Many people across the country say that they have had major difficulties in reserving appointments for coronavirus vaccinations, with long waits to get through to booking numbers and confusing variation in practice from municipality to municipality.
An Yle survey of 18 municipalities found the problem has been widespread, and was particularly evident in early February, when the vaccination roll-out expanded beyond nursing homes and moved to appointments at health centres.
In some municipalities, not enough staff had been allocated to answer calls or there was no dedicated number for bookings. There have also been technical problems with telephone booking systems, leading to hundreds of calls being queued up.
In addition, attempts by people not yet eligible for a jab to try to book an appointment have also been a burden on resources.
Long phone queues may continue for the foreseeable future. On Monday, in Hämeenlinna, the local vaccination booking line was so congested that service had to be suspended. Similarly, in Jyväskylä last week, service was temporarily halted for the same reason.
The big cause of problems has been and still is, however, the availability of vaccines.
Time pressures
Healthcare staff are usually informed of the delivery of a new batch of vaccine at close to the last minute. As a result, procedures and communication have to be fast-tracked.
"Since the size and time of arrival of the batches of vaccine are uncertain and only confirmed the day before, communication is a very big challenge, especially for the elderly, as the elderly often do not use the internet," points out Laura Saurama, director of economic and administrative affairs for the City of Turku.
Municipalities post information about vaccination schedules on their own websites or municipal association websites, in local newspapers and other local media, and on social media. Also, for example in the Jyväskylä region, text messages are sent to people on the vaccination schedule.
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If a batch of a few hundred doses of vaccine arrives in a locality and there are thousands of people in the area in the age or risk group to be vaccinated, naturally there are not enough appointments available for everyone who wants one.
"In addition, THL's risk group 1 of people under the age of 70 is remarkably large, although there is little vaccine reserved for this group," says Tapani Strander, the chief physician in charge of coronavirus vaccinations in the Pori region.
Variation in appointment practices
Vaccination times cannot be booked on behalf of a relative everywhere in Finland. By contrast, in many municipalities booking an appointment for an elderly person is possible even without official authorisation or a valid ID.
For example, in the Pori region, an appointment booking on behalf of a relative is possible if the person making the booking is noted as a contact in the patient's records.
There are also differences in how online bookings are made. This depends not only on the site's technical features but also on whether patients are screened on the basis of age alone, or also on the basis of risk group.
Most municipalities are urging the public to use online bookings as their first option.
Screening is yet another bottleneck. In a number of municipalities if someone booking online belongs to both an eligible age group and an eligible risk group, a nurse does a follow-up phone call to confirm the information. Some other municipalities require confirmation of risk group status when the online booking is being made.
More staff, better information
Yle's survey found that local governments have been hiring more personnel to handle bookings and have launched more booking contact numbers. This has not, though, been enough to resolve problems in all cases.
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Some municipalities have introduced a callback service for setting up appointments. Responses to a callback request are usually made within a few days. These services have also been congested from time to time.
From the outset, some local authorities have invited the elderly to be vaccinated by letter or phone call in order to ease telephone queues.
Understandable criticism
Tarja Myllärinen, who heads the Social and Health Unit of the Association of Finnish Local and Regional Authorities, acknowledges criticism of the slow pace of vaccination, but points out that right now the process is dealing with hard-to-reach age groups.
"They have to be dealt with one at a time. The vaccination roll-out schedule specifies that this group must be reached first," she points out.
Myllärinen adds that she understands that the situation is stressful for everyone and sparks a variety of reactions. This is also reflected in the debate on possibly changing the order of eligibility for vaccination.