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story.lead_photo.caption An advisory shown at covidvaccine.mo.gov/map/ on Sunday, Jan. 17, 2021, indicates the Missouri vaccination availability map is intended for use at this time only by populations that are eligible for Phase 1A and Phase 1B Tier 1 priority vaccination.

Wondering where to go to get a coronavirus vaccine in Missouri? On Friday, the state launched an interactive map detailing where more than 1,100 providers are located across the state.

But not all locations identified on the map as providing the vaccine actually have vaccines on hand to administer. And reports that the federal government has already exhausted its supply of reserve COVID-19 vaccines could hamper efforts in Missouri to quickly expand the number of residents with shots in arm.

"Before contacting a vaccinator on this map to coordinate your vaccination, please understand that many vaccinators are still awaiting supplies from the federal government," the map notes.

Among the providers listed is the Sullivan County Health Department in Northern Missouri. On Friday, Deborah Taylor, the administrator of the Sullivan County Health Department, said her department has yet to receive its first vaccine shipment.

The department was approved as a vaccinator a couple of weeks ago, Taylor said, and worked with other providers in the region to submit an order for a shipment of Pfizer vaccine.

"We're just waiting," Taylor said.

It's an issue providers are facing across the state. Currently, a request for doses does not mean an order will be approved, due to the state's limited supply.

Members of the state's vaccine planning and distribution team stressed Thursday that while the state is expanding who is eligible to receive their first dose, the state hasn't received enough vaccine from the federal government to cover everyone within those categories.

Starting Thursday, first responders and other health care workers can now receive their first dose after the state activated the first tier of "Phase 1B." On Monday, tier two will begin, allowing residents 65 years and older and people with certain underlying health conditions, like cancer or Type 2 diabetes, to be vaccinated.

The two tiers contain more than 40 percent of the state's population, with an estimated 2.7 million people.

The state is still working through vaccinating all of the roughly 500,000 frontline health care workers and residents and staff of long-term care facilities who are in "Phase 1A." The state's vaccine distribution and planning team said Thursday that an estimated 35-40 percent of Phase 1A has received their first dose, with about 18 percent of long-term care facilities residents and staff having received that initial shot.

Juanita Welker, the administrator of the Bollinger County Health Center, said her health department had not yet ordered any doses because residents in her area weren't yet eligible under Phase 1A. Health departments were informed of the newly activated tiers on Thursday morning, and since the state's announcement, "the phone's ringing off the wall," Welker said.

Requests for doses must be submitted to the state by 5 p.m. on Wednesdays, but the state didn't announce it was expanding eligibility for the vaccine until Thursday. That means some providers may not see a vaccine shipment for at least another week — and that's if their order is approved.

"It kind of caught us off guard," Welker said of Thursday's announcement. "Notice would have been helpful — at least a week."

Adam Crumbliss, the director of DHSS' Division of Community and Public Health, said on a call with vaccinators Thursday that the limited supply will continue to be a "rate limiter."

"Simply because we're moving into a new tier, does not mean that we have suddenly developed a new vaccine supply chain," Crumbliss told vaccinators. "We're still constrained in what we have."

Lynelle Phillips, the president of the Missouri Immunization Coalition and vice president of the Missouri Public Health Association, said the state faces "a big distributive justice challenge." It must weigh when competing groups will receive the vaccine, like people who are high-risk because exposure could make them sicker versus those who are high-risk for potentially more widespread exposure.

"You have to — in public health decision making — justify why the 80-year-old with Type 2 diabetes who never goes anywhere gets vaccinated first, before the very healthy 21-year-old that's returning to campus that could potentially spread COVID all over the place," Phillips said. "It's just a real conundrum."

The map unveiled Friday marks the first comprehensive look at who has been approved to offer the vaccine throughout the state. Earlier in the week, local public health departments had said they had not yet been told by the state who else was providing the vaccine.

The Missouri Independent is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.

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