Rural Americans in pharmacy deserts hurting for Covid-19 vaccines - CNN

But more than 1.6 million people must travel more than 20 miles to the nearest pharmacy, which can mean facing difficult weather and road conditions in remote areas.

"If pharmacies are closed, especially in places where there's no other health care provider, then you've got essentially a health care desert," said Michael Hogue, president of the American Pharmacists Association.

But as vaccination opens up to the general public and supplies of the vaccines increase, local health departments may be overwhelmed with demand and may need to offload the task of vaccinating local residents to other health care providers.

"It's probably not playing out yet because we're not getting enough supply," said Keith Mueller, director of the Rural Policy Research Institute's Center for Rural Health Policy Analysis.

"That means we have some time for those local health departments to figure this out: Who in my radius, if you will, has the capacity to administer vaccines?"

From 2003 to 2018, 1,231 independent rural pharmacies closed, Mueller's team found, leaving some 630 rural communities with no retail drugstore.

"We don't even have a doctor."

With the closest pharmacy located in a neighboring county an hour away in Durango, vaccinations in San Juan County have been handled by the public health director and two nurses.

Hospitals, which didn't traditionally vaccinate the general public, have had to create programs to distribute their allocated doses.

In Colorado, pharmacies give over a million flu shots a year, said Emily Zadvorny, executive director of the Colorado Pharmacists Society, and, particularly in smaller towns, have a much closer relationship with their customers than larger health care providers do.

Pharmacies that are not part of those networks can apply to be vaccine providers in their states.

"The biggest hurdle for most pharmacies is just getting approved," said Kyle Lancaster, pharmacy director for Our Valley Pharmacy, a three-pharmacy chain in rural Lincoln County, Wyoming.

Our Valley applied to federal and state health agencies and had to upgrade its freezers with digital data loggers, which upload the pharmacies' refrigerator and freezer temperatures and report them directly to the CDC.

Most small pharmacies like his, he said, had been limited to the Moderna vaccine, which has less stringent temperature requirements than Pfizer's version.