Great post! You might be interested in this post, contrasting our recent experience in NYC with a 1947 smallpox vaccination campaign: https://www.lesswrong.com/posts/JPyH3kxSzECAsM9bm/a-vastly-faster-vaccine-rollout

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I've also been wondering about this! In New York, it seems that initially demand was lagging (when they were adhering strictly to group 1a only), but now that they have expanded eligibility, lack of supply is the primary problem.

We talked about pooling for COVID testing in my class on Thursday. Basically, small labs have the advantage of proximity (no need to ship samples across the state), but the drawback of higher variability than centralized testing facilities. If we had real-time data on turnaround times at different labs, then we could get the best of both worlds: benefits of pooling and short transportation times. However, collecting this information could be challenging, both logistically and for incentive reasons (what lab wants to publish long wait times, especially if it might cause them to lose business?).

For vaccination, it is crazy to me that we don't have a more centralized registration system. However it doesn't seem that this alone would fully "pool" vaccinations: unless vaccination is performed at one central site, potential no-shows still impact each site individually.

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I completely agree. That's where the Israeli "system" worked well. You let people that don't mind the inconvenience of waiting and driving to different places absorb the slack.

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Agreed. If the primary goal is to maximize flow rate, then a long flow time (line) perhaps isn't a big concern. Alternatively, you could try to get the best of both: schedule some appointments, and also tell a smaller number of people that they are on a standby list, and are invited to show up. This seems preferable to intentionally overbooking, as you have managed expectations (the people on a standby list are hopeful, but know that they may not get it). Also seems preferable to having people queue all day hoping for an extra dose at closing time, as described in this article: https://www.theatlantic.com/health/archive/2021/01/covid-19-vaccine-giveaways-are-getting-out-control/617669/

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Feb 3, 2021Liked by Gad Allon

You could also co-locate the COVID vaccine and COVID testing sites and use the people arriving for testing to fill no-show capacity.

No-shows could also be penalized with a bounded exponential decay of their reschedule window (first no-show can be scheduled again in a week, second has to wait two weeks, third, fourth, and greater have to wait a month each time).

All of the vaccination challenges are also amplified by the two-dose vaccines.

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