Rural communities across the Inland Northwest have moved quickly to vaccinate their health care and frontline workers, including staff and residents in long-term care settings.

Now, small towns are basically awaiting the state’s go-ahead to move into the next phase: vaccinating residents older than 70 and people older than 50 who live in multigenerational households.

“We’re gunning to go to the next phase because we want to get it out into our communities, and we want to start vaccinating our high-risk people,” said Michelle Wilkins, quality manager at Lincoln Hospital in Davenport.

The success of the vaccine rollout in many rural communities stands in contrast to the slow pace in cities, where heavy criticism is prompting changes at the federal and state level.

The Lincoln Hospital’s clinic has five doses that must be given out this week due to an open vial. Beyond that, everyone eligible in the state’s vaccination phases who wants it at Lincoln Hospital and in northern Lincoln County has received at least a first dose.

To the north, Ferry County is experiencing a similar scenario. Most frontline workers and first responders in Republic have received their second dose of the vaccine in the past week.

Aaron Edwards, CEO of Ferry County Health, said they received no doses in the initial shipment to sites statewide, but Northeast Tri County Health District and North Valley Hospital shared some of their doses with the critical access hospital.

Ferry County Health has both Moderna and Pfizer vaccine doses. It also has a list of community members interested in receiving those doses, but needs the official “go-ahead” from the state. Ferry County Health has about 300 doses of both vaccines left, Edwards said, which will be given to residents when they are deemed eligible.

“It’s not like we’re sitting on massive amounts of vaccine,” Edwards said.

Edwards said he has not been asked to send his doses elsewhere, and the logistics of a transfer could be tricky, due to the ultracold storage and shipment requirements.

But in a small community like Republic, getting more people vaccinated quickly is at the forefront of priorities for Edwards. The critical access hospital there also has a long-term care unit for seniors, and keeping residents safe and getting providers and first responders coming into the hospital vaccinated was of the highest importance to him. Edwards, like other rural providers, wants to continue to use the vaccines in their communities as the pandemic grows.

Republic has the freezers to store the vaccine doses, but it doesn’t have a respiratory therapist. With the virus rates as high as they are statewide and in the region, Edwards said he is focused on ending the pandemic in his community as quickly as possible, noting that it will also help alleviate more populated parts of the state, such as Spokane, where patients are transferred for more intensive treatment.

Dr. Sam Artzis, health officer of the Northeast Tri County Health District, agrees that rural communities should be vaccinating as many people as possible, as quickly as possible, to ease the burden on larger health care systems.

“The more people we get it into, the less people we’re sending down to Spokane,” Artzis said. “It makes no sense for us to put the brakes on or redistribute it elsewhere.”

The Northeast Tri County Health District has received vaccine doses and has been getting them out the door almost as quickly as they arrive. While the district does not have a lot of its first allotment left, providers throughout the three northern counties are beginning to compile lists of patients who would be next in line.

District Administrator Matt Schanz said the majority of second doses from the district’s first distribution are being administered this week. Schanz asked that residents not flood hospital and clinic phone lines asking about vaccines, however, as it’s unclear when their next doses will arrive.

“We haven’t heard back from the Department of Health of when our next availability or shipment of vaccines for new recipients will be,” Schanz said late last week. They expect to learn about the status of more doses for the district by Thursday.

The state is not in charge of delivering vaccine doses, which are coming from the federal government or the vaccine manufacturers. The state, however, is placing orders on behalf of vaccine distributor sites, prioritizing where the state’s allotted doses go.

The Whitman County Department of Public Health reported that providers countywide are continuing to vaccinate frontline workers there this week, with more than 1,000 doses administered.

While some rural hospitals are finishing up the first phase of vaccine distribution, not all rural health care providers that have signed up to distribute the vaccine have received it.

Dana Fox, CEO of Mattawa Community Medical Clinic, said they have yet to receive any doses of the vaccine, which she said would help, as the community has seen a dramatic uptick in COVID-19 activity since the winter holidays.

The clinic does COVID-19 testing for a catchment area of about 6,000 people as well as seasonal workers who come to the region and are scheduled to arrive soon. Fox is concerned that her small operation is going to be tasked with an influx of people needing virus testing at the same time they receive the vaccine.

“We need to have the vaccine available, continued supply of the BinaxNOW testing, supplies and funding to continue to support our community,” she said during a Tuesday call with U.S. Sen. Patty Murray.

Distributing vaccines to frontline and health care workers statewide has proved challenging, as some workers are hesitant to take it. Artzis estimates that about 50% of those eligible to get the vaccine during the first phase accepted it.

“A third or a quarter of those (who didn’t take it) are waiting to see what’s going to happen with their colleagues,” he said.

Wilkins said she is encouraging those debating whether to get the vaccine to do their research, and noted that some frontline workers who were on the fence or said “no” initially have now been vaccinated. In the meantime, the clinic in Davenport is making a list of patients who would be eligible to prepare for when they can move ahead.

But for now, they wait.

“I understand in a bigger area there needs to be more time,” Wilkins said, “but in smaller communities, our hands are tied.”