Vaccine scarcity is giving way to hesitancy as issues of trust and access emerge, especially in more rural areas

Alaska’s top doctor awoke last Tuesday not knowing her state would throw open access to coronavirus vaccines that afternoon, making everyone 16 and older eligible for immunization.

Two messages that morning made clear to the chief medical officer, Anne Zink, that it was time to act. The first was a warning from a nurse on a statewide call that appointments for a large weekend clinic were going unclaimed. The second was a question from the governor, Republican Mike Dunleavy, who had seen the latest immunization data and phoned Zink to ask, “Why are we slowing down?”

The abrupt decision March 9 to discard eligibility requirements in Alaska — making it the first state to do so — illustrates how quickly access is expanding throughout the country, and some of the reasons. Chief among them is a lack of demand for the shots, as vaccine scarcity gives way to vaccine hesitancy, or even outright resistance in some communities.

Health officials said vaccine misinformation metastasizing online plays a role in that resistance and is adding to their sense of urgency about the pace of vaccinations. “It felt like we were in a race against not only the virus and the variants, but also misinformation,” Zink said.

Moves to simplify eligibility and expand access are signs of success, experts said. But as supply becomes more abundant, “vaccine hesitancy becomes all the more apparent,” said Katherine Poehling, a professor of pediatrics at the Wake Forest School of Medicine and a member of the panel that advises the government about how vaccines should be used.

Mississippi on Tuesday joined Alaska in making the vaccines available to all residents 16 and older. A number of individual counties, from the desert floor of Arizona to the coastal plains of North Carolina, have also beckoned everyone to make appointments. ...

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