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A Pittsfield police officer directs traffic recently outside the COVID-19 vaccination clinic at Berkshire Community College. Municipalities across the state have begun developing their own systems to streamline the registration and vaccination process.

Massachusetts cities and towns are managing the vaccination rollout in part by relying on local resources and infrastructure as the state's approach and strategies face continued criticism.

Municipal officials who recently spoke to the News Service pointed to their own registration systems and educational campaigns as bright spots in the effort to get as many people vaccinated as possible. The state remains at the beginning of its second phase of vaccinations, with residents 75 and older eligible to get their shots, along with companions in some instances, as well as anyone in the phase one groupings.

While municipalities are dependent on the state to get vaccines, some cities and towns have turned to online registration systems to start gathering residents' information before they are eligible to receive a shot.

Brockton rolled out an online preregistration form last week that directs residents to the city's website in an attempt to streamline the appointment process. The city does not have a state designated public vaccination site, prompting Mayor Robert Sullivan to send a letter to the governor requesting a site in his city.

Sullivan said residents in all phases of the state's vaccination distribution plan can use the city's registration form. That allows the city to have a database of contacts that officials can use to reach out to residents to set up appointments once they're eligible to receive the vaccine, Sullivan said.

"This is allowing us to actually manage the process," Sullivan said. "Because before we incorporated this, and I give a big shout out to our city IT department, we were just getting inundated with phone calls: the mayor's office, city councilors, the Council on Aging, even people at the library were getting calls."

The database also allows the city to quickly utilize vaccines in cases where a person does not show up to an appointment or relays to city officials that they have already received a shot, Sullivan said.

"It is really a game changer, because we need to be able to control our own destiny and this is something that's really helping us do that," he said.

Gov. Charlie Baker has indicated that community health centers will play a central part in the state's vaccination plan. He said local health centers have a "historic role in those communities as a trusted source of guidance, advice, and health care services." The governor has also launched a state call center to assist the state's oldest residents with vaccinations.

Throughout the pandemic, the Baker administration has established ground rules through executive orders while allowing municipalities to control their testing, reopening, vaccination, and recovery paths.

Everett Mayor Carlo DeMaria said he likes the fact that he is able to manage his city's vaccination process.

Like Brockton, Everett does not have not have a state-run vaccination site, and relies on its own resources to get shots into people's arms.

"Some cities, some smaller towns don't have the resources, right, hence the reason why there are state-run facilities," he said. "We in Everett, we have the resources, we have the staff. We are able to hold these clinics and able to get our residents vaccinated. We can actually do more."

The city is utilizing its 3-1-1 phone line to assist residents with booking a vaccination appointment, physical mailers to all citizens 75 and older, reverse 9-1-1 calls, email notifications, and online registration. DeMaria said the city instituted a call center after recognizing a gap in the state system and determining that Everett could step in and provide the service.

"Why we had a call center, because we saw that the state didn't and there was some feedback, negative feedback that they didn't. So we were like, 'Oh, wow, we can do it and we put it in place,' " DeMaria said.

In Revere, city officials set up a fully staffed COVID vaccination hotline last week that facilitates outgoing and incoming calls from residents. A spokesperson for the city said officials now have phone numbers for 3,500 residents aged 75 and older and also plan to send out a direct mailer with a list of local resources.

"We understand that many seniors are having difficulty accessing online registration platforms today and are eager to be vaccinated," Mayor Brian Arrigo said in a statement issued at the end of January. "We are urging patience and asking for your confidence that my office and the Revere Board of Health will continue to share information with you as soon as it becomes available."

In Braintree, which also does not have a state-run vaccination site, town officials created an internal registration with their police, fire and EMT departments for Phase One injections. Mayor Charles Kokoros said as the end of that phase approached, officials started to contemplate the best way to facilitate the registration process.

Now, residents aged 65 and older who want to be placed on a waiting list to receive a vaccine can navigate to the town's website where they can fill out an online form. Alternatively, residents can call the Braintree Health Department or email covidvaccine@braintreema.gov if they cannot access the online form.

Kokoros said the city has had to determine how many doses are available at any given point and schedule accordingly. Instead of residents walking and making appointments, he said, the city wanted to first compile a list so that officials could manage the process.

"So the upside to that was that folks got to put themselves on a list prior to Phase Two starting, in addition to that, when we call them, if they already have an appointment somewhere else, then we can take them off the list. If they don't, we get to get them right in," he said. "The bottom line is that we just wanted to make sure that anyone in our community that wanted to get vaccinated had a means of communicating with us to get on that list."

Unlike Brockton, Kokoros said his town has not gone beyond residents aged 65 or with two or more comorbidities. He said Braintree has registered around 5,000 individuals, many of which might fall off the town's list because they've received a shot somewhere else.

Kokoros said it would have been easier if the town allowed people to go through the state to set up appointments "but we knew that it was going to be difficult because of the volume of folks that want to get vaccinated."

"We also wanted to vaccinate them close to home," he said. "That's why we created this registration system. So, the reality of it is there's a lot more that goes into it, and it's consumed a lot of time, but the end result has been so positive, it's just absolutely amazing."