How does London’s COVID-19 vaccine booking system compare to other regions?

People line up outside of the COVID-19 vaccination clinic at the Agriplex in London, Ont., on March 4, 2021. Sawyer Bogdan/Global News

Since opening this week, the Middlesex-London Health Unit‘s COVID-19 vaccine appointment booking system has been marked by staggering demand, phone outages, and frustration.

Appointment booking for those 80 and older opened on Tuesday, and within roughly two hours, all 5,000 or so available appointments up to March 16 were filled.

Read more: Health unit provides additional vaccine appointments for seniors in the London area

Late Wednesday, the health unit announced that it was making an additional 6,900 vaccination appointments available between March 4 and March 18.

The health unit also said that a portion of the additional appointments would be available exclusively to those booking by telephone, which has seen significantly more volume than the website.

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In a tweet Wednesday night, Medical Officer of Health Dr. Chris Mackie urged the public to treat health unit phone staff with respect.

“For goodness sake, please do not call the (health unit) phone number and yell, swear, demean, or otherwise criticise (sic) the excellent staff answering the phones there,” he wrote.

During a media briefing on Thursday, Mackie said that members of the public can send feedback via email to

“The most important thing for us is that people are able to book and we’re seeing that. I mean, appointments are disappearing as soon as they’re available through the online system and now some (appointments have been) reserved for phone callers today,” Mackie said.

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“We know we’re in a situation where we need to move as quickly as possible and that means that no system is going to be perfect.”

Mackie says they’ve received some feedback that parts of the online system were difficult to enter data into. In particular, the system was not allowing people who entered the version code — the letters following the numbers in the health card — to proceed.

Read more: 2nd Middlesex-London vaccination clinic opens in Mount Brydges to serve rural communities

He added that the the phone system presents the biggest challenges.

“I think we recognized that it wasn’t going to be possible to create a phone system that would handle the literally hundreds of thousands of calls that we were getting within a few hours of opening on Tuesday,” he explained.

“So, of course, there were a lot of people who are frustrated with that, which I understand and appreciate. And hopefully those people are being able to get back into the system, whether it’s online or through the phone.”

Under the appointment-booking system employed by the MLHU, which involves partnerships with the London Health Sciences Centre and the City of London, eligible residents can either call a telephone line to try to book an appointment or head to a website to grab a slot.

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If there are no appointments available, they can try again the next day.

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What’s happening elsewhere?

A provincial system is expected to be up and running by mid-March, but six regions are doing a soft launch: Kingston, Frontenac, and Lennox and Addington; Peterborough County-City; Hastings and Prince Edward Counties; Leeds, Grenville, and Lanark; Grey Bruce; and Lambton.

The website will not be available to the general population in those regions during the soft launch. Instead, public health officials are reaching out to a small number of individuals who are 80 or older, as well as some eligible health-care workers.

Outside of those six regions, several other health units have their own unique booking systems.

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In the Hamilton region, anyone 85 and older whose received hospital or clinic care in the last six months will be contacted with an appointment time while those who have not can register via telephone.

Hamilton Public Health Services had similar phone issues to the MLHU, prompting an apology from its medical officer of health on Monday.

Read more: Seniors line up at York Region COVID-19 vaccination site, families express relief

Several health units have taken a pre-registration approach, which involves people reaching out to the health unit and providing their information and then staff contacting them later to actually book the appointment.

Peel Region is allowing eligible residents to book or pre-register through two websites which it says will be active until a provincewide booking system launches later this month.

The Windsor-Essex County Health Unit offers pre-registration either online or over the phone.

Wellington-Dufferin-Guelph Public Health also uses a pre-registration system. It started vaccinating those 80 and older in late February and its vaccination rate is now above the provincial and national average.

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Chatham-Kent Public Health is taking appointments by phone, like the MLHU, but it is asking that those with last names beginning with A through M to call Monday, Wednesday, Friday and those with last names N through Z to call Tuesday, Thursday, Friday.

CKPH also says that if you don’t get through, you can leave a voicemail and they will return the call.

The Simcoe Muskoka District Health Unit offers online and telephone appointments as well as a waitlist, but as of March 4 even the waitlist was full.

Ottawa Public Health is booking appointments for seniors 80 and older in select neighbourhoods, based on postal codes.

The city asks that residents fill out its screening tool to confirm they are among the eligible vaccine recipients based on their age, postal code and other qualifying factors.

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What’s next for the MLHU’s system?

Mackie says the health unit is “definitely looking at any tweaks to improve the system.”

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He says the main goal is to get people booked and that has been a success, the sticking points are around customer service especially when it comes to the phone process.

Pre-registration is a possibility that Mackie says “is something we certainly will consider for the next round of large doses being available for the general public.”

The health unit has already employed that approach with health care workers “because it is a defined population.”

“We can reach their employers. It’s a much, much easier process to get in contact with people to get their information.”

Read more: Canada on track to get nearly 1M vaccines this week and next: officials

In the meantime, the health unit has made some forecasting, processing, and staffing changes that allow them to increase the number of appointments available.

As part of the effort to offer an extra 6,900 vaccine appointments, Mackie says the health unit has reduced its “coverage for risk of delayed vaccines,” meaning that it’s reduced the amount of vaccine it keeps on hand in case deliveries are delayed.

As a result, he says there is now a risk that future appointments could be impacted if a delivery is delayed by one or two days.

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The health unit also “took control” of the forecasting model which was previously handled by a third party.

“I actually spent several hours looking through the spreadsheet yesterday and was able to find a few errors that really changed the amount of vaccine available,” Mackie said Thursday.

“For example, the total at end of day was used in a way that applied it to the wrong day. So it looked like you were going to run out of vaccine a day earlier than was actually the reality.”

Read more: U.S. will have enough coronavirus vaccines for all adults by May, Biden says

More doses were also made available thanks to improved processes “so we’re consistently getting six doses” per vial. Previously, there was “always some risk that we wouldn’t get all of those six doses” and so forecasting was initially done on the basis that there would be 5.5 doses per vial.

“The other big change was we allocated more appointments to right away and less appointments to two weeks from now or three weeks from now,” he added.

“It’s all hands on deck right now and we want to get these vaccines in arms as soon as possible. And we will handle the logistical hassle of increasing and decreasing supply as we need to to make sure that this gets done as quickly as possible.”

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— with files from Global News’ Craig Lord, Matt Carty, Don Mitchell, Daina Goldfinger, Ryan Rocca, and Ken Mann as well as The Canadian Press’ Nicole Thompson.

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