Clinic Appointment Reservation Tiers

Appointment reservation tiers allow standard and mobile clinics to allocate percentages of appointment capacity for each of the four appointment types:

  • first dose,
  • second dose,
  • walk-in, and
  • first come, first served (referred to in VAMS as “free for all,” these are any appointments not allocated to first dose, second dose, or walk-in appointments).

Appointment reservation tiers allow clinics to have more flexibility in constructing their schedules and reserving appointments for specific types. The reservation tiers are rolling time frames (with day 1 always being the current day) during which the reservation percentages are in effect.

The tiers are based on vaccine protocol and allow clinics to set different percentages for different time periods if they anticipate their needs changing as recipients return for a second dose. VAMS updates tiers as protocols and vaccine availability change.

Tier 1

Tier 1 is the percentage of appointments available for each appointment type, on a rolling basis, for the first 20 days out from the current date.

Duration of Tier 1: Current Day–20 Days Out

Consider allocating the highest percentage for first come, first-served appointments in this tier so that most availability in this 20-day time frame is open to any individual who needs an appointment (i.e., first or second dose). Consider allotting a small percentage of appointments for walk-ins based upon clinic forecasting.

Tier 2

Tier 2 appointments have start dates consistent with the recommended time frames for second doses based on the vaccine product. There are two kinds of Tier 2 appointments to account for the different recommended intervals between doses.

Tier 2a (Pfizer-BioNTech)

Tier 2a is to accommodate the first week Pfizer-BioNTech vaccine recipients would be eligible for their second dose. This tier is the percentage of appointments available for each appointment type, on a rolling basis, for 21–27 days out from the current date.

Duration of Tier 2a: 21–27 Days Out

If your clinic administers Pfizer-BioNTech vaccine, consider allocating a higher percentage for second dose appointments and a lower percentage for first dose appointments in this tier to accommodate recipients ready to schedule their second dose after 21 days.

Use the walk-in appointment allocation in this tier to reduce clinic capacity. This will block any appointment capacity you would like to become available when a date in time reaches Tier 1 eligibility.

Tier 2b (Moderna)

Tier 2b is to accommodate the first week Moderna recipients would be eligible for their second dose. This tier is the percentage of appointments available for each appointment group, on a rolling basis, for 28–34 days out from the current date.

Duration of Tier 2b: 28–34 Days Out

If your clinic administers Moderna vaccine, consider allocating a higher percentage for second dose appointments and a lower percentage for first dose appointments in this tier to accommodate recipients ready to schedule their second dose after 28 days.

Use the walk-in appointment allocation in this tier to reduce clinic capacity. This will block any appointment capacity you would like to become available when a date in time reaches Tier 1 eligibility.

Tier 3

Tier 3 is the percentage of appointments available for each appointment type, on a rolling basis, for 35 days onward from the current date.

Duration of Tier 3: 35 Days Out–Clinic End Date

Consider allocating percentages that make up your clinic’s ideal mix of appointment types (except for walk-ins) in this tier.

Use the walk-in appointment allocation in this tier to reduce clinic capacity. This will block any appointment capacity you’d like to become available when a date in time reaches Tier 1 eligibility.

Example: Reservation Tier Allocation

Clinic Appointment Reservation Tiers Table

* Tiers are broken down based upon vaccine protocol (Pfizer-BioNTech second dose eligibility at day 21, Moderna second dose eligibility at day 28).

**First-come, first-served appointments are the appointments not allocated to first doses, second doses, or walk-ins.

***Blocked walk-in appointments are not available for scheduling by recipients. In tiers 2a, 2b, and 3, allocating a percentage of appointments available to walk-ins reduces clinic capacity, helping ensure appointments are available to recipients in earlier tiers (e.g., blocking 10% for walk-ins in Tier 3 and 7% for walk-ins in Tier 2b will open up 3% further capacity that can then be booked by recipients).

How Do I Allocate Percentages of Appointments at My Clinic?

Your jurisdiction may have already allocated percentages for appointments at your clinic. If so, you will see a message when you click the Clinic Reservations tab telling you the percentages have been set. You may override their settings at any time by clicking the View Appointment Reservations button to review or edit the reservations.

Edit or Allocate New Percentages

  • Click the Clinic Reservations On this page, you will see a table with the tiers listed in rows and appointment type percentages listed in columns.
  • Hover over a cell within the table you want to edit (see the example below where we have hovered over the cell Tier 1, % Reserved for First Doses cell) until you see the pencil icon in the right corner of the cell.
  • Click the pencil icon to edit the percentage set for the appointment type in that tier.
  • Enter a whole number percentage (e.g., 20) in each editable column for each tier. Press Enter or click out of the field after each number you type.
  • When you finish entering all percentages, click Save underneath the table.

Quick Tips for Allocating Appointment Type Percentages

  • You only need to allocate percentages for first dose, second dose, and walk-in appointments when setting tiers. Any percentage left over after adding up the first dose, second dose, and walk-in percentages will automatically allocate to first-come, first-served appointments (any dose). For example: If first dose allocation is 25%, second dose is 50%, and walk-in is 15%, the remaining 10% of appointments will be allocated to the firstcome, first-served appointment type.
  • Use walk-in appointments in Tier 3, Tier 2b, and Tier 2a as a way to reduce clinic capacity in a tier. By lowering the walk-in percentage from Tier 3 to Tier 2b to Tier 2a to Tier 1, you can ensure appointments are available for booking in all tiers. Use walk-in appointments in Tier 1 as a way to reduce capacity and accommodate actual clinic walk-ins.
  • For Tier 1, consider setting first and second dose reservation percentages to 0% so your clinic can book to full capacity. This will automatically allocate 100% of appointments not allocated for walk-ins as first come, first served. • If you would like to have a first dose-only clinic, set the first dose appointment percentages to 100% for all tiers.
  • If you would like to have a second dose-only clinic, set the second dose appointment percentage to 100% for all tiers.
  • If you want your clinic to remain open to all recipients on a first-come, first-served basis, set first dose, second dose, and walk-in percentages in all tiers to 0%.
  • The Janssen (Johnson & Johnson) vaccine is considered a first dose in VAMS. Adjust first dose appointments across all tiers accordingly based upon expected inventory.
  • Tiers will not change previously booked appointments. If your clinic already has booked appointments, it may take several weeks to see results of clinic reservation percentage tiers. In addition, tiers will not allow your clinic to go over capacity (e.g., setting a second dose percentage in a tier to 50% when 60% of clinic capacity is already second dose appointments does not mean your clinic will book to 110% capacity).
  • If you do not customize your percentages and your jurisdiction did not set them for you, your clinic will not have tiers activated and all appointments will book as first come, first served.
Tiers, Appointment Types
Tiers First Dose Appointments Second Dose Appointments Walk-in Appointments Free-for-all (no reservations)
Tiers 1 Day 0-20 0% 0% 0% 100%
Tier 2a Day 21-27 25% 20% 2% 33%
Tier 2b Day 28-34 25% 50% 4% 21%
Tier 3 Day 35-clinic end of day 25% 60% 6% 9%
Page last reviewed: September 2, 2021