As more COVID-19 vaccine appointments open up daily around Alaska, some providers say they’re encountering a recurring issue: appointment no-shows.
“It’s been a significant problem over the course of the last week, if not longer,” said Heather Harris, director of the Anchorage Health Department.
Case in point: More than 200 people never showed for their scheduled appointments at the Anchorage School District vaccine clinic on Wednesday, said Lisa Miller, a spokeswoman with the school district.
While ASD and other clinic providers have largely been able to adapt to last-minute changes to vaccine usage so far, health officials say no-shows are causing some strain on providers, and they’re encouraging Alaskans to cancel appointments in advance if they aren’t going to be there.
“I think what’s nice is that we’re not wasting vaccine,” said Kelsey Pistotnik, a program manager with the Alaska Immunization Program, during a call with media on Thursday. But “it’s a big burden on providers when they are expecting a certain number in a day and they get much less,” she said.
It’s at the point where “clinics are needing to do somersaults and backflips to make sure no vaccine is wasted,” Harris said.
The issue seems to be that people have been making appointments for the soonest available slot — which might be weeks away. But since appointments are added to the site regularly, some may check back later, book an earlier or more convenient slot, and then forget to cancel the old one, said Tessa Walker Linderman, a co-lead with the Alaska Vaccine Task Force.
“We definitely have ‘appointment shopping’ around, and I get it — we all want to get vaccinated sooner rather than later,” Pistotnik said. “But we’re still trying to find that sweet spot so it all really functions well from the provider side” as well as the patient side.
“This definitely is a newer problem,” Pistotnik said.
Alaska this month became the first in the nation to open up vaccine appointments to anyone 16 and older who lives or works in the state, without any other eligibility restrictions — thanks in part to large numbers of unfilled vaccine appointments that were available at the time.
Public health officials said this week that while demand for the vaccine has generally been high since Alaska removed eligibility requirements, the overall saturation of appointments in the state — particularly in Anchorage — has made it easier for people to be choosy about which vaccine appointment slot they sign up for.
“We’ve moved from a place where you have to schedule an appointment that’s many weeks out to having many options right now,” Harris said.
Many clinic providers say they’ve been able to adapt to missed appointments. At the ASD clinic, the health team has changed how much vaccine they pull out of storage freezers each day.
“What we’re doing to ensure zero waste is, if in the morning if there’s 1,000 registered, we will pull 500” doses from the freezer, said Miller, the school district spokeswoman. She added that no vaccine has been wasted so far.
The Pfizer vaccine can keep in freezers for about two weeks, and then can last in a refrigerator for about five days, she said. Once the vials have been punctured, they only last about six hours.
So, “we’re not pulling from ultra-cold storage unless we absolutely have to,” she said.
Not every clinic has had the same issue. Rene Dillow, a Mat-Su public health nurse, said Thursday that only about 10% of scheduled vaccine appointments in the region were being missed.
And vaccination clinics in Juneau see both no-shows and cancellations, said Robert Barr, planning section chief for the emergency operations center in Juneau. But it hasn’t become an issue yet, he said.
Usually people who cancel or don’t show either have gotten vaccinated in advance somewhere else, or have a travel issue that affects their ability to get a second dose.
On half-day clinics, which vaccinate around 400 people, they see about 10 no-shows. And full days, when roughly 1,000 people might get a vaccine, they see around 30 no-shows, he said.
“That’s a manageable number for us. We can work with that,” Barr said.
The Juneau clinics have a public waitlist, which means they’ve been able to call people who want shots and make up for those open appointments, Barr said.
But that could change soon, as the supply of vaccine increases and demand begins to slow down the more that people on the waitlist receive vaccinations.
“I think maybe in April — certainly in May — we will start to see supply and demand sort of equal out, and then it’ll be harder for us to deal with that,” Barr said.
There’s about a 7% no-show rate for the large vaccine clinics held at the Carlson Center in Fairbanks, said Clint Brooks, an incident commander for the unified command of the Fairbanks North Star Borough.
But despite the no-shows, Brooks said filling slots hasn’t been a problem. They plan around it by overbooking appointments by around 7%, keeping the clinic listed as open online as well as keeping a standby list.
Harris, with the Anchorage Health Department, said that an open vaccine clinic Friday was an effort to test whether eliminating the need to schedule an appointment would make getting a vaccination easier for some people.
The Anchorage School District team has been reaching out to those who miss their vaccine appointments and offering them a chance to re-book.
Miller said that although very little vaccine has been wasted, the clinic does ask that Alaskans cancel their appointments in advance instead of simply not showing up.
“Honor your appointment, and if you can’t make it, cancel so that we’re able to track that,” she said. “It helps the process.”