Here are just some ways Kansas City-area residents have found COVID-19 vaccine appointments: calling their local health department, filling out an online form, following a Twitter account, getting an email from friends and going to a local brewery.

But for many, vaccination scheduling success meant driving more than an hour to another county to get the shots.

Why are so many people having to travel?

There’s no centralized system for finding vaccination appointments, and there’s a stark difference in vaccine supply between federally qualified health centers in some rural counties and partners with local health departments. 

Health centers and pharmacies that get their vaccine supply through the federal government can get the doses faster, while city health departments and clinics have to rely on state-run distribution.

“The whole vaccination process was just very frustrating, trying to find clarity, where you could qualify, who had the vaccine at all,” said Nick Comes, 38, of Lenexa. “It was clear that it was ‘take care of yourself, the government wasn’t going to do it for you.’”

The process led Comes to Crawford County in southeast Kansas – an hour and a half drive – to get his vaccine on March 18 at the local Dillons Pharmacy. 

He wasn’t the only Johnson County resident to drive south. One southeast Kansas group of clinics, the Community Health Center of Southeast Kansas, says 6% of the 17,000 vaccines it has issued have gone to Johnson County residents.

When asked about why so many residents of Johnson County – the most populous county in Kansas – were traveling so far to get a COVID-19 vaccine, here’s what local health officials said:

“If people are able to find the vaccine in other places, we’re good with that,” said Sanmi Areola, director of health and environment in Johnson County, through communications staff. “We’re just a mobile society.”

Federal versus state vaccine allocations

Comes says he hesitated to sign up for the vaccination appointment in Crawford County.

“This feels weird, living in Johnson County, the richest county in the state, and now I’m signing up to go to one of the poorest counties in the state to get the vaccine,” he said. “But at the same time, I qualified (in Crawford County), and they had a surplus of the vaccine.”

In Crawford County, 18.5% of people are in poverty, according to the Census Bureau, and the median household income is $41,004. In comparison, in Johnson County 5.3% of the population is in poverty and the median household income is $89,087. 

That plays into the difference in distribution.

Some vaccine providers receive their supply directly from the government. Two health centers in Missouri and four health centers in Kansas get an allocation through the Health Center COVID-19 Vaccine Program, although more have been invited to participate. The health centers are spread out across both states, with some in rural areas and some in Wichita and Kansas City.

 “This feels weird, living in Johnson County, the richest county in the state, and now I’m signing up to go to one of the poorest counties in the state to get the vaccine.”

Nick Comes

The health centers primarily help the medically underserved, like seasonal agricultural workers, patients 65 or older, and rural and low-income communities.

Another group of vaccine providers that get a direct allocation from the federal government include pharmacies participating in the Federal Retail Pharmacy Program for COVID-19. In Kansas and Missouri, this includes Walmart, Hy-Vee, Kroger, Walgreens, Costco and others. Pharmacies in urban areas also get vaccines through the federal program, but they run out more quickly due to demand.

Crawford County is one of 14 counties in Kansas with a surplus of COVID-19 vaccination appointments at CVS, Walmart and Rite Aid, according to GoodRx. They are all part of the federal partners program.

For local health departments, the process is more complicated

For example, the Kansas Department of Health and Environment receives a notice of the amount of vaccines that will be available, then determines how much local health departments and other providers should get. KDHE then places an order with the federal government.

On March 29, Kansas City Mayor Quinton Lucas and over 100 other mayors signed a letter to President Joe Biden requesting that the federal government provide vaccines directly to cities. The letter stated that mayors want to make sure states “do not interfere” with allocations.

At the end of February, for instance, thousands of vaccines were left over and redirected after rural mass vaccination events in Missouri. At one event in Unionville in north-central Missouri, only 32.2% of the vaccines were used.

Right now, in Missouri, 31.4% of the population has started their COVID-19 vaccination. In Kansas, 34.2% have received one dose of the vaccine.

Difficulties finding a Kansas City COVID vaccine appointment

People who want the vaccine also have to navigate the vaccination tiers and rules of different counties and states.

Adam Davis, 47, of Lenexa, Kansas, has a health condition and became eligible to be vaccinated in Missouri earlier than in Kansas. Because Davis works in Missouri, he signed up with the Kansas City, Missouri, Health Department and Jackson County Health Department to be notified once a vaccine became available.

In the following month, Davis didn’t hear anything back but found an appointment at a Hy-Vee in Kansas City, Missouri, through a Twitter account that was sent to him from a coworker.

Four hours before his appointment, Davis got a call that he couldn’t get the shot because he lived in Kansas.

“I was trying to be patient,” he said. “It was very jarring to have an appointment and have it taken away.”

Instead, Davis drove an hour and 40 minutes to a Walmart in Chillicothe in north-central Missouri, which was allowing Kansans to be vaccinated. He found the spot from another email that was making its way around his workplace.

“They had a ton of appointments,” he said. “It didn’t seem like I would be taking the vaccine away from anyone.”

Back in Crawford County, the Health Department will vaccinate you at your workplace as long as at least 10 people are willing to receive them.

“Usually, we’re among the poorest, most underserved communities,” said Jason Wesco, executive vice president of the Community Health Center of Southeast Kansas. “To have access to the vaccine shows the success we’ve had in our work. It’s good to be able to do this for our community, but we’re not sorting people out. We welcome people from other communities.”

The health center is part of the federal Health Center COVID-19 Program. It has a location in Crawford County along with 14 others in southeast Kansas and Oklahoma.

In addition to Kansas Citians, the center has vaccinated people from Wichita, Lawrence and Topeka, Kansas, Wesco said. Some people have come from as far as Texas — at least six hours away.

Wesco said the reasons for traveling he’s heard include not knowing how to get the vaccine in their area, or that they weren’t eligible for the vaccine where they lived but were in the Community Health Center’s service area.

That was Comes’ experience.

“It seemed like the entire process of who qualified changed daily, but also changed depending on who you talked to and what report you read,” Comes said. 

He heard from a coworker that Dillons Pharmacy, part of the Federal Retail Pharmacy Partners program, was allowing government employees like him to get the COVID-19 vaccine. The closest location with available vaccines was in Pittsburg, Kansas, an hour and a half away in Crawford County. Meanwhile, Johnson County’s vaccine site is only 4 miles from his home.

Comes’ pharmacist at Dillons said there were one to two weeks with few vaccine appointments, but that since then, Kansas Citians have been filling the spots. Kroger, which owns Dillons Pharmacy, didn’t respond to a request for comment.

Comes said he felt privileged to be able to get vaccinated.

“I’m very aware that I was fortunate to get the vaccine. Even though I had to take off a half day of work to do it, that ultimately is a minor inconvenience,” he said. “I worry about the people who can’t travel to even a local site if they don’t have a car or can’t take off of work.

“Everyone needs to get vaccinated, but having the opportunity to is a very different thing.”

Send tips for finding a vaccine appointment and advice for overcoming vaccine barriers to our health care and environment reporter Brittany Callan. We may include them in an upcoming article. 

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Brittany Callan covers health and environment at The Beacon, and is a Report for America corps member. Funding for this reporting was provided in part by the Health Forward Foundation.