As more avenues open for residents to be vaccinated against COVID-19, Dubuque County health officials reported Monday that local providers have appointments to fill.

“With our other vaccine providers, they are looking at some difficulty filling appointments with the allotment they’ll be receiving this week,” County Health Department Director Patrice Lambert told the county Board of Supervisors.

As of Monday, 53.6% of Dubuque County residents who are at least 16 years old have received at least one dose of a COVID-19 vaccine.

Kara Nadermann, director of pharmacy at MercyOne Dubuque Medical Center, told the Telegraph Herald on Monday that 1,000 of 1,700 appointments were available for local MercyOne clinics this week.

“From our assessment, it seems that people that were actively seeking appointments have been able to secure an appointment and be vaccinated,” she said in an email. “We want people that were delaying vaccination, for fear that others at higher risk were not able to get vaccinated, to know that vaccines and appointments are readily available and now is the time to roll up their sleeve.”

Reports nationwide have shown a significant amount of “vaccine hesitancy,” or skepticism in the vaccines against the coronavirus. Lambert has acknowledged that skepticism in Dubuque County, but she told the Telegraph Herald that there are a variety of reasons that providers have open appointments.

Many of those reasons are unrelated to such hesitancy.

“We know that when some of our providers contact their patients or anyone they have on their lists, a lot of people have conflicts with their work schedules,” she said. “The appointment that provider has might just not work for the person. Then, some of the people may not have all the correct information. Some might not know that they’re eligible for the vaccine.”

Per Gov. Kim Reynolds, all Iowans qualified for the vaccine as of April 5.

Lambert said another problem is that residents are casting wide nets to receive the vaccine.

“Some have triple-booked themselves to different pharmacies or even gone outside the county,” she said. “They will go to whichever one was first and then didn’t cancel their other appointment.”

U.S. Rep. Ashley Hinson bemoaned this problem during a call with reporters on Friday, especially as she said she and the rest of Iowa’s congressional delegation are pushing for more doses to be delivered to their state.

“I think it’s frustrating also when I’m hearing that many of the appointments to get the vaccine are canceled,” she said. “I saw that about 30% of those appointments are no-shows in many places. Those are shots that could be going in people’s arms.”

Lambert said Dubuque County is trying to keep those problems to a minimum.

“We are seeing no-shows,” she said. “But previously, when people would call our different numbers, we would put people on a waiting list. If providers were planning on doing a clinic at the (point-of-distribution site) or in their office and had people not show up, we had a list of people to give them.”

Robin Scalise, vice president of operations at UnityPoint Health-Finley Hospital, said that so far no-shows were not a huge problem there, mainly because to date most appointments have gone to regular patients.

The county COVID-19 Incident Management Team now is specifically asking residents to either keep their appointments or call to cancel them if they are no longer needed.

“That would help a ton,” Scalise said. “It would help us know how much vaccine should be thawed and reconstituted. So far, between all of us, we manage to use up the vaccine. But it’s pretty labor-intensive.”

Lambert said the county’s new vaccination phone line at 563-690-6253 can help ensure those still needing to be vaccinated get paired up with providers who have open appointments. In its first week, City of Dubuque staff fielded 710 calls to the line and were able to schedule vaccination appointments at several area providers.

“MercyOne (Dubuque Medical Center), Hartig (Drug) and Walmart worked last week because they had spots available and appointments could be easily scheduled,” said Randy Gehl, City of Dubuque public information officer and a member of the county’s Joint Information Center for COVID-19. “Vaccine navigators did verbally refer some people to other sites if they said they could sign up on their own, but we don’t track those because we cannot confirm.”

Lambert also said she hopes that as more providers and more sites come online to administer the vaccine, conflicts for residents will decrease.

“We are seeing that (happen) as our pharmacies are getting more and more through their federal program,” she said. “We also have the new site at Grand River Center.”

Lambert said Dubuque firefighters administered 210 vaccines at the Grand River Center site on Thursday. Of those, 75% went to people in demographics defined by the Iowa Department of Public Health as vulnerable populations.

Gehl said the City of Dubuque also did specific outreach to clients of low-income-housing programs.

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