“Most of our major providers already have those systems built, so we weren’t going to say, ‘Well, here’s another big road you can take,’” Murphy said. “Just didn’t seem like it would be worth that effort.”
Nicholas Stewart, a senior research scientist at the international health data nonprofit Surgo Ventures, said Montana’s high national ranking, despite its lack of a unified system, has been a surprise.
Montana’s success may be partly due to officials’ familiarity with the inherent challenges that come with delivering health care in the fourth-largest state by land, yet eighth-smallest state by population. Public health workers have long worked to reach isolated people and spot hurdles to accessing care, such as a lack of internet access.
Ideally, states would test different scenarios before expanding vaccine eligibility, but needs have rapidly shifted. “What we have constantly been seeing is decisions are being made on the fly,” Stewart said.
In Carter County, in the southeastern corner of the state, early vaccine efforts faltered because nobody was on hand to administer the shots. The area’s health officer resigned in mid-December and the county had been without a public health nurse since summer. In January, residents eligible for a shot had to drive to neighboring Fallon County, where Carter County had sent its allotment of vaccines to prevent wasting doses.
Trish Loughlin, Carter County’s interim public health nurse, has led the vaccine effort part time since late January. Despite the initial lag, Loughlin said, the county is catching up and everyone who wants a dose should be able to get one by early April.
“The collaboration of a neighboring county is what helped; it’s the only way we did that,” Loughlin said.
Fallon County’s health director also resigned in December. Mindi Murnion, Fallon County’s public health specialist, said residents angry about pandemic-related rules drove out the health director before the county got its first supply of COVID vaccines.
“There was a little bit of panic,” Murnion said. “But after we got through that first clinic, now we whip it out like clockwork.”
She said she’s relieved the state let Fallon create its own vaccine plan, which includes calling people already in its system to book appointments and working with other counties to move doses based on need.