COVID vaccine pharmacy data in Georgia and other states is incorrect, CDC says
Health officials are unable to accurately track the number of vaccines administered in several states because of a reporting issue between pharmacies and state databases, CDC officials confirmed to McClatchy.
The CDC could not specify the states affected or when the issue began, only that there was a reporting issue among a “small subset” of shots. Federal officials say they are working with vendors and pharmacy partners to rectify the issue “as soon as possible.”
Georgia is one of the states affected by the error. A state health department data team discovered the state’s shots were undercounted because site locations were not entered in electronic health records after a vaccine dose was administered through the Federal Retail Pharmacy Program.
The shot would be incorrectly credited as a dose administered in the pharmacy company’s home state instead of the state where the shot was actually given, a state health department spokesperson told McClatchy.
Doses were undercounted in Georgia by at least 250,000, Gov. Brian Kemp and the state health department announced last week.
The CDC was unable to confirm if this same issue led to the data reporting errors in other states.
“(The error) is a big deal,” said Harry J. Heiman, a clinical associate professor at Georgia State University’s School of Public Health. “If you want to target vaccines to priority, at-risk populations ... and identify where the populations are that fit into the priority groups that need to be vaccinated, you need that data in real-time. I think what we’re seeing is a combination of trying to ramp up a really challenging vaccine administration infrastructure and a reflection of our failure to meaningfully invest in that infrastructure all along.”
Why this matters
The states affected by this issue and the exact scale of the error are currently unknown. The issue calls into question the true number of shots given and the portion of vaccinated residents in each state.
In Georgia, the issue didn’t affect data tracking the number of doses shipped to the state.
“Occasionally, technical issues have occurred related to how the data are being processed and transmitted from pharmacies through a third party to the state. In this case, the issue impacts some of the vaccine administration data reported by pharmacy partners to select state Immunization Information Systems,” a portion of the CDC’s statement to McClatchy reads.
TJ Muehleman, co-founder of the Standard Co., a data company that assists groups like the World Health Organization with collecting and analyzing various health data, said this issue is another example of one of the pandemic’s challenges — reliable data reporting. The issue doesn’t alarm him as much as some of the earlier COVID data problems, he said, but that could change depending on the number of misallocated shots.
“This sort of thing is not uncommon,” he said. “What (Georgia) described makes sense. But it is a problem because it does make reliable data reporting difficult. It does skew numbers in a variety of directions.
“Do I think in the grand scheme of things — is it going to be like an ‘Oh, no’ moment? I don’t think so,” he added. “There’s going to be data weirdness at the beginning. What I want to see is continuous improvement.”
Amber Schmidtke, a public health microbiologist and member of a Georgia coronavirus data task force, said the error means there isn’t an accurate figure tracking vaccination percentages. But there could be a workaround as a person’s state of residence is tracked by the CDC and should be kept in the vaccine data.
“I think those pharmacies are going to have a patient record with their mailing address even if they don’t run their insurance,” she said. “It’s another one of those instances where public health deals with imperfect data, and we sort of have to peer through the fog to figure out what’s going on.”
How one state discovered the issue
In Georgia, at least 250,000 doses were administered through the federal pharmacy vaccination program but not counted in vaccine tracking data. The uncounted doses would represent about 9% of the state’s 2.74 million reported shots, as of March 16 when Georgia announced the data error.
Health officials discovered the undercount during a data review, said Department of Public Health spokesperson Nancy Nydam.
“They discovered that if a site ID (where the vaccine is administered) is not provided through electronic health records — which many large pharmacy chains use — the system will default to the location of a parent company or corporate headquarters,” she said. “So if it defaults to a location outside of Georgia, we do not get credit for that dose being administered here.”
The Federal Retail Pharmacy program is a partnership between the federal government, states and territories, 21 national pharmacy partners, and independent pharmacy networks. As vaccine supply increases, the program will expand to more than 40,000 pharmacies.
Pharmacies participating in Georgia include:
- CPESN USA, LLC
- CVS Pharmacy, Inc. (including Long’s)
- Good Neighbor Pharmacy and AmerisourceBergen Drug Corporation’s pharmacy services administrative organization (PSAO), Elevate Provider
- Publix Super Markets, Inc.
- The Kroger Co. (including Kroger, Harris Teeter, Fred Meyer, Fry’s, Ralphs, King Soopers, Smiths, City Market, Dillons, Mariano’s, Pick-n-Save, Copps, Metro Market)
- Walgreens (including Duane Read)
- Walmart, Inc. (including Sam’s Club)
CVS, Walgreens and Walmart are partners in most southern states, according to the CDC. CVS is headquartered in Rhode Island. Walgreens is headquartered in Illinois, and Walmart is headquartered in Arkansas. Regional chains participating in the program in other states include Kroger, Albertsons, Meijer, Rite Aid and others.
How will correcting the figures affect vaccine data?
Gov. Brian Kemp announced the undercount during a COVID-19 press conference last week.
“We’re still working with the CDC to identify the exact number of doses this applies to,” Kemp said during the news conference. “Until we know that data point, we do not have a full understanding of how badly this issue has affected Georgia when the media compared us to other states.”
Georgia’s vaccine rollout ranks among the worst in the nation, but fixing the reporting error may slightly improve the state’s standing.
Uncorrected data shows 19% of Georgians have received at least one vaccine shot. Only Puerto Rico and Micronesia reported lower percentages. Georgia has fully vaccinated 11% of the state’s population, ahead of only six other U.S. states and territories.
Roughly 70% of the state’s delivered doses have been administered, according to the New York Times. Adding the 250,000 uncounted shots would increase Georgia’s doses used figure to 75.9%, just above the national average.
While Georgia’s data could improve after it’s corrected, it doesn’t address larger issues with the state’s vaccine rollout, Heiman said.
A report published by the CDC last week showed Georgia ranked 22 out of 48 states for county-level COVID-19 vaccination coverage for high vulnerability groups from December 14 to March 1. White residents are five times more likely than Hispanic residents to be vaccinated in Georgia, according to data recently published by the KFF, a nonprofit organization focusing on national health issues.
“We still have a long way to go as a state between where we are now and where we want to be,” Heiman said. “I haven’t seen an equity strategy. An equity strategy means not just targeting mass vaccinations sites, but actively engaging with community organizations and leaders at the neighborhood level to make sure you’re reaching your target population.”
This story was originally published March 23, 2021 at 6:00 AM.