The two top priorities Governor Cuomo identified in his State of the State speech Monday morning were “Defeat COVID” and “Vaccinate New York.”

Judging by my personal experience of the Health Department’s labyrinthine vaccine appointment system, the state is not fully prepared to take on either challenge.

Monday was the first day that the general public over 75 was eligible for vaccination, the result of an abrupt policy change by Governor Cuomo that had been announced only three days earlier. Cuomo warned that supplies would run short, but encouraged older New Yorkers, who are known to be acutely vulnerable to the coronavirus, to put in their names right away.

As he said in his speech, “We would rather have people signed up and awaiting the vaccine than have the vaccine awaiting people.”

Signing up was easier said than done, however.

On Monday afternoon, an 80-year-old Albany resident asked me to make an appointment on her behalf. I ultimately succeeded, but only after confronting a bewildering array of poorly designed websites, contradictory instructions and several apparent dead ends.

The first step was finding the right website. The correct address – covid19vaccine.health.ny.gov – is long and hard to remember and doesn’t yet come up at the top of a simple Google search (such as “new york vaccine appointment”). It is, however, prominently linked from the home pages of the governor and Health Department.

The site asked for a name, address, birthday and contact information. The form was fairly easy to fill out, and the system quickly confirmed that someone born in 1940 would be eligible for vaccination. 

The next step was to find a provider, and that’s when things got complicated. The Health Department website generated a list of potential providers near the given address, but it didn’t indicate which ones had available vaccines or open time slots. To actually make an appointment, I would have to directly contact each provider by phone or on the web. In other words, there are hundreds if not thousands of different appointment systems, each with its own instructions to figure out, and no central coordination.

At the top of the recommended list (because it was closest to the 80-year-old’s home) was the Albany College of Pharmacy. However, a recorded message at the college’s phone number said, “We are not currently a vaccination site” and suggested calling the state Health Department.

Next on the list was an independent pharmacy. But the banner at the top of its home page declared: “The Covid-19 Vaccine is NOT yet available at the pharmacy. Please check this website for updates.”

Third was the name of a chain pharmacy. But under the heading “How to Schedule Appointment” it warned: “Scheduling will start in next day or two please check back.”

Fourth was the Albany County Department of Health – which seemed promising, because counties had developed mass vaccination plans long before the pandemic started, a system that the governor initially bypassed in distributing vaccines. However, the recording on its phone line did not offer an option for vaccine appointments. It said only that coronavirus information was available on the county’s website. 

After some scrolling through that site, I found a notice that appointments could be set up through the Capital Region Vaccine Network, which is operated by Albany Medical College.

The network was one of many hospital-affiliated organizations designated by the governor to coordinate the vaccination program. Yet it did not seem prepared for an influx of newly eligible people on Monday. Its website (which triggered a security warning in my browser) did not offer an option for scheduling an appointment. Instead, it said people 75 and over “will primarily be vaccinated at pharmacies and other sites that are part of the ‘retail network.'” It recommended visiting the Health Department’s website, which is where I had started, or calling the state’s hotline at 1-833-NYS-4-VAX. 

After four dead ends, I finally found a working online appointment system at the fifth option: a vaccine “point of dispensing,” or POD, located at the State University of New York at Albany. A link from the Health Department provider list took me to the POD’s sign-up page. This again asked for basic identifying information, including address and birthday, then led to a menu of appointment days and times. As of Monday afternoon, slots were still available for later this week.

Had I focused my search on retail pharmacies – which the Capital Region Vaccine Network said was the avenue designated for people over 75 – I might not have considered the SUNY option at all.

My search ended successfully. But I’m a health policy analyst who has been following the situation closely, has experience using government websites and wasn’t easily deterred by confusing directions. New Yorkers without those advantages would likely find the system in this condition hard if not impossible to navigate.

One likely explanation for the confusion is that many providers were caught unprepared. Although they were tasked with vaccinating 1.4 million vulnerable New Yorkers, they had received only three days notice of the start date, did not necessarily have vaccines to administer and weren’t sure how many doses they would receive or when. Nor had they had the chance to prepare for an onslaught of phone calls and web queries. The SUNY POD was an exception, perhaps because it’s actually managed by the Health Department itself, and therefore has a clearer line of communication with the governor’s office.

Although the governor declared in Monday’s speech that ending the pandemic is his top priority, his administration does not yet seem to have a fully fleshed-out plan for reaching herd immunity. The rushed and chaotic launch of the state’s vaccine appointment system is another sign of trouble, and weakness to be fixed.