Vaccinators play ‘wait-and-see game’, scheduling appointments based on supply estimates

MADISON, Wis. – Entering the pandemic, most didn’t know what we were getting into.

“We pretty much have been homebodies,” Potosi resident Dorothy Hodges said. “I haven’t had a dentist appointment, we don’t get haircuts.”

Now a year later, it’s clear vaccination appointments are the way out. That means juggling an unknown amount of future supply with scheduling appointments for patients.

“I was so elated when I got one in January,” Hodges said. “I’m 81.”

The day before her second dose four weeks later, she got a call saying her appointment had been rescheduled.

“Having gone through this, I don’t want it to be a waste of time,” Hodges said.

Rescheduled appointments

Many viewers got ahold of News 3 Now, frustrated that their vaccine appointment had been rescheduled, in some cases multiple times. Last week, UW Health had to reschedule about 4,000 appointments because of a lack of supply.

“We’re discouraged right along with you that that needed to take place,” said UW Health’s Dr. Matt Anderson. “It certainly was never anybody’s intention.”

Anderson explained they were booking patients 65 and older to meet a request by the State to get that population vaccinated by March 1 when new groups became eligible.

“When we were asked to vaccinate our primary care population and do that by March 1, we looked at that and said, ‘How do we build that capacity?’” he said. “Obviously, supply didn’t work out from that vantage point.”

Now the health system is adjusting, taking into account what supply they’ve usually been receiving.

“We know what we’ve been getting week to week so we can recalibrate a bit,” he said.

Scheduling appointments based on incoming supply estimates

Basing appointments on supply estimates is what Unity-Point Health Meriter and SSM Health have been doing. Neither have had to do any major rescheduling.

Mo Kharbat, regional vice president of pharmacy services at SSM Health, said they estimate conservatively.

“If we learn we will be getting more, we can on a very short notice, open more appointments very quickly,” Kharbat said. “We’d rather do it this way … and call our patients with this happy call.”

UnityPoint Health-Meriter’s emergency preparedness safety manager, Nathan Bubenzer, said the State is now letting them know their vaccine allocation for two weeks instead of one, but scheduling is still a balancing act.

“Demand is so much greater than availability and we all have to play this sort of wait-and-see game for appointments and vaccine,” Bubenzer said. “Every bit of information helps.”

Supply limited for everyone

Area vaccinators including Group Health Cooperative of South Central Wisconsin report receiving between about 25% to 50% of their requests.

“These are problems we’re all facing, because demand is really high and supply isn’t quite there yet,” GHC-SCW Chief Medical Officer Chris Kastman said.

At Meriter, Bubenzer said they’ve been getting anywhere from 250 to 500 of the 1,000 doses they’ve been requesting per week.

SSM Health, with its network of 18 vaccination sites statewide, requests 2,000 doses per clinic, and ends up with about 9,000 total. They’re able to send vaccines where they’re needed the most within that network.

While UW Health has the ability to vaccinate 7,000 people a week, they’re only being allocated about 2,000 doses for its four clinics in Dane County.

“It’s been clear that the more counties that you are allocating to, the more doses that you’re eligible for,” Anderson said. “Dane County has a large number of vaccinators, so what DHS has shared with us is they’re not necessarily giving proportionately. So the more vaccinators you have, that dilutes the amount of vaccine that can be given.”

UW Health is continuing to focus on vaccinating patients 65 and older.

“We appreciate their patience,” Anderson said. “We know they want to get vaccinated quickly. We’re doing everything we possibly can.”

At the same time, SSM Health is now allocating 20% of its supply to vaccinating teachers, with 80% still reserved for those 65 and older and previously eligible groups. Kharbat said there’s bound to be overlap between eligible groups.

“This is the right time to move onto the next phase,” he said.

Second doses factored in ahead of time

When vaccinators get a shipment, they know which vaccines are allocated for first doses and second doses, so no one should be left hanging.

Hodges was worried when her second dose appointment at GHC was rescheduled for a week later that it might be rescheduled again, putting the vaccine’s effectiveness into question.

Kastman, however, said that the only reason any appointments had been rescheduled was because of the nation’s winter weather storm last month that delayed supply delivery.

“We had a day and a half where we had to reschedule appointments, not because we weren’t getting the vaccine we were promised, just because it was stuck on a truck or distribution center somewhere,” Kastman said.  “Luckily, all those folks that were temporarily delayed, we were able to vaccinate as soon as possible.”

Hodges left the clinic with her second dose and a lighter heart on Wednesday.

“Despite the wrinkle I have run into with the Covid-19 vaccine regimen, in many, many ways Tom and I consider ourselves very fortunate to have been able to survive so far in reasonable comfort during this difficult period when so many have had to suffer greatly—our hearts go out to them,” she said.

Plans to expand with expected supply increase

A GHC administrative site where testing was once done is now a vaccination site.

GHC can currently do about 400 vaccinations a day at its three sites, according to Kastman, who said they’re planning to expand that as supply increases.

“The signs are favorable things will open up,” he said. “All systems in town, including GHC, will be able to vaccinate a lot more people.”

The first shipment of the Johnson and Johnson vaccine to Wisconsin is expected next week. The vaccinators News 3 Now spoke with said that while they’re keeping the newly approved one-shot vaccine in mind, it’s too early to say how it will fit in with scheduling appointments.

Scheduling recommendations for the future

The goal, health officials say, is to get people vaccinated no matter where they make an appointment.

“We want our patients to get vaccinated as quickly as possible,” Anderson said, suggesting that patients look into all their options.

The Wisconsin Department of Health Services launched its vaccine registry page on Wednesday. For those already eligible for the vaccine, the registry gives patients a way to sign up for an appointment if there are any available where they live. Those who are not yet eligible can sign up to get a notice when they’re able to sign up for an appointment in their area.

Kastman encourages patients to fill out vaccine interest forms that most providers offer and sign up for MyChart to get health notifications that way.