Massoumi poached talent from the disbanding Amazon-Berkshire Hathaway-JPMorgan venture, Haven, and hired staff from the Biden-Harris transition team. He sought advice from the founders of health startups and scheduled calls with the New York City Department of Health.

Meanwhile in Atlanta, Chion, a creative technologist for The New York Times, had a similar idea for a centralized wait list for Covid-19 vaccines about to spoil, calling it Vax Standby. The two joined forces.

"This is a side project that quickly became a full-time job," Chion said.

In preparing for the launch, Massoumi was intent on avoiding widespread press that would draw savvy vaccine hunters. Instead, he wanted to focus on spreading awareness among communities of color. The team has forged connections with the NAACP, the Community Action Network, the Indian Health Service, and with iHeartRadio's Spanish-speaking channels, among others.

Yet a question surfaced among many who'd been sent a link to the website, or seen it on social media: Who is Dr. B?

The answer comes from the days of the Spanish Flu. Massoumi's grandfather, affectionately called Dr. Bubba, became a physician during the 1918 pandemic. The platform's name is an homage to him.

"He served everyone," Massoumi said. "He wanted to bridge the gap."