Was your COVID vaccine appointment canceled? Here's why, according to experts.

With weeks of travel ahead for a slew of weddings, my husband and I were eager to get the latest COVID vaccine as an extra layer of protection. However, on Wednesday, my husband learned via a voicemail that his appointment at a major pharmacy had been canceled due to limited supply.

Over Slack, I asked my colleagues at Yahoo if they had had a similar issue. One said yes — both he and his wife’s appointments were canceled in the suburban Washington, D.C., area. Another pointed to an article from the Philadelphia Inquirer that stated many pharmacies in the Philadelphia area aren’t yet rolling out the vaccine (which is not considered a booster as it is targeting a new strain of the virus) due to “shipping delays.” In the same state, Pittsburgh residents shared with WPX1 that they’re struggling to get boosted. And an Inside Edition report also said that thousands of people hoping to get vaccinated this week found their appointments were canceled.

To get journalistic justice for my partner (and others, of course!), I set out to find some answers as to what could be behind the cancellations and delays.

Did the shots get lost in the mail?

Typically these vaccines are ready to go once they are approved by federal agencies. Dr. John Sellick, an infectious disease expert at the State University of New York at Buffalo, recently told Yahoo Life, “The companies that make these vaccines probably have them packed up and ready to go ... the trucks will be pulling out like deployment of the Army."

RiteAid, CVS Health and Walgreens Boots Alliance said that manufacturers are experiencing shipping delays, Bloomberg reports.

However, Pfizer, one of the makers of the two currently available new COVID vaccines, isn’t reporting any shipping woes, with a representative telling Yahoo Life, “Pfizer has substantial supply of its 2023-2024 COVID-19 vaccine and does not have any shortages. Following the FDA approval, which was closely followed by the CDC’s recommendation last week, Pfizer has shipped and delivered several million doses of its 2023-2024 COVID-19 vaccine. We’re continuing to fulfill orders and we anticipate delivering millions of additional doses each week.” Moderna also told Bloomberg that shipping to retailers and wholesalers began as soon as the shot was authorized.

Blame health insurance?

But shipping may not be the issue here as both Pfizer and Moderna can’t point to why the delays are happening. Rather, insurance companies may be to blame.

CVS said in a statement to Inside Edition regarding the cancellations, “Some [insurance companies] are still updating their systems and may not yet be set up to cover the updated COVID-19 vaccines. If this happens, our pharmacy teams can help patients schedule an appointment for a later date.”

When the COVID vaccines were first rolled out in 2021, insurance wasn’t an issue.

“Back in 2021, you and I and all the other taxpayers paid for the vaccine, and it was totally free,” Dr. William Schaffner, a professor at the Vanderbilt University School of Medicine, tells Yahoo Life. “Now that we have gone beyond the emergency use authorization for the pandemic emergency, we have reverted to the conventional way our vaccines are paid for, whether through our private or public insurance programs.”

People without insurance, or who are underinsured, can get a free vaccine from their local health centers or health department, as well as pharmacies participating in the Bridge Access Program.

Case closed?

According to Dr. Amesh Adalja of the Johns Hopkins Center for Health Security, this shift to having insurance pay for COVID vaccines seems to be the biggest reason why people are finding their appointments canceled.

“Private insurance companies are now covering the shot. Some of them may not have updated their software that shows that this is a covered expense,” he tells Yahoo Life. This represents a massive technology problem that happens with other medications and vaccines as well. Because the COVID shot was recently updated, there may be a lag between when it’s available, operational and when insurance shows something is covered. “People are getting their appointments canceled because it shows that there's a chance that it hasn't actually been added yet, from an IT perspective, so the person doesn’t have a co-pay. It’s a bureaucratic logistical issue regarding how quickly insurance companies add a new product to their catalog of covered services.”

For those who are able to get the shot, delays in insurance billing codes mean they are getting sent bills of nearly $200 when they should be covered without a cost. Pharmacies, Adalja says, want to avoid that if possible.

“My understanding of this is they are voluntarily canceling appointments, so people don't get stuck with a copay until the databases are all updated,” he says, noting that this isn’t a problem just for the COVID vaccines, which target the XBB 1.5 strain of COVID-19 but offer protection around other variants circulating as well. “The same thing is true, for example, with the RSV vaccine. They were telling people, Don't get it, even though it's available, in certain areas, because your insurance might not be uploaded into your insurance company’s catalog.”

The takeaway

Adalja doesn’t believe that there’s a supply issue. Still, it’s important to make sure that the vaccines are getting into the arms that need them most. Less than 50% of people over 65 got the bivalent booster, and “that’s not something people want to repeat,” says Adalja.

The Center for Disease Control and Prevention (CDC) recommends the updated vaccines for everyone 6 months and older, but Adalja says they’re especially necessary for the most vulnerable populations. “We really want to target or prioritize individuals that have risk factors for severe disease because that’s how we make COVID-19 even less of a problem.”