Like many states, Iowa is now weeks into distributing the coronavirus vaccine to residents who are 65 or 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. 

Chuck Betts is 74 and lives in eastern Iowa. He says getting an appointment to get vaccinated was anything but easy.

He started by calling 2-1-1.

“And I got an operator in Chicago Cook County. So my 211 call went to Illinois,” Betts said.

Betts then put his name on a waiting list with the county health department. 

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

But during the whole search, 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, who’s responsible for centralizing all this?’” he said.

That’s a question lots of Iowans have asked. 

For many people, trying to get vaccinated has meant navigating a patchwork of public and private registration systems.

Earlier this month, Iowa officials said they were partnering with Microsoft to create a centralized registration system. It’s something other states like Indiana already have in place.

But last month, Gov. Kim Reynolds announced the state would not be moving forward with it. Instead, the state is launching a simpler online system listing places that offer vaccines. Iowans still have to call around to find an appointment.

Brad Anderson, the state director of AARP, called the new system a “terrific step forward.” It includes an option for seniors to get help scheduling an appointment by phone.

Anderson said the patchwork system hasn’t worked 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,” said Anderson.

But Scott Grawe said a centralized system isn’t the main linchpin to improve the vaccine rollout.

He is a professor at the Iowa State University College of Business. He said what the state really needs is better communication about the steps needed to find and register for the vaccine.

“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,” said Grawe.

Other rural Midwestern states like North Dakota are among the leaders for vaccine distribution, even without a centralized system. 

State officials there took steps like establishing a vast network of distributors early, and that helped get word out to the public. The state even hired contact tracers to sign up people by phone.

Grawe said Iowans haven’t had clear direction on where to even find vaccine information.

“I mean, the communication has been downright awful. In terms of knowing where to go get the vaccine, and how to go get that vaccine,” Grawe said.

But Iowa appears to be trying to improve communication with its new system. Reynolds told reporters last week that the state will also use vaccine navigators to help Iowans 65 and older schedule appointments.

She said navigators will start contacting seniors who have reached out to the state’s Area Agencies on Aging — also known as triple A – for help.

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Joe Sample heads the state’s six triple A locations. Before the state’s recent move, he said calls have nearly tripled at some locations. But they can’t do what the overwhelming majority of callers want: to schedule an appointment. Instead, he said they tell people where to call, starting with local pharmacies.

Sample said he appreciates the state is now giving more attention to scheduling seniors. He said the state’s localized system has 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,” said Sample.

Shuva Rahim said her senior parents in eastern Iowa are computer-savvy, but still struggled 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 there was — 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?” said Rahim.

Rahim said her mother was able to get her first shot at her doctor’s office.  Her father is still waiting. 

This story was produced by Side Effects Public Media, a public radio collaborative covering healthcare. It is based at WFYI in Indianapolis and has partner stations in six Midwestern states, including Iowa Public Radio. Natalie Krebs works out of Iowa Public Radio.

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