Healthcare technology executives are weighing whether to attend the Healthcare Information and Management Systems Society’s annual trade show amid the COVID-19 pandemic and following cancellation of the 2020 event.

HIMSS21, which is slated for Aug. 9-13 in Las Vegas, hasn’t opened registration for attendees yet. The conference and exhibition has traditionally been one of the largest gatherings of health IT professionals, drawing in tens of thousands of attendees. But some companies, like Cerner Corp., have already said they won’t have a booth at the 2021 event.

“We remain committed to partnering with HIMSS to continue engaging with our clients and the healthcare community in safe and productive ways,” a Cerner spokesperson wrote in a statement. Cerner did not immediately respond to a request for comment on whether the company planned to participate in virtual components of a HIMSS21 event.

Other executives, like Chuck Christian, vice president of technology and chief technology officer at Franciscan Health in Indiana, haven’t decided whether to make the trip. He’s attended every HIMSS show since the ’90s, but for HIMSS21 he’s considering COVID-19 precautions, whether vendors he’s interested in meeting with are participating on-site in Las Vegas or virtually, and whether on-site education sessions—which haven’t been posted yet—are pared down from previous years.

Christian is scheduled to get the COVID-19 vaccine in March but recognizes that might not be the case for everyone.

Recent estimates have suggested the U.S. will reach mass immunization by the summer.

“I’ll just have to wait and see,” Christian said. He said he’s looking forward to attending an in-person HIMSS event in the future.

Pam Arlotto, president and CEO of healthcare consultancy Maestro Strategies, also said it’s “up in the air’ whether she’ll attend HIMSS21. She typically attends every year—2020 was the first year Arlotto hadn’t attended the conference since 1982—but this year may be a “game-day decision” due to COVID-19, she said.

And she’ll be more cautious, considering whether there’s specific clients or vendors attending that she wants to meet with.

Arlotto said companies typically spend months planning and preparing booths for the HIMSS exhibition hall, so those who haven’t committed to participating—and say they’re waiting to see how COVID-19 and vaccinations progress—may opt to have a smaller presence.

“When we return, things will be different,” she said. “But I don’t know at what level.”

HIMSS in messaging sent to exhibitors earlier this week said that HIMSS21 will be a “completely reimagined hybrid event” with options for attendees to participate in-person or virtually.

HIMSS will likely open attendee registration within the next 30 days and continue through the August event, said Karen Groppe, HIMSS’ senior director of strategic communications.

There’s also more competition in the healthcare-technology conference space this year, as HIMSS and the College of Healthcare Information Management Executives won’t host their joint CIO forum during HIMSS21. CHIME said a two-day virtual event in April will replace the group’s previous one-day HIMSS event.

“Will that impact the CIOs that go (to HIMSS)?” said Marc Probst, former chief information officer at Salt Lake City-based Intermountain Healthcare. “It could … It was just really convenient to have them both together.”

HIMSS22 is also right around the corner, scheduled for March 2022 in Orlando, Fla. Some health systems struggling financially may not have the budget to send people to multiple conferences.

Probst’s now CIO at healthcare data archiving and interoperability company Ellkay and an adviser to SR Health, a patient engagement platform from company Solutionreach. He said he’s planning to attend HIMSS21, as well as CHIME’s events. “I think they’re both important,” Probst said.

In previous years, only 3% of attendees have registered five months out from the health information and technology conference and exhibition, which typically takes place in March, according to a note HIMSS sent to exhibitors Tuesday. That keeps HIMSS on pace with its registration timing, the group wrote.

HIMSS has received more than 700 proposals to speak at sessions and more than 300 applications for reviewers, tracking comparable to previous years. Registration among exhibitors has lagged previous years.

More than 400 exhibitors have committed to attending HIMSS21, according to HIMSS. While that’s almost 65% the amount compared to the same timeframe in previous years, the society isn’t concerned.

“We’re very optimistic,” Groppe said of an in-person event. “There are 400 exhibitors who are also hopeful.”

HIMSS last year faced pushback over its decision to not refund exhibitors and sponsors after canceling the 2020 event just days before it was slated to start as COVID-19 related shutdowns began in March, citing a force majeure clause in its exhibitor contracts—raising questions over whether vendors would return.

HIMSS has offered partial credit on 2021 and 2022 conference participation.

Epic Systems Corp. and Athenahealth have both reserved space for island booths in the conference’s exhibition hall, according to a HIMSS21 website. Teladoc Health and Amwell also have reserved booth space.

Rebecca Whaley, vice president of marketing at Allscripts, in an emailed statement said Allscripts was “committed to having a presence at this year’s show,” but is “still determining the appropriate level of our engagement” in HIMSS21 due to the pandemic.

Meditech in an emailed statement said the company will evaluate plans for HIMSS21 in the coming weeks as it monitors information about the pandemic and related vaccine rollout

“Additionally, we see this as an opportunity to reimagine the future of large international conferences and how they can evolve and adapt to an increasingly virtual world while still supporting valuable networking and educational opportunities,” a Meditech spokesperson wrote in an emailed statement.

Amazon Web Services, which was one of the first companies to pull back on plans to attend HIMSS20 at the onset of COVID-19, has reserved booth space for the 2021 event. Based on a review of the website Thursday, Google and Microsoft Corp. have not reserved booth space in the exhibition hall.

Softworks, a company that sells workforce management tools, will not attend HIMSS21 on account of HIMSS’ decision to not refund exhibit fees last year.

“HIMSS has now retained 100% of our money for an event that did not take place,” wrote Órnait Glynn, marketing manager at Softworks, in an email to Modern Healthcare. “We feel it is unjustified and unethical to retain this money given that similar events, also canceled due to Covid-19, offered a full refund or a 100% transfer of fees to the 2021 event.”

Softworks last year led a petition, signed by about two dozen companies that had planned to exhibit at the 2020 show, requesting refunds from HIMSS.

HIMSS will have to rebuild trust among some companies, particularly small vendors and startups, who have remained frustrated about the 2020 event, said Maestro Strategies’ Arlotto.

“So many people were hurt, particularly smaller companies, by the lack of refunds,” she said. “There are a lot of people who didn’t take that very well. There’s some work to be done.”

Joe Scotto, chief marketing officer at cybersecurity startup CyberMDX, said CyberMDX will be exhibiting at HIMSS21.

While the company signed onto the petition seeking refunds last year, the company in 2021 is exhibiting as a title sponsor with a booth in the event’s cybersecurity command center, he said.

“We’re just trying to be optimistic about it,” Scotto said, although “we know that (an in-person event) is not a given.” “You have to choose to be optimistic or not.”