LULU GARCIA-NAVARRO, HOST:
We're about three weeks into the biggest vaccination effort in history. And here in America, it's happening slower than initially promised, except in West Virginia, which has become the first state to complete the initial vaccination in all of its long-term care facilities. Now it's delivering boosters and initial doses to others, including teachers age 50 and over. NPR's Yuki Noguchi explains why it's on a faster track.
YUKI NOGUCHI, BYLINE: Gretchen Garofoli is a pharmacist in Morgantown, W.V., and administered one of her state's first COVID-19 vaccines.
GRETCHEN GAROFOLI: So we got the vaccines on Tuesday, December 15. And we got the vaccines at the pharmacy around noon. And we were out in the nursing home by 2 p.m. administering our first doses.
NOGUCHI: That was nearly two weeks ahead of when most other states started sending pharmacists into long-term care facilities to vaccinate residents and staff.
GAROFOLI: A lot of people are looking to us as a state because after the first week we had, I believe, around 90% of doses that were allocated to our state into arms, which was really unheard of elsewhere.
NOGUCHI: West Virginia is charting its own path to vaccination. Every other state signed on to a federal program to contract with CVS and Walgreens to vaccinate elder care facilities. Instead, West Virginia delivered its vaccine supply to 250 pharmacies, many of them small, independent stores. Garofoli is also a pharmacy professor at West Virginia University. She says the federal plan to rely on big chains wasn't going to work for her state.
GAROFOLI: We have a lot of independent pharmacies or smaller pharmacies that are in those more rural communities. So in order to get the vaccine out to some of those areas, we needed to follow something a little bit different.
NOGUCHI: So the state set up its own distribution system. Krista Capehart was a key architect of that plan. She says many long-term care sites already use local pharmacies for twice weekly COVID testing of residents and staff. By piggybacking on those existing relationships, the state was able to start scheduling appointments and securing consent forms two weeks ahead of others.
KRISTA CAPEHART: When it got here, we already had pharmacies matched with long-term care facilities, so we were already ready to have vaccinators and pharmacists go into those facilities and start providing first doses.
NOGUCHI: The vaccination process isn't easy. The approved vaccines require special storage and handling. Plus, patients must make appointments and sign paperwork. Those factors are tripping up delivery in some states. And patience is wearing thin.
Claire Hannan is executive director of the Association of Immunization Managers, representing state and local public health officials.
CLAIRE HANNAN: They're trying to get CVS and Walgreens to come to their facilities. And CVS and Walgreens are moving at the pace they're moving.
NOGUCHI: By contrast, she says, West Virginia controls its own vaccine supply. It's a smaller operation that can adapt and switch gears, while other states must navigate the bureaucracy of huge national chains.
HANNAN: They're not as flexible. They're not as nimble as public health to make adjustments. You know, add 500 people. Move a hundred people. You know, go to more facilities at one time.
NOGUCHI: CVS and Walgreens insist they are on track. Both say they will complete initial vaccinations in all long-term care facilities by January 25, about a month after West Virginia hit its milestone.
Mark Parkinson is CEO of the American Health Care Association, a long-term care trade group.
MARK PARKINSON: What I would be doing if I was governor is I would be on speed dial with the CEOs of CVS and Walgreens every single day.
NOGUCHI: Parkinson is, in fact, a former governor of Kansas. He credits West Virginia Governor Jim Justice for mobilizing resources early. The challenge is handling the more complex phases of vaccine rollout to the general public. Yuki Noguchi, NPR News.
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