It took several phone calls last week for Roy Brooks to locate the only pharmacy in Siloam Springs taking part in a statewide program, starting Monday, to vaccinate people age 70-plus against the coronavirus.
When the 82-year-old went to sign up, he got a shock -- 600 to 700 others already had.
He asked how many covid-19 vaccinations the pharmacy expected to carry out each day. The answer: "between six and 12."
"I'm guessing it could be June before I finish up," said the retired restaurant and hotel operator. "They've known this was coming for almost a year. It seems like somebody should have had a better plan."
After months of enduring covid-19 pandemic miseries, many senior citizens hoped vaccinations against the coronavirus would come rapid fire. Instead, the vaccine rollout -- at least initially -- is going to be slow, according to state officials, health experts and health care providers.
There are long waiting lists and too few doses, they say.
Arkansas Gov. Asa Hutchinson announced during his weekly covid address Tuesday that he was accelerating the start date for coronavirus vaccinations for people 70 and older, along with employees of schools, universities and colleges, and day care centers. These two groups comprise part of what the state calls Phase 1-B.
"We want to continue as fast as we can getting these doses into the arms of Arkansans, and, at the same time, be able to manage the limited supply of vaccine we are getting," the governor said.
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Like many states, Arkansas has been struggling to quickly roll out the vaccines it's been receiving from the federal government. State health officials say it largely boils down to supply chain issues -- that the roughly 35,000 to 50,000 doses received weekly simply make it impossible to move any faster.
Some of those doses are reserved for the booster shots that individuals get a couple of weeks after their first injections.
Hutchinson said Tuesday that a good percentage of people in Phase 1-A -- front-line health care workers, residents of long-term-care facilities, first responders -- have received vaccinations, which partly led to the decision to open up access to more general segments of the population.
He also said he expected the state to receive bigger dose allocations in coming weeks, another reason for opening up to more groups that are high-risk, like senior citizens. "We have been getting about 50,000 doses a week," he said. "I expect that to increase."
But on Friday, The Washington Post reported that the federal government would not be able to increase dose allocations of the Moderna and Pfizer vaccines to states because national stockpiles have virtually run out.
"I was disappointed in the news that there is no reserve vaccines to be released," Hutchinson said in an emailed statement. "While we do not have sufficient supply to complete the new categories, we have enough to start, and we remain hopeful the supply of vaccines will increase."
Now it could take weeks, even months, to make a dent in those new groups.
Dr. Jennifer Dillaha, the Health Department's state epidemiologist, estimates it will take weeks, though she hopes not many months, to immunize the 311,000 Arkansans who are age 70 and older, along with the 132,000 education staff members who comprise the second phase.
The slow vaccine rollout is chiefly because of "the low number of doses being allocated" by the federal government, she said.
But in the days since the governor announced Monday's start of Phase 1-B, health care providers say they have concerns that it may take a long time, and not just because of supply issues.
They are urging members of the public to be patient as the providers offering the vaccine struggle to cope with lists that sometimes contain thousands of people who have signed up for their turns.
"The next couple of weeks are going to be hard," said John Vinson, head of the Arkansas Pharmacy Association, which is working as a liaison between the state and pharmacies for vaccine distribution. "I would really like to ask the public to be patient and kind, not to be rude, not to point fingers."
Arkansas is one of only a handful of states that is relying heavily on community pharmacies, which are independently owned and usually small operations, to help with vaccinations. These pharmacies first started assisting with vaccinating residents and employees of long-term-care facilities.
This week they will start injecting senior citizens and educators.
Vinson said an initial list of 212 community pharmacies has been expanded to more than 230 as part of a strategy to increase access. He said it is possible some pharmacies may not receive any of the 37,000 or so weekly allocation of doses expected to start arriving in the state.
In Little Rock, City Pharmacy added five phone lines to cope with the overwhelming call volume since the governor's announcement.
"Yeah, it has been something else," said Amy Rodgers, pharmacy manager.
She said between City Pharmacy and its partner location, Market Place Pharmacy, also in Little Rock, waiting lists are nearing 5,000. Rodgers said she is certain that people are signing up on multiple lists.
