During a period of just seven hours, the Augusta hospital’s vaccination appointment center was bombarded with more than 400,000 telephone calls – the equivalent of one for every three Maine residents – from people trying to snag just 440 time slots.

In York, anger over the chaotic rollout of that hospital’s first vaccination sign-up was so swift and fierce that administrators sent out a public message pledging dramatic improvements, ending with the words “We promise.”

And while Maine’s largest health care provider offers pre-registration for vaccinations, so many people were growing anxious after waiting weeks for an appointment call that the organization began making courtesy calls to reassure registrants that they were still “on the list.”

Those are just three examples of the confusing and, at times, disjointed systems that the nearly 200,000 Mainers age 70 or older must navigate in hopes of securing some of the roughly 20,000 COVID-19 vaccine doses arriving in Maine weekly.

The lack of a centralized, statewide registration and appointment database has forced hospital and health care networks to launch their own systems. The resulting hodgepodge has led to confusion and frustration among many Maine seniors.

“Due to the lack of an actual system in Maine, I feel constantly on edge scrambling to figure out next moves to try to get a vaccination scheduled,” said Cathy King, a 73-year-old York County resident who, like many of her peers, has been trying to get on as many lists as possible.

Hospital and health care networks have made numerous and, in some cases, dramatic improvements to their internal systems in response to public feedback or pressure. But a statewide system still appears weeks away.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said last week that a centralized system “is probably the top priority of our entire team.”

“This is an all-gas, no-brakes situation or solution that we need to have ready to go,” Shah said.

A DIFFERENT SYSTEM FOR EACH

Like more than 40 other states, Maine opted not to utilize a federal registration system launched in the middle of the pandemic because it did not offer the one-stop-shop that states were expecting: registration, legal consent, appointments and follow-up tracking of vaccinations regardless of whether the doses were given in hospitals, pharmacies, mobile clinics or independent doctor’s offices.

Maine’s status as the oldest population in the nation – with more than 20 percent over age 65 – and spotty access to the internet presents additional challenges. So Shah said the Maine-specific system will require both online and phone-based registration that is easy to use and understand.

In the absence of that system, however, Maine has a disjointed series of registration and appointment platforms that don’t communicate with each other.

MaineHealth, which is the state’s largest hospital and health care network, has a phone-based pre-registration system that is available to anyone. More than 60,000 Mainers who are eligible for vaccination now have already registered, but the system, at present, does not provide any information about when they can expect that much-anticipated appointment call.

Two medium-sized health care networks in the Portland area, InterMed and Martin’s Point Health Care, are only vaccinating their own patients and are reaching out to those who are eligible for registration or appointments.

Northern Light Health, another large hospital and health care network, has to date forgone pre-registration and waitlists. Instead, Northern Light offers only a first-come, first-served vaccination appointment website and call center that has only been open for a few hours every Monday before all appointments are booked.

Lewiston-based Central Maine Healthcare is also only offering appointment slots to individuals on a first-come, first-served basis without pre-registration.

The phone system fielded 4,325 calls over three days, but all 450 appointments for this weekend’s clinics in Lewiston, Bridgton and Rumford were filled within an hour. Additionally, all 278 appointments scheduled for next Saturday at Central Maine Medical Center were filled within 35 minutes.

Chief Medical Officer John Alexander said the system worked well but they are looking at improvements to make it more efficient, user-friendly and able to handle more calls. Alexander said having a centralized, statewide system “would be worlds better,” however.

“A statewide system would be streamlined and would prevent people from having to check with multiple health systems and hospitals for appointments,” Alexander said in a statement. “It has a big impact on staffing. Our team members have been great about stepping up to help out at these clinics. Each person who is vaccinated at a community clinic interacts with six (staffers), and two of them are handling aspects of registration.”

‘TERRIBLY DISAPPOINTED’

Visitors to Northern Light’s vaccination website outside the brief registration period on Mondays find only a posting that “vaccine registration is currently full” and advising them to “Please, check back Mondays at 2 pm for updated availability.”

Michael Hopkins, a 72-year-old Biddeford resident who has been a Northern Light patient for more than a decade, tried for several hours on different days to get an appointment. He couldn’t get through on the phone number, and the website, after initially not loading, told him there were 100 local appointments only to say there were zero a few minutes later.

“I’m terribly disappointed,” Hopkins said. “I know that, in this case, a lot of it is not their fault. But the communication could be a lot better and certainly the website is terrible and frustrating to deal with.”

Like many, Hopkins also registered with MaineHealth weeks ago but didn’t hear anything until this past Thursday morning. The call wasn’t to schedule his appointment (it’s still not his turn) but was a new feature launched by MaineHealth last week to assure anxious registrants that they were still on the proverbial list.

