The Trump administration awarded a no-bid contract to Deloitte to develop software to track vaccinations, but the system has flaws. A competitor has accused the C.D.C. and the company of stealing her idea.
WASHINGTON — Last spring, when coronavirus vaccines were just a glimmer of hope, the Trump administration awarded the first of two no-bid contracts worth up to $44 million to a national consulting firm to help patients register to be immunized and states collect detailed data on vaccine recipients.
The result was VAMS, a vaccine administration management system built by the firm, Deloitte, which has been spurned by most states and become an object of scorn. And now, an immunization expert who had offered the government her own mass vaccination tracker at a lower price than Deloitte’s is accusing the company and the Centers for Disease Control and Prevention of stealing her intellectual property.
Tiffany Tate, the executive director of the Maryland Partnership for Prevention, made the allegation in a cease-and-desist letter obtained by The New York Times, and later confirmed its authenticity in an interview with her lawyer on Friday. Ms. Tate, who has spent two decades running immunization clinics in underserved communities, said she previewed her platform last May for Deloitte officials who were identified by the C.D.C. as consultants.
The C.D.C. expressed interest in buying it, she said. But the centers instead asked Deloitte, without a competitive bidding process, to its build its own system, dismissing warnings from state and local health officials and immunization managers that it was unwise to roll out an untested platform in the middle of a crisis.
The letter, dated Aug. 30, says the C.D.C.’s specifications “mirror” the system Ms. Tate created — including a “new feature” that “eventually found its way into VAMS.” Ms. Tate, who is African-American and whose work has focused on minority communities, said the rejection was especially painful in the thick of a pandemic that disproportionately affects people of color.
“I was in shock, and I really was heartbroken because I’ve worked with these people my entire career and I respected them and I trusted them,” Ms. Tate said in the interview. “It was very, very upsetting.”
Ultimately, the marketplace spoke. VAMS, which Mississippi’s state health officer, Dr. Thomas E. Dobbs, described this week as “suboptimal,” is being used in about 10 states. Ms. Tate offered to license her own system for $15 million — about a third what the C.D.C. has committed to pay Deloitte — so the centers could give it free to states. When the C.D.C. rejected her, she said, she sold it to states herself.
Now, 28 are using it, including North Dakota, which as of Friday had administered the first shot of a two-dose coronavirus vaccine to a higher percentage of its population than all but four other states. Louisiana recently signed on and Virginia has abandoned VAMS for the system, known as PrepMod, Ms. Tate said.
“She is a reputable person,” said Claire Hannan, the executive director of the Association of Immunization Managers, who said that she, too, had assumed that the C.D.C. was buying Ms. Tate’s platform after hearing C.D.C. officials describe their forthcoming system in conference calls last year. “This is a good system. It is built out of experience running these clinics. Does it do everything? No. Is it the perfect solution that everybody wants at the drop of a dime? No. But it’s working in many states.”
At least one other developer of vaccine information systems, Mike Popovich, the owner of STChealth, which contracts with states to run their immunization registries, said he and his competitors were also asked to sit in on meetings and share information with C.D.C. and Deloitte — only to be shut out of the bidding process.
In its published “notice of intent” to award the contract to Deloitte without seeking other bids, the C.D.C. justified the decision by saying that the company had developed VAMS using its own “GovConnect proprietary platform.”
The agency did not respond to a request for comment.
Deloitte dismissed Ms. Tate’s claims as “baseless” in a statement issued by its spokesman, Jonathan Gandel, who described VAMS as a “scalable, Salesforce-based application designed to C.D.C.’s requirements and not based on” Ms. Tate’s “information or technology.” He said Deloitte was “proud to be supporting the largest public health campaign in our nation’s history to help end the Covid-19 pandemic.”
Collecting immunization data is critical to the success of the government’s mass vaccination campaign, especially with vaccines that requires two doses, like the two currently in use in the United States. President Biden has promised to make sure that vaccine distribution is equitable, given the pandemic’s outsized impact on people of color. But that pledge can only be fulfilled with accurate demographic data.
Apart from the problems with VAMS, the C.D.C. also reported this week that its effort to gather race and ethnicity data on vaccine recipients was faltering. It has such data for just 52 percent of those vaccinated — a figure that Dr. Julie Morita, a former Chicago public health commissioner and expert in health equity, called “disheartening.”
Gathering vaccination data has long been a state-by-state effort; each state has its own immunization registry, which vary in sophistication and quality and are often geared toward childhood vaccines. A push two decades ago to develop a federal registry imploded after an uproar over patient privacy and how the data would be used.