This, she says, is concerning because pharmacies will not be able to estimate the true doses of vaccines needed per pharmacy if hundreds, even thousands, of people sign up at numerous locations.
"It is a problem," Rodgers said. "I don't think we can say hell, but that is kind of what it is."
Rodgers said some people living in metropolitan areas are calling pharmacies in rural parts of the state and adding their names to those lists as well, with the hope of shorter wait times.
"For this to work efficiently, people should get on one pharmacy's wait list and wait their turn," she said.
Unlike other states, such as Oklahoma, Arkansas does not have a centralized registration system to keep track of who needs a vaccine and who doesn't. (The state Health Department does offer a phone and email help line: the ADH covid-19 call center at (800) 803-7847, or email [email protected].)
Oklahoma created state-run vaccination centers, or "points of dispensing" sites, for larger segments of the population. State health officials say Oklahoma so far has vaccinated about 6% of its nearly 4 million residents. Arkansas by comparison has immunized about 3% of 3 million.
Keith Reed, Oklahoma's deputy health commissioner, said community pharmacies eventually will be used for distribution but not until a substantial percentage of people have been inoculated.
"We have to take care of the masses and then bring on the pharmacies," Reed said during an online media briefing Friday. "We can't expect a local pharmacy to handle a wait list of two to three thousand."
Reed added: "That is our territory. That is our responsibility as a state public health entity. We cannot push that off on anyone else."
Arkansas has resisted mass vaccination events until the state receives enough doses to handle large numbers, Hutchinson said Tuesday.
"Mass distribution is still part of the plans," the governor said. "But it would not be good to have a stadium for mass distribution when you only have a limited supply of doses."
Some pharmacies are partnering on an ad hoc basis with churches or other community organizations to organize vaccination events that can serve more people.
In Hot Springs, where there is a substantial retirement community, the Oaklawn Center on Aging -- an organization providing resources for senior citizens -- has partnered with a local pharmacy and is organizing a vaccine event at a public venue, said Dr. Jack Porter, the board chairman.
Over a four-day period, the center collected nearly 2,100 applications, Porter said, adding that the "vast majority" of the applications were dropped off rather than submitted online as the 70-plus generation "are not electronically savvy," yet another challenge that many providers are facing as they try to sign people up.
"I was really worried how we were going to reach these people," Porter said. "I could not believe we had over 2,000 applicants who had to get in their car and drive and put [applications] in a box."
Others say they are even more concerned about low income individuals and elderly people living in rural areas where there is limited broadband access. So far, there have been no mass mailings or telephone notifications for senior citizens in the state.
The state Department of Health website contains a list of at least 230 mostly independent pharmacies statewide that will distribute the vaccine: https://bit.ly/39BXyd0.
Hospitals are also involved.
CHI St. Vincent hospitals will start Phase 1-B vaccinations for teachers and people 70 and over.
People can register online: https://chistvincent.com/getmyshot.
The University of Arkansas for Medical Sciences announced last week a large-scale vaccination program to start Tuesday to put covid-19 vaccinations in 300 arms daily. After that, the clinic will be open weekdays, 9 a.m.-4 p.m.
On Friday afternoon, when UAMS first began taking calls for appointments, the entire UAMS phone system crashed after being overloaded with at least 1,000 calls per hour.
Over about a four-hour period, UAMS received 4,445 calls and scheduled 2,146 appointments, Leslie Taylor, a UAMS spokesperson, said via email. This weekend, UAMS employees are listening to 2,000 voicemails left over from Friday, she said.
"We are in a real challenging position," Dr. Robert Hopkins, division chief of internal medicine at UAMS said, adding that vaccine shortfalls may force UAMS to pause its clinic, which could lead to "a lot more unhappy people."
"There is still a lot of consternation, a lot of, 'why not me?,'" said Hopkins, also the chairman of the National Vaccine Advisory Committee. "Stress causes bad behavior."
"It is a good problem to have, in a way," Hopkins said. "It is good we have so much demand, so many people who want to be vaccinated."
