AILSA CHANG, HOST:

When it comes to COVID vaccinations, the U.S. has come a long way since early January, when only health care workers and people in nursing homes could get the shot. Now more than half of all U.S. seniors have gotten at least one dose of the vaccine, and the arrival of the one-shot Johnson & Johnson version means many more Americans could be fully vaccinated before Memorial Day. But all over the country, people who are eligible are still searching for the shot, and access to the vaccine can vary widely depending on what state you are in. So here to discuss the states' successes and problems are Patty Wight from Maine Public Radio, Brett Sholtis of WITF in Harrisburg, Pa., and Sebastian Martinez Valdivia with KBIA in Columbia, Mo.

Hey to all of you.

PATTY WIGHT, BYLINE: Hi.

SEBASTIAN MARTINEZ VALDIVIA, BYLINE: Hello.

BRETT SHOLTIS, BYLINE: Hey there.

CHANG: So let's start in a state where things seem to be going pretty well, at least. That's Maine. Patty Wight, I understand that 25% of Maine's population have gotten at least one shot, which puts Maine, I think, at No. 6 among all of the states. What is Maine doing right, you think?

WIGHT: Well, Ailsa, a key focus of Maine's strategy is on mass vaccination clinics. These are sites that have the capacity to administer at least a thousand doses a day, if not more. We have several of these sites, and new ones keep being added. They're certainly not the only option to get a shot here, but our state CDC director has pointed to these high-volume clinics as being among the reasons why we've been able to pick up the pace. For example, last week we had a record day where more than 17,000 doses were administered across the state. There's also been consistent pro-vaccine messaging from health officials and our governor. And the eligibility rules about who can get the vaccine are really straightforward.

CHANG: Well, what are the eligibility rules in Maine?

WIGHT: Well, a few weeks ago, Maine totally simplified it and moved to a strictly age-based strategy because the risk is greater the older you are. It's also a lot simpler. You don't have to decide which medical conditions and frontline jobs should go first or have vaccinators verify that information. So right now the eligibility is for people 60 and up as well as school and child care staff.

SHOLTIS: That's really different from Pennsylvania. This is Brett here in Harrisburg. And here eligibility is a bit more complicated. Everybody 65 and up can get the vaccine but also any adult who has certain medical conditions or who works certain jobs. And that's all added up to just about a third of the state being eligible for the shot. So it's kind of a confusing messaging where you have 4 million residents who have been told that you deserve the vaccine. It's your turn. But the supply isn't there, and it's led to people kind of competing for appointments. And in Pennsylvania, there are almost 500 separate places giving out the vaccine if they have it available that week.

CHANG: Well, Sebastian, I understand that in Missouri, they're also turning to these mass vaccination sites. Are those sites working as well there as they are in, say, Maine?

MARTINEZ VALDIVIA: Not really. Since the start of vaccine distribution, Missouri has lagged towards the back compared to other states. And the idea here was the state would divide up its weekly shipment of doses so that more than half would go to a handful of big hospitals and a couple of major health departments in big cities like St. Louis, Kansas City and here in Columbia. And a quarter of the state's allotment were reserved for those mass vaccination events. Those have been held almost exclusively in rural areas, and that's been pretty inefficient at times. So towns like Leopold, Mo., which has a total population of 65, have hosted these events where they hope to give out thousands of doses.

CHANG: Whoa.

MARTINEZ VALDIVIA: But what happened is many of these events, hundreds of doses, would go unused either from people not making appointments at all or not showing up to their appointments. So what happened and continues to happen is people in urban areas are driving hours and hours to get to these rural mass vaccination clinics so that they can get a shot. And obviously, not everyone has the resources to make that drive.

CHANG: Wow. I mean, it sounds like Missouri is trying to spread things out geographically and not neglect rural areas, and yet it's now created this disparity between cities and the rest of the state.

MARTINEZ VALDIVIA: Yeah, there's been a lot of pushback on that. In urban areas, Missouri residents are very unhappy. So health officials in Kansas City and St. Louis have complained, and some people have even accused Governor Mike Parson of playing politics, making sure that rural Republican voters are taken care of, which he denies.

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MIKE PARSON: There are some out there who want to push the narrative that we are not efficiently and adequately administering COVID-19 vaccines, especially in the St. Louis area. This is simply not true.

MARTINEZ VALDIVIA: But his administration is changing its strategy and has announced that there will be more large events in cities. The first is going to be in Kansas City this weekend. Also, hopefully with the new Johnson & Johnson vaccine, that will help with that demand as well as bigger shipments of all of the vaccines in April.

CHANG: Yeah, let's hope so. OK, Patty in Maine, your state has a lot fewer people than Missouri or Pennsylvania. It seems to be smooth sailing in Maine. But tell us; are the numbers there really telling the whole story in your state?

WIGHT: Not exactly. Maine is a rural state. So like in Missouri, there are Mainers who don't have access to transportation or broadband, and a lot of appointments can only be made online. There are efforts to reach people in rural communities through things like pop-up clinics, and I went to one last week. Here's one of the organizers, Lee Anne Howard (ph).

LEE ANNE HOWARD: One that really sticks out to me is a lady that really - she started to just break down and cry. And she said, I thought they'd forgotten about us. And so that just really is - I keep thinking of that. And that's a really big motivator for us.

WIGHT: And Maine officials announced last week they're working with the transportation company to offer free rides to anyone who needs one.

CHANG: Oh, nice. OK, Brett, I want to hear more about Pennsylvania because despite the problems you've already described, Pennsylvania at seems to be doing about average among all of the states with 22% of Pennsylvanians having had at least one shot. Do residents there think it could actually be a lot better than that but it's not getting there?

SHOLTIS: They do. But to be fair, we had a leadership gap just as the vaccine was being made available. Our state health secretary, Dr. Rachel Levine, was tapped to be assistant health secretary for President Biden. We now have a new health secretary, but people are still frustrated about where to go. Each vaccination provider has its own signup.

So, for example, I've talked to people in their 80s who tell me that they called their local pharmacy and were told, you'll get a callback whenever we have something. And they're just patiently waiting. And then meanwhile, I've talked to people in their 30s who use computers professionally and who systematized it and contacted dozens of pharmacies across the state. And so they're willing and able to drive across the state. And also, you know, they have stronger networks on social media through Facebook and other social media platforms. So there's kind of an unfairness in that type of system.

CHANG: Yeah. So what is Pennsylvania doing about that unfairness? Are they doing anything?

SHOLTIS: Well, the state is making targeted efforts to groups that may not speak English and other groups that may not have as much access to health clinics. But what's really been interesting here is it's been the regional leaders and local health systems that have taken the lead on mass vaccination sites. For example, in Lancaster, we have a mass vaccination site that was set up in an empty department store at a mall. And they did that without any approval from the state or any guarantee that they would even get vaccines that they needed. It was really only when this was up and running that the governor visited and kind of held it up as a great example of what we will be doing going forward. And then the state did give them 6,000 doses of vaccine.

CHANG: That is Brett Sholtis in Harrisburg, Pa., Patty Wight in Lewiston, Maine, and Sebastian Martinez Valdivia in Columbia, Mo.

Thank you to all three of you.

MARTINEZ VALDIVIA: You bet.

SHOLTIS: Thank you.

WIGHT: Thank you. Transcript provided by NPR, Copyright NPR.