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Weeks Into Vaccine Rollout, Some Worry Vulnerable Iowans Will Be Left Behind

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Natalie Krebs
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IPR File
UnityPoint nurse Tammy Miller asks Beverly Gerard, 92, of Chelsea, questions before administering her first dose of the Moderna COVID-19 vaccine on Feb. 1. Gerard secured an appointment at the Tama County Public Health Department clinic through her niece.

Iowa is now weeks into Phase 1B of distributing the coronavirus vaccine. That phase includes more than a half million Iowans ages 65 and older.

With vaccine demand still far outstripping supply, many Iowans are struggling to get an appointment and are frustrated. But some worry the state’s most vulnerable residents are also at risk for getting left behind.

Keokuk resident Chuck Betts said getting an appointment to get the COVID-19 vaccine was anything but easy.

When the 74-year-old became eligible earlier this month, he said he first called the services referral line 211.

"And I got an operator in Chicago, Cook County. So my 211 call went to Illinois," he said.

Then he said operating off a tip from a friend, he put his name on a waiting list with the Lee County Public Health Department.

Betts also banded together with friends to search for appointments. One friend found that a Hy-Vee across the river in Illinois had slots. He said he was able to get one online for his wife and himself.

But during the whole search, Betts said one thing kept bothering him.

"Well, one of the questions I kept asking myself and other friends was, ‘Who's in charge? Who's responsible for centralizing all this?’" he said.

That’s a question many Iowans seem to be asking right now.

For many Iowans trying to get appointments this month, it’s meant navigating a patchwork of public and private registration systems.

Earlier this month, state officials announced they were partnering with Microsoft to create a centralized vaccine registration system.

But last week, Gov. Kim Reynolds announced the state would not be moving forward with it. Instead, the state plans to focus on strengthening the current systems in place.

This upset many Iowans, including Brad Anderson, the state director of AARP Iowa.

He said this current patchwork system isn’t working for older Iowans, especially for those without internet access and those in rural areas.

"They're finding their voicemails being unreturned and many times, they have operators who are unable to help and some of these locations are clearly understaffed," Anderson said.

Anderson said AARP is calling on the state to build a centralized system so older Iowans have one place where they know they can get an appointment.

But Scott Grawe, a professor at the Iowa State University College of Business, a supply chain expert, said he doesn’t see this centralized system as the main lynchpin to improving the state’s vaccine rollout.

Grawe said what the state really needs is better communication.

He said state officials have failed from the beginning to clearly tell people what steps they need to take to find and register for the vaccine. That’s left people in the dark.

"When you create a system where you announce the system, and then you change those plans, it creates confusion among the customers and those who are really seeking the vaccine. And they just don't know where to go to get it," he said.

Other rural Midwestern states like North Dakota have managed to top the nation's list of vaccine distribution rates without a centralized system.

Instead, North Dakota state officials established early on a vast network of vaccine distributors, who helped get word out to the public, and even employed contact tracers to help register residents for appointments by phone.

Grawe said Iowans don’t even have clear direction on where to find information.

Reynolds told reporters last week the state is working on building up services like 211. In the meantime, she directed older Iowans to call the state’s Area Agencies on Aging, also known as triple-A, for help.

But this has put an increased strain on these agencies. Joe Sample is the executive director for the state’s six triple-A locations. He said call volume is way up in recent weeks.

"Some of the agencies are seeing almost triple the call volume than what their typical week looks like. So we know the demand is huge," he said.

Sample said the agency can’t do what the overwhelming majority of callers want: to schedule an appointment. Instead, he says they can walk them through where to call, starting with their local pharmacy.

He said many people are grateful for this help, but says this current system does put older, vulnerable Iowans at risk of being left behind.

"Or be so late to the game that they continue to have enhanced risk for not only the virus, but then just, you know, the mental health effects of social isolation," Sample said.

Iowa City resident Shuva Rahim said her senior parents in Scott County are computer-savvy, but they’re still struggling to chase down appointments, even with her help.

Rahim said she feels the state’s rollout has been very reactive, not proactive.

"But I also wish the setup was already there, like, where are you going to hold your clinics? And when are they going to be and who's the contact?" she said.

Rahim said her mother has registered at her doctor’s office and expects to get vaccinated soon. Her father is still waiting.

Natalie Krebs is IPR's Health Reporter and collaborator with Side Effects Public Media. Krebs has expertise covering health news and issues, including maternal health and rural health care access. She's covered abortion access and women's health care in Iowa and the Midwest, news from Iowa's state health agencies, and medical care and health concerns for elders. Krebs is a graduate of the University of Texas at Austin.