Many Midwest states are now weeks into distributing coronavirus vaccines to residents who are 65 or older. With demand still far outstripping supply, many seniors have struggled to get an appointment and are frustrated. And some worry the most vulnerable residents could be 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," he says.
Betts then put his name on a waiting list with the county health department, and 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 says.
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, calls the new system a “terrific step forward.” It includes an option for seniors to get help scheduling an appointment by phone.
Anderson says 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," he says.
But Scott Grawe, a professor at the Iowa State University College of Business and an expert in supply chain management, says a centralized system isn’t the main linchpin to improve the vaccine rollout.
He says the state really needs 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," Grawe says. "And they just don't know where to go to get it."
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 on, and that helped get word out to the public. The state even hired contact tracers to sign up people by phone.
Grawe says 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," he says.
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 says navigators will start contacting seniors who have reached out to the state’s Area Agencies on Aging for help.
Joe Sample, executive director for the six Area Agencies on Aging locations, said before the state’s recent move that calls had nearly tripled at some locations. But they can’t do what the overwhelming majority of callers want: schedule an appointment. Instead, they tell people where to call, starting with local pharmacies.
Sample appreciates the state is now giving more attention to scheduling seniors. He says 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," he says.
Shuva Rahim says her senior parents in eastern Iowa are computer-savvy, but still struggled to chase down appointments — even with her help.
Rahim 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 says.
Rahim says 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 news collaborative covering public health.