"The telephone company contacted the call center to make the call center aware that they were at risk of shutting the phone system down," said Dr. Barbara Brookmyer, county health officer, at a briefing Wednesday afternoon.

The health department plans to give out 800 doses of injectable vaccine for H1N1 flu, also called swine flu, at a clinic on Friday.

Calls were accepted at a toll-free phone number starting at 9 a.m. Wednesday to take appointments for Friday's clinic. Calls were to be accepted through 9 p.m. or whenever the 800 appointments were filled. After the first hour, the call center put a recording on the line saying no more calls would be accepted.

The department contracted with Florida-based Total Communications, a company with call centers up and down the East Coast. The goal was to prevent people from having to wait in long lines to get vaccines. The company had all its call lines in use.

"In neighboring counties, people had lined up as early as 10 p.m. the night before a clinic," Brookmyer said. "We were hoping this would be avoided."

Other Maryland counties tried the same approach for scheduling vaccinations, but with internal call centers. Some were overwhelmed, with one county recording 1,400 calls in an hour.

"I thought using a professional call center, we should be able to make appointments efficiently," Brookmyer said.

"The demand was overwhelming, and ended up testing the limits of technology."

Some of the volume was likely due to repeat callers, she said. Some people hung up and got calls back from call center employees. Others left messages on an answering machine.

"They did have a system in place to record and identify the first calls in," Brookmyer said. That is why some callers received calls back without having left a message. Calls were returned in the order in which they were received, she said.

"Some people were wondering, 'If I left a message, what's going to happen?'" she said. "They will be returning all of those calls." About 500 messages were left.

All appointments made Wednesday will be honored, Brookmyer said. "They did not overschedule appointments."

She does not know if the department will use up its vaccine at Friday's clinic, which will be at the Church of the Redeemer, formerly Circuit City, at 5606 Buckeystown Pike, behind Sam's Club. Only those with appointments will get the vaccinations on Friday.

The department hoped to schedule appointments for 500 people considered at high risk, and 300 pregnant women. Pregnant woman are six times more likely to die from swine flu than people who are not considered high-risk.

Based on other counties' experiences, Brookmyer said she expected no more calls than 280 lines could handle.

She is not sure if the department will try that approach again.

"I want to explore what is possible to avoid the threat of shutting down the phone company," she said. "I am still waiting for an analysis of what happened."

The health department will receive more doses of H1N1 flu vaccine, and they could come at any time, she said. She also recommended that people try to get a vaccination through their health care provider.

The department contracted with the call center on a per-minute basis for the cost of the operation. Brookmyer said she has not figured out what the cost will be, but the call center will lose money on the operation.

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