Systems like VAMS and Ms. Tate’s PrepMod work in conjunction with state immunization registries, allowing patients to enter their own data when they make appointments, which can speed the vaccination process. Once patients receive their shots, the provider can send the data — along with the lot number and other relevant information — to the state registries.
The initial idea behind VAMS was that it would be used by every state — a national system for a national vaccination campaign unlike any in recent history. But some states balked.
“Some states thought about making a switch from their system completely to VAMS, and a lot of them decided it wasn’t the most prudent thing to do,” said Dr. Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials.
He said he told the C.D.C. that the money would be better spent beefing up the existing state registries.
Once it was rolled out, the Deloitte system was rife with problems. It was supposed to operate as part of an information-sharing network through a federal platform called the IZ Gateway, set up to allow state registries to send information to one another and the C.D.C. Information sharing is vital, experts say, especially in cases where people live in one state but get vaccinated in another, or move from one state to another between doses.
But VAMS has been unable to connect to the IZ Gateway, said Rebecca Coyle, executive director of the American Immunization Registry Association. That forced the C.D.C. to create a “workaround,” she said, adding that she believes the problem is being addressed.
“If you look at a software system that was available to all jurisdictions to be used and you have less than 10 that have decided to use it,” Ms. Coyle said, “I think that maybe can speak for how useful it has been.”
Patients in states that use VAMS have also reported problems logging on to make appointments. “The promise of VAMS has not really come to fruition,” said Dr. Dobbs said.
Such problems were reported last month by MIT Technology Review. PrepMod, too, has drawn some complaints, notably in Los Angeles. But Ms. Tate said Los Angeles officials put it into use without receiving proper training, and were using the system, intended for consumers, in long-term care facilities — settings for which it is not intended.
Ms. Tate, 50, was silent about the dispute with the C.D.C. until being approached by The Times; she said she did not want to be characterized as a “whistle-blower” and spoke reluctantly, saying she did not want to jeopardize her working relationship with public health colleagues.
She said she began her public health career more than two decades ago helping to administer flu shots to older African-Americans in Baltimore, in an effort to erase the racial disparity in vaccination rates. She has run her Maryland-based nonprofit for 20 years, often speaks at conferences and appeared in December on MSNBC to talk about the logistics of the coronavirus immunization campaign.
PrepMod is owned by a for-profit affiliate of the Maryland group. Ms. Tate’s work developing the vaccine management system grew out of her own frustration with tracking immunizations during the H1N1 pandemic of 2009, when she worked as a technical consultant for the state of Maryland. A big drawback, she said, was the lack of an automated system to track who was coming in to be vaccinated and when.
“There was tons of paper, there were long lines and we had to do all this data entry; it was a really inefficient process,” she said.
Eventually, she partnered with a software developer to create an online application called ReadiConsent, which won an award in 2018 from the National Adult and Influenza Immunization Summit, a coalition that partners with the C.D.C. to improve the use of vaccines. The product drew so much attention that in January of last year, she convened a consortium of 30 states that were interested in buying ReadiConsent.
According to the cease-and-desist letter, on March 13 — the same day that President Donald J. Trump declared the pandemic a national emergency — Ms. Tate approached some officials she knew at the C.D.C. to tell them she was updating her platform, and that she had a software firm with extensive government experience ready to scale it up for a “national rollout.”
The next month, she presented PrepMod to the American Immunization Registry Association, which was researching various software platforms for possible use in a mass vaccination campaign, and to C.D.C. officials, at meetings where Deloitte was present. The meetings included “a slide presentation and screenshots of PrepMod with detailed explanations of current and planned features,” the letter said.
Soon afterward, the agency inquired about the cost. “It was very clear that they were very very excited about what I was presenting to them and they told me that they didn’t have anything else,” Ms. Tate said in the interview.
In May, the C.D.C. awarded Deloitte a contract for $15.9 million — about $600,000 more than Ms. Tate had asked for. It has since awarded the company an additional $28 million for VAMS.
After the initial Deloitte contract was awarded, Ms. Tate said, she approached the company about forming a partnernership with her. Instead, her complaint said, they tried to hire her to “work on the very software and project that she had already developed and created.” But the offer required her to sign “a release,” embedded in a nondisclosure agreement, and she refused.
Her lawyer, Howard A. Newman, said they were still awaiting a substantive response from the government; under federal law, they must wait six months before filing suit. Ms. Tate said she was trying to move on: “I’m really busy trying to help people save lives. That is my primary goal right now and this litigation stuff — we’ll just see how that plays out.”
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