Darlene Davis has checked for an available COVID-19 vaccine appointment in the Kansas City area at least three times a day.

Davis, a 77-year-old nurse who lives in Independence, developed a routine appointment checker online.

“I go in the morning when I wake up at 6:00 am. I go around 5:00 pm because the government tends to get things right before they go home,” said Davis. “And then I’ll go again at midnight just because it’s the start of a new day and I think maybe something will open up then.”

Davis had put her name on nearly a dozen lists. She checked the state’s Vaccine Navigator Register for mass vaccination incidents only to have her family vetoed the option out of concern over the two-hour drive in winter to get to the next Clinton incident.

Her search had been in vain for weeks, with no clarity as to where she had fallen on the many waiting lists.

Her luck finally changed on Monday after Davis got an appointment at Truman Medical Center Lakewood.

But Davis’s venture underscores the confusion and frustration of many Missourians in search of a vaccine, with a few driving lessons in more rural communities to find an available appointment.

Meanwhile, calls for expanding the number of people currently eligible – and for groups such as teachers – have risen as the state strives to reach the more than 3 million residents who are now qualifying under state levels.

However, demand continues to exceed available supply. For the week of February 15 alone, the state’s website said it received order inquiries for more than 250,000 cans – more than 2.5 times the 93,125 cans it was allocated that week.

Lack of access

It’s a demand Jan Morrow, director of the Ripley County Public Health Center in southeast Missouri, sees among residents of her county. Morrow said she was asked to sign up through the state’s centralized registration system, Vaccine Navigator – but that can be a problem for many without internet access.

“Our computer system goes up and down – I don’t know how many times a day,” said Morrow. “We have people 20 miles west of us who have no internet and who live in the countryside.”

For those without internet, the state has set up a hotline that Missourians can call if they need help registering for an appointment. But on Monday afternoon the demand was so high that no one was available.

“Due to the unusually high volume of calls, we are currently unable to take your call,” said a recording on the hotline around 12:45 pm. “Please call back at a later date.”

At that moment, Morrow said her health department usually receives a call from “really hacked” residents.

“I have no answers for these people,” said Morrow. “And I feel bad about it because I don’t want this for our county.”

Morrow said it was unclear how the state’s Vaccine Navigator waiting list will integrate with its own waiting list of over 600 people. She’s not getting rid of her department’s list anytime soon while waiting for approval on her next application for the vaccine.

“While the state may think it’s a great tool, it’s an obstacle in this area,” Morrow said of the state’s system.

Where do the cans go?

From the Kansas City area to southeast Missouri, the state’s residents are still struggling to find vaccines.

The state has been criticized by rural and urban lawmakers for believing their voters have been left behind, with the St. Louis area in particular calling for an appropriate distribution of doses based on population.

Dates earlier this month from Senator Jill Schupp, D-St. Louis County seemed to underscore the concern.

In the first two months of vaccine distribution in Missouri, Cape Girardeau County received enough vaccines to supply more than half its population, while some other counties – rural and urban – did not have enough doses for even 5 percent of their population, a county – Breakdown of the shipments requested by Schupp’s office by district.

During the eight week period, the City of St. Louis received 67,125 doses, enough for about 19.2 percent of its population. St. Louis County received 82,925 cans, enough for 8.6 percent of its population. St. Charles County received 16,825 doses, enough for 3.8 percent of its population.

Counties of Clinton and Newtown only received enough doses for about 0.8 percent of their population.

In a letter sent to Dr. Randall Williams, director of the Department of Health and Senior Services, said Schupp the data confirmed her fears.

“The data not only show these differences from district to district, but also regional differences,” wrote Schupp.

However, the data sent by the state to Schupp do not show the complete picture.

Not only does it not contain doses sent to long-term care facilities, but it also skips vaccine redistribution between facilities and across county boundaries, the governor’s office said in an email to the Missouri Independent.

For five weeks after the state was introduced, Missouri’s share of Moderna doses was allocated to the federal partnership with CVS and Walgreens to vaccinate residents and employees of long-term care facilities.

All that remained were doses of Pfizer’s vaccine, which had to be stored in ultra-cold freezers at minus 94 degrees.

“This is notable for Pfizer’s storage and handling requirements, which resulted in over 100 redistributions from facility to facility or county to county,” said Robert Knodell, assistant chief of staff to Governor Mike Parson.

For example, according to data provided to Schupp’s office, Cape Girardeau County received 43,300 doses from December 14, 2020 through February 1, 2021 – enough to cover about 54.2 percent of the county’s nearly 80,000 residents.

As of February 1, Cape Girardeau County’s residents were given 12,058 doses – about 15 percent of the population, according to the state’s dashboard.

Knodell said it was designed for Cape Girardeau County to distribute significant fractions of the Pfizer vaccine to other counties.

Morrow said her department had not received any redistribution of the cans, including from Cape Girardeau County. While Cape Girardeau healthcare systems are designated as “high throughput” providers for the area, it is not always accessible to Ripley County residents who need a two-hour drive to get there, Morrow said.

A similar restriction applies to stock numbers that the state released last week.

For the first time, the state published spreadsheets showing which vendors requested and received how many doses. However, redistributions between providers are not taken into account.

Schupp said her office had received no reservations about the dates such as reallocations.

Redistributions have been a tool since the inception of government rollout that still affects some of the largest healthcare departments.

For example, the Jackson County Health Department and the St. Louis County Department of Health recently received hospital redistributions in their areas after they had not received direct supplies of the vaccine from the state in weeks.

Schupp said she requested the data to ensure that allotments are made based on the population, the state said.

Approximately 2,000 doses are allocated for each mass vaccination event sponsored by the Missouri National Guard. Meanwhile, the Highway Patrol region, which includes the St. Louis area, makes up about 37 percent of the state’s population, and the Kansas City region makes about 23 percent.

Schupp said more populous areas should receive more than one mass vaccination event per week, and she would have preferred if congressional districts were used to split up the state to ensure efforts were more evenly distributed among the population.

“I just have the feeling that we are, to a certain extent, starting from a wrong premise by dividing a region in this way,” said Schupp.

The data requested from Schupp’s office only reflects the first eight weeks of the vaccine’s launch in Missouri, which means it does not include vaccine allocations in the past three weeks for National Guard mass vaccination events and “high throughput” hospital systems.

While Schupp is encouraged by the new models of the state to distribute the vaccine, she wants to make sure that the state brings vaccines to people – instead of letting them drive for hours to get them.

“That’s expensive. And it doesn’t work for everyone,” said Schupp. “The people who have the most will be vaccinated, not the people who have the least.”

It is a major Davis concern that residents with fewer resources face in the face of unclear information. As a nurse who knows how to navigate healthcare, she felt better equipped to look for an appointment – and even then it was still frustrating.

For Davis, vaccination means she can feel more secure finding another job implementing electronic health records or volunteering to fire shots herself. And hopefully she can see her family and grandchildren again when it is safe enough to do so.

Despite the hours of work Davis put into finding a shot, she doesn’t take this for granted.

“I was incredibly lucky to find the right person at the right time today,” said Davis, later adding, “It’s a lucky thing.”

The Missouri Independent is a non-profit, impartial news organization dedicated to the state government and its impact on Missourians.

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