No-shows for COVID-19 vaccine appointments in Alaska add strain but little waste so far

As more COVID-19 vaccine appointments open daily in Alaska, some vendors say they face a recurring problem: no-show for appointments.

“This has been a significant problem over the past week, if not more,” said Heather Harris, director of the Anchorage Department of Health.

Case in point: More than 200 people never showed up for their scheduled appointments at the Anchorage School District immunization clinic on Wednesday, said Lisa Miller, a spokesperson for the school district.

While ASD and other clinic providers have largely been able to adjust to last-minute changes in vaccine use so far, health officials say no-shows exert a some pressure on suppliers and encourage Alaskans to cancel appointments in advance if they are not. not going to be there.

“I think the good thing is that we don’t waste vaccine,” said Kelsey Pistotnik, program manager with the Alaska Immunization Program, on a media call Thursday. But “it’s a big burden on providers when they expect a certain number in a day and they receive a lot less,” she said.

It’s to the point where “clinics have to do somersaults and backflips to make sure no vaccine is wasted,” Harris said.

The problem seems to be that people made appointments for the earliest available niche – which could be weeks away. But because appointments are regularly added to the site, some may come back later, book an earlier or more convenient time slot, and then forget to cancel the old one, said Tessa Walker Linderman, co-director of the Alaska Vaccine Task Force. .

“We definitely have ‘research appointments’ around, and I understand – we all want to get vaccinated as soon as possible,” Pistotnik said. “But we’re still trying to find that perfect place to make things work really well on the provider side” as well as on the patient side.

“It’s definitely a more recent problem,” Pistotnik said.

Alaska this month became the first in the country to open appointments for vaccines to anyone 16 years and older who lives or works in the state, with no further eligibility restrictions – in part thanks to the large number of unfilled appointments for vaccines available at the time.

Public health officials said this week that while demand for the vaccine has been generally high since Alaska removed eligibility criteria, the general saturation of appointments in the state – particularly in Anchorage – made it easier for people to choose which vaccine appointment window to register for.

“We’ve gone from a place where you have to schedule a date in several weeks to have a lot of options right now,” Harris said.

Many health care providers say they were able to cope with missed appointments. At the ASD clinic, the health team has changed the amount of vaccine they take out of storage freezers each day.

“What we’re doing to ensure zero waste is that if in the morning, if there are 1,000, we take 500 doses out of the freezer,” said Miller, the school district spokesperson. She added that no vaccine has been wasted so far.

The Pfizer vaccine can be stored in the freezer for about two weeks and then can last in the refrigerator for about five days, she said. Once the vials are punctured, they only last about six hours.

So, “we don’t go out of ultra-cold storage unless we absolutely have to,” she said.

Not all clinics had the same problem. Rene Dillow, a public health nurse from Mat-Su, said Thursday that only about 10% of scheduled vaccination appointments in the area were missed.

And immunization clinics in Juneau are seeing both no-shows and cancellations, said Robert Barr, chief of the planning section at the Juneau Emergency Operations Center. But that hasn’t become a problem yet, he said.

Usually, people who cancel or don’t show up have been vaccinated in advance elsewhere or have a travel problem that affects their ability to receive a second dose.

In the half-day clinics, which vaccinate about 400 people, they see about 10 no-shows. And whole days, where around 1,000 people could get vaccinated, they see around 30 no-shows, he said.

“It’s a manageable number for us. We can work with that, ”Barr said.

Juneau clinics have a public waiting list, which means they’ve been able to call people who want vaccines and make up for those open appointments, Barr said.

But that could change soon, as the supply of vaccines increases and demand begins to slow, the more people on the waiting list are vaccinated.

“I think in April – certainly in May – we’ll start to see supply and demand balance out, and then it’s going to be harder for us to deal with that,” Barr said.

There is a no-show rate of around 7% for large immunization clinics held at the Carlson Center in Fairbanks, said Clint Brooks, an operations commander for the Unified Command of the Borough of Fairbanks North Star.

But despite the no-shows, Brooks said slot filling was no problem. They plan around this by overbooking appointments by around 7%, keeping the clinic listed as open online, and keeping a waiting list.

Harris, of the Anchorage Department of Health, said a vaccination clinic open on Friday was an effort to test whether eliminating the need to make an appointment would make vaccination easier for some people.

The Anchorage School District team contacted those who missed their vaccine appointments and offered them a chance to book again.

Miller said that although very few vaccines were wasted, the clinic is asking Alaskans to cancel their appointments in advance instead of simply not showing up.

“Honor your date, and if you can’t make it, cancel so we can follow it up,” she said. “It makes the process easier.”