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Montana sticks to its patchwork COVID vaccine rollout as eligibility expands

Katheryn Houghton, Kaiser Health News on

Published in News & Features

MISSOULA, Mont. — Montana’s COVID-19 vaccine distribution is among the most efficient in the nation, but closer examination reveals a patchwork of systems among counties and tribal governments that will be put to the test as the state opens vaccine eligibility to all people 16 and older starting this month.

KHN, Montana Free Press and the University of Montana School of Journalism surveyed all 56 counties and eight tribal governments to find out how vaccine distribution has worked over the past four months and what residents might expect when the floodgates open.

Montana’s rate of COVID-19 vaccines given is in the top tier in the nation, according to the Centers for Disease Control and Prevention. More than 186,500 people — roughly 17% of the state’s population — had been fully vaccinated by the end of March. But that progress papers over a disjointed rollout that’s been left to individual public health departments that are already overstretched. An increasing number of employees have resigned after working long hours while being harassed and blamed for enforcing COVID-19 restrictions such as mask mandates. At least 10 counties have lost their top health official in the past year, though many more public health workers have left jobs.

The pressure remains as larger shipments of vaccines arrive and highly contagious variants of the coronavirus spread in Montana. More pharmacies are coming online to administer doses, which is expected to help in the race to vaccinate Montanans. But the task of ensuring everyone who wants a shot gets that chance will likely continue to fall on local health officials.

For those seeking vaccines, the process can be bewildering. In Missoula County, Dennis Klemp qualified early on for the shot as an 81-year-old with kidney disease. Klemp, who doesn’t have a computer, put the county’s health department on his phone’s speed dial and called daily, but he was unable to secure a spot in vaccination clinics that filled within minutes.

“I was pretty despondent,” Klemp said. “There was mass confusion, and I’ve got a lot of friends who were just as confused as I was.”


After spending more than a month trying to book an appointment, Klemp called his local television station for help in February. NBC Montana reporter Maritsa Georgiou said she managed to book an appointment for him over the phone, and she estimated she similarly helped at least 30 others register for vaccines.

There are multiple ways to get a vaccine in Montana. Tribal governments are getting doses to Native Americans and some are also vaccinating non-Natives either through the state or the federal Indian Health Service program. The U.S. Department of Veterans Affairs is a source for veterans, their spouses and caregivers. Federally contracted pharmacies are giving vaccines to the general public after distributing shots in assisted living centers.

For counties and tribes that participate in the state program, a mishmash of strategies has resulted in the absence of a detailed state plan to sign up people for doses. Montana’s patchwork approach is no accident. State leaders deliberately left it up to local governments with few rollout guidelines because they said local leaders know best how to reach their residents.

Some states have set up one-stop vaccine registration systems to bring order to the scramble of the largest vaccine effort in history. But Jim Murphy, head of Montana’s Communicable Disease Control and Prevention Bureau, said that a pandemic wasn’t the time to force a new system on local governments, and that Montana’s approach is working.


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