“So I don’t know when I’ll get an appointment, but the call was good and it’s nice to have some progress,” Hopkins said.

Northern Light spokesman Andrew Soucier said at the current rate of vaccine deliveries to Maine, it would take months to call everyone on a hypothetical waitlist. Soucier added that while waiting is hard, “we also know it’s often harder to wait for that call back.”

“It seems like every health care system is managing this differently, which we know can be confusing,” Soucier said. “And while we can’t say one approach is better than another, it is human nature to find the grass often looks greener on the other side. When planning for vaccinations, Northern Light Health considered several options, and ultimately our approach has been to take steps to reassure people that when they make an appointment the dose will be here for them.”

400,000 CALLS FOR 440 SLOTS

Progress has been slow nationwide because of smaller-than-anticipated supplies of the vaccine drugs from the federal government. As of Friday afternoon, Maine had administered 130,551 first doses – with 35 percent given to Mainers age 70 or older – and 46,410 second doses of either the Pfizer or Moderna vaccines.

Patience is in just as short supply as vaccine doses, however, as MaineGeneral Health in Augusta and York Hospital experienced in recent weeks.

At 8 a.m. on Friday, Jan. 29, MaineGeneral opened the lines of its first vaccination call center with 10 people ready to help fill the 440 available appointments. The phone system enabled 20 people at a time to be placed on hold or leave a message for a call back. Everyone else got a busy signal.

By 11:30 a.m., the system had received 178,000 calls, which grew to roughly 400,000 calls by the end of the day. The vast majority of those were repeat calls from people who received a busy signal but simply hit redial – apparently over and over and over again, desperately hoping to get through.

“Most people called and redialed and never got anything but a busy signal,” Chuck Hays, president and CEO of MaineGeneral Health, wrote in response to questions. “The most common complaint we heard was that people dialed and re-dialed throughout the day and never got through until they got the automated message that our slots were full and the registration was closed until next week. Those people asked for some way to be able to let us know that they want to be on the list even if they cannot get the vaccine right away.”

MaineGeneral responded by revamping its system this past week.

The organization added both an online and a phone-based pre-registration system that will be used to schedule appointments for eligible individuals in the order that they were registered once there are doses available. Between the phone and the online system, the latter of which is available 24/7, MaineGeneral registered more than 2,900 people between Thursday and Friday morning.

Hays added that he knows “this isn’t the perfect answer,” in part because pre-registered people will likely get anxious as weeks pass without news on an appointment. MaineGeneral still only plans to schedule appointments one week at a time based on how many doses will be shipped the following week.

“But we hope that people see that we heard them, we have taken action, and we are continuing to listen to them and to work to improve what we have to get them in our system and scheduled and then vaccinated,” Hays said.

‘NOW I’LL … SIT BACK AND WAIT’

The virtual scene was equally chaotic at York Hospital last Tuesday.

York County has been a hotspot ever since the coronavirus first appeared in Maine last spring, accounting for 16 percent of the state’s population but 21 percent of COVID-19 cases. Yet just 6.6 percent of York County’s population had received a first dose of vaccine as of Friday, compared to 11.1 percent in neighboring Cumberland County, 10.1 percent in Penobscot County and 11.4 percent in Aroostook.

With vaccination opportunities in short supply in the county, York Hospital was overwhelmed by the response to the small facility’s first clinic sign-up event last week. The 189 appointments disappeared in just 11 minutes, according to news reports.

In the hours that followed, people who had tried for appointments complained about not being informed before beginning the online process that they’d need to submit pictures of their driver’s license and insurance card. And by the time they had the documents in hand, all appointments were gone.

Later that day, the hospital announced plans for a registration phone line during the next sign-up opportunity and eliminated the need for additional documentation. The hospital also created an appointment waiting list, with registration available Monday through Friday via phone or 24/7 online.

“We understand that COVID-19 vaccine demand far exceeds quantity at this time, and empathize, recognizing the road to this vaccine has been filled with detours,” the hospital said in a message to community members. “However, with your feedback and patience, York Hospital will continue to improve the path that leads you there. We promise.”

Cathy King, the York County resident, was among those who tried last Tuesday and thought she had an appointment three times before being told by the system the slot was gone. So at noon on Friday, King was back in front of her computer prepared for the next sign-up.

King wasn’t able to secure an appointment but did register for York Hospital’s vaccine waitlist. A day earlier, she had also received the automated courtesy call from MaineHealth informing her that her name was still somewhere on its waitlist.

“Now I’ll take a deep breath and sit back and wait,” King said.

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