ENGLAND -- Only in a pandemic could the narrow halls of Landmark Baptist Church transform into a makeshift pharmacy.
In a matter of days, the small-town church on the Arkansas Grand Prairie has become only one of a handful of coronavirus vaccination drive-thru clinics in the state.
In Arkansas and around the country, health care workers have had to get creative during the covid-19 pandemic with temporary hospital beds in unusual places and drive-thru testing in empty parking lots.
Scott and Mary Carole Polk, owners of Polk Pharmacy, have a limited -- but significant -- number of doses: just enough vaccines to turn a Baptist church into a vaccination clinic, inoculating about 70 people a day.
The couple, both pharmacists, run the small pharmacy in England, where Scott Polk was raised. Most of Polk Pharmacy's staff has been working at the church clinic since it opened on Jan. 18, while a pharmacist remains at the brick and mortar shop down the road.
But while drive-thru pharmacies are nothing new, and drive-thru testing has become commonplace over the past 10 months, a lack of doses has limited most pharmacies' ability to vaccinate people in mass.
"It's just a little easier than having them come up to the store, and this way they don't have to get out of their car," Scott Polk said of his drive-thru vaccination clinic.
The pharmacy is one of hundreds of independent drug stores around the state that have become the linchpin of the state's vaccination plan as it shifts away from the large drug-store chains that helped vaccinate people at long-term care facilities.
On Jan. 18, Arkansas moved into the first part of phase 1-B, meaning people 70 and older or those who work in education are eligible for the vaccine. That shift has created a much larger pool of people who can get inoculated against the coronavirus, as thousands are on waiting lists for the vaccines at pharmacies that often have fewer than 100 doses.
To keep up with the demand, Polk Pharmacy hired extra staff and brought on a volunteer to help take calls, manage appointments and update spreadsheets for patients' visits, Scott Polk said.
"We were going to have it at the store, but then we just realized the sheer volume of trying to do the normal flow of business, having the extra traffic, we would need more space," Scott Polk said.
The 3-foot-wide corridors of Landmark Baptist Church have become a secondary off-site pharmacy in England with pharmacy staff seated at folding plastic tables, answering phones, filling out paperwork for patients and updating spreadsheets.
Landmark Baptist Church became the ideal location for the drive-thru clinic, Scott Polk said, pointing to its open space, ample parking and high-speed internet connection.
When his pharmacy received a shipment of doses for the next phase of the state's vaccination plan, Scott Polk turned to Wayne McLean, one of his employees and a deacon at the church.
McLean immediately signed off on it, then went to the church's pastor to tell him of the plan.
"I just started calling everybody telling them what we were going to do," McLean said. "Everybody was for it, I didn't need permission. I mean, we were going to do it."
One afternoon last week, just near a side exit, Scott and Mary Carole Polk, both dressed in white lab coats, took turns scurrying into the church and then emerging with syringes containing the Moderna coronavirus vaccine.
Inside, Scott Polk prepared each dose, carefully piecing a syringe into a vial of the vaccine, before carrying it out to a car parked under a covered drive next to a side exit of the church.
The drive-thru vaccination clinic is a rarity for a town the size of England. In England, a bedroom community of about 2,600, many travel to Little Rock or Pine Bluff to see a doctor.
News of available vaccines at Polk Pharmacy's drive-thru pharmacy spread through word of mouth at grocery stores and among neighbors. Independent pharmacists, who often have personal relationships with their patients especially in a small town like England, can be key when there is some skepticism about the safety of the vaccine, Mary Carole Polk said.
"There's a long line of trust, you know, years of trust when you deal with somebody every month or week about your meds," Mary Carole Polk said.
Randy Atchison, a retired grocery store manager in England, said he heard about the drive-thru clinic through word of mouth. Atchison, 71, said he was eager to get the vaccine as he and his wife have been "hibernating" alone together since March.
"I've been waiting on it and I have checked three times different locations to get on the list," Atchison said. "I was afraid Scott would call and he would run out of the vaccine and that I wouldn't get it today."
National public health officials recognized the vital role independent pharmacies would play in the covid-19 vaccine rollout before the first vaccine had ever been approved. In November, the U.S. Centers for Disease Control and Prevention announced a partnership with independent pharmacy networks to administer the upcoming vaccines.
In a statement announcing the partnership, the CDC pointed to the role pharmacies, particularly community pharmacies, play in their towns.
"Many pharmacists and the interns and technicians working under their supervision are trained to provide immunizations and are already important immunizers in their communities," the CDC said. "Pharmacists are also a trusted health resource in their communities, and have played a vital role in the public health response to COVID-19 by counseling patients, expanding access to childhood vaccinations during the pandemic, and ordering and administering COVID-19 tests. By working with these partners, the federal government will rapidly expand access to COVID-19 vaccines."
Arkansas has more than 6,500 licensed pharmacists, according to the Arkansas State Board of Pharmacy. It is home to about 760 retail pharmacies, according to the board.
It may take some time for drive-thru vaccination clinics to catch on in the Natural State.
Nicki Hilliard, director of professional development at the Arkansas Pharmacists Association, said a lack of supply is preventing more pharmacies from making drive-thru pharmacies.
Drive-thru vaccination clinics create logistical and bureaucratic problems, such as the requirement that people have a 15 minute observation period post-vaccination. If someone is in a car, they could simply drive off without waiting the mandatory 15 minutes, Hilliard said.
Some pharmacies also don't have the space to accommodate the cars, but the main reason is the lack of supply, Hilliard said.
"Right now the biggest hurdle we have is the short supply of vaccines, so it's just easier for them to do it like at a pharmacy because we don't have hundreds of doses to be able to give out at a time," Hilliard said.
While most people are getting vaccinated at local pharmacies, around the state there are some schools and churches that are being used as vaccination sites.
Like many pharmacies around the state, Polk Pharmacy received only one shipment of the Moderna vaccine containing 100 doses.
With vaccines in short supply, Mary Carole Polk said some have traveled from neighboring Pulaski County after they heard about their make-shift clinic in England.
"You feel like you're in the midst of something bigger than you are -- it's really cool," Mary Carole Polk said.
CORRECTION: Landmark Baptist Church sits on the edge of the region of Arkansas known as the Grand Prairie. An earlier version of this article gave an incorrect name for the region.