San Antonio COVID-19 vaccine registry too little, too late

While months ago a vaccine registry for the City would have filled a clear and urgent need, it is now simply an inferior offering compared to the numerous alternatives now available.

On March 31, City Council met in a special session to discuss creation of a vaccine registry, otherwise referred to as vaccine waitlist. Ultimately Council voted unanimously to move forward with this initiative, expected to cost taxpayers $200,000*. After two weeks of development, the approved registry entered its pilot phase the week before last. This registry lags other major metroplexes throughout Texas where a registry was established much sooner, including Austin, Houston, and Dallas.

Back on February 4 of this year, Council considered the possibility of a vaccine registry. At the time, Assistant City Manager Colleen Bridger strongly advised against such a measure, stating that “all of us who are doing the work are clearly communicating to you and everybody else that that is not a best practice [to provide residents with a vaccine registry].” As these discussions were occurring, residents throughout San Antonio were calling hundreds or even thousands of times each, attempting to register for the available vaccine appointments. Councilman John Courage described his own frustration in attempting to schedule vaccination for himself during this same meeting. The volume of calls necessary to successfully register for vaccination at this time resulted in a clear equity gap, where the more affluent with time available to spend hours on the phone were able to get appointments, while those who needed to work or had other responsibilities had no opportunity to schedule a vaccination appointment.

Returning to present day, following the vote to establish this registry, Council members were quick to promote this decision as a victory for San Antonio residents frustrated with existing processes available to register for vaccination. In a newsletter to District 7 residents on April 2, Councilwoman Ana Sandoval noted that “I have heard for months from residents that getting a vaccine appointment feels like a lottery system that only those with fast internet and flexible schedules can win.” If Council had chosen to take action in the February 4 meeting in response to these residents pleading for a better solution, before Texas expanded eligibility for the vaccine to all residents over 16, this registry would have already completed pilot testing and reached general availability in time to support the millions of San Antonians newly eligible to be vaccinated now.

Because Council chose not to establish a registry earlier this year, private corporations stepped in to bridge the gap. As of writing this, HEB, Texas MedClinic, Walgreens, and many other private vaccine providers all have first vaccine appointments available to be booked this week in and around San Antonio. These available appointments can be scheduled through the corresponding company’s easy-to-use website. HEB, for example, provides a vaccine search able to target appointments within configurable radius around a specific zip code, optionally filtered by which specific vaccine is available, which will continually refresh and alert the user as soon as an appointment is available. Tools such as this have been available for weeks and in some cases months to all San Antonians, regardless of age. Residents have learned to rely on these privately funded resources in place of City resources, as indicated by decreasing call volume to City and County call centers in conjunction with an increasing number of Texans qualified to receive the vaccine leading up to the March 31 Council meeting.

In addition to the private sector contribution to readily available vaccinations, no-appointment vaccinations are now regularly available at the Alamodome.

Meanwhile, the City’s vaccine registry is only now entering an early pilot phase. A press release from the City on April 14 notes that “it is possible for it to take several weeks to get an appointment.” The registry is additionally currently only available for residents 65 years of age or older. The City’s registry pilot is clearly lacking in comparison commercially available alternatives and only incorporates a small percent of the vaccine providers working across the City.

While months ago a vaccine registry for the City would have filled a clear and urgent need, it is now simply an inferior offering compared to the numerous alternatives now available. The registry seems like a attempt by the City to catch up on a missed opportunity. Instead of pouring hundreds of thousands of dollars into this unnecessary tool, much more targeted efforts to reach vulnerable communities unable to take advantage of existing tools would have provided far more value to the San Antonio community.

* See 1:20:00 timestamp in 2021-03-31 special session, where this cost estimate is noted.

Donating Bone Marrow: A Life-Changing Experience

On the big day, I walked into the South Texas Blood and Tissue Center at 7 am for what was my seventh time in the center, but this time was special. After months of preparation, blood tests and waiting, it was finally time to take that big step. It was time to donate marrow and save the life of a 28-year-old male with non-Hodgkin lymphoma.

As I walked in to the donation center, I was definitely not expecting all of this twists and turns that would come over the next two days. For one thing, at this point I was only expecting to be donating for one day. But even with all the unexpected twists and turns of the next couple of days, I am still so very happy that I was given this opportunity. How often can any of us say that we had the chance to directly and undebatably save another human’s life? There’s not a feeling on earth like it!

This time coming into the center, like the four times prior, I was given two injections of filgrastim. This drug coerces my bone marrow to generate extra blood stem cells which are then extracted through the peripheral blood stem cell (PBSC) donation process.

After waiting for the filgrastim to take effect, I was hooked up to the donation machine and the process began. After only about thirty minutes of donation, I set a first for the South Texas Blood and Tissue Center; I passed out during a marrow donation. The last thing I remember, I was sitting up, eating Bill Miller breakfast tacos, and the next thing I know I’m horizontal on the chair and my feet are being held above my heart by one of the staff.

The my registered nurse, Eloy Rodriguez, began frantically taking my vitals, trying to determine what was wrong, but nothing was showing up. My blood pressure was normal, my pulse too. There was nothing obviously physiologically wrong with me other than I was pale as a ghost (yes, more pale than my normal) and I had just been involuntarily unconscious. After checking with the doctor, the decision was made to let me sit for thirty minutes and then try again.

After taking a break, everything was fine. I continued donating until about 1:30 pm, at which point Eloy approached me with some bad news. Apparently, my marrow had not generated enough stem cells to fill the need for the recipient in just one day. I needed to come back for a second day.

The next day I arrived at 8:30 am to do round two of donation. I have to admit that I was slightly less excited to be there a second day. I felt guilty, honestly. I hated the fact that the recipient was waiting, very sick, for an additional day because my body couldn’t make enough stem cells. But speaking with one of the staff members, I discovered that needing a second day of donation isn’t extremely uncommon. Approximately two out of every ten donors need that second day to fill the order.

Knowing that, the day got better. This time, I didn’t even pass out! Day two was far less eventful than the previous day. I watched Ratatouille for the first time, then began doing some programming work for the UTSA Rotaract site, and even got a visit from the resident PR photographer. By around 2 o’clock I was finished donating.

Even with all of the unexpectedness of these two days, they have been easily the most rewarding days of my life. I encourage everyone to to register in Marrow Registry. Saving a life will stay with you for a lifetime.