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Efforts to administer COVID-19 vaccines in rural southwest Montana is underway, as county health departments coordinate with local providers and pharmacies to reach far-flung and sometimes isolated residents.

The nationwide rollout of the COVID-19 vaccine already promised to be complicated, with volatile, unknown supply, heavy demand and logistical challenges related to scheduling people for two doses weeks apart without causing crowding at immunization sites.

The 1A phase in Montana — which included frontline health care workers and staff and residents of long-term care facilities, has been ongoing for weeks, but counties are preparing for the 1B and subsequent phases.

It is still unclear to some counties and providers when they will receive vaccines for the 1B phase, and how many doses they might get.

But officials are already starting to wrestle with the challenge of reaching out to people who are eligible in that phase — those over 70, ages 16 to 69 with certain health conditions, or at-risk Native American people and people of color — and scheduling their immunizations.

Rural counties face particular challenges in that effort.

“We’re a very big county,” Park City-County Health Officer Dr. Laurel Desnick said. “We have people spread out for hundreds of miles, so we’re hoping to take the vaccine to some of the more rural parts of the county.”

The health department is focusing on people over 80, Desnick said, and is calling on churches and other groups that serve older people to help keep them informed.

On Friday, Desnick said her department received a slew of calls after releasing a video with information about vaccinations.

Many of those calling were in their 80s, or older. One 101-year-old woman who has spent months during the pandemic alone called in, Desnick said, ecstatic that she may soon be able to be vaccinated.

The department placed an order for vaccines, Desnick said, and are expecting to hear about their allocation early next week.

Besides the city-county health department, four other providers in Park County are preparing to immunize people: Livingston HealthCare, Community Health Partners, Osco Pharmacy and Western Drug.

Livingston HealthCare chief medical officer Doyle Coleman said having five vaccine providers helps take the burden off the county and his health system, but cautioned patience will still be needed

“Demand is going to greatly exceed supply for probably at least the first month,” Coleman said.

The county and Livingston HealthCare are contacting the state directly for vaccine allocations, but Desnick said they are expecting to share some of their allocation with local pharmacies until they are able to get their own supply.

“We don’t want to be holding back vaccines,” Desnick said. “The more providers we have that can offer appointments the sooner this vaccine gets out to people.”

A lack of consistent information on vaccine availability has hampered communication efforts for some health care providers in the region, several officials said.

Livingston Healthcare is working on a plan to reach older people who live independently, Coleman said.

“We can identify those in phase 1B, but how do we reach them and how do we get them scheduled?” Coleman said. “I’m worried about folks over 70 who just don’t spend much time on the internet.”

Park County is using social media, their emergency alert service and print media to put out information on the vaccine, Desnick said, and providers like Community Health Partners are preparing to reach out directly to patients who may be eligible.

In Madison County, local health care providers are preparing for vaccine administration with logistical support from the county government.

Allen Rohrback, Madison Valley Medical Center CEO, said they are getting calls from interested people who are eligible in the 1B phase.

Like other health care providers, the medical center staff are compiling a list of patients interested in the vaccine, and will start reaching back out to them once they know when they’ll have doses on hand, Rohrback said.

Ruby Valley Medical Center is also asking for those who meet the 1B criteria and are in their service area to contact them, COVID-19 task force spokesperson Emilie Sayler said, or to their primary care providers.

It’s too early to know how many people the medical center will vaccinate in the 1b phase, Sayler said, but some of the challenges smaller and rural communities face can also help them.

“One thing you have to consider with rural Montana, especially destination areas, is that our population fluctuates seasonally ... so that will make a big difference over time,” Saylor said. “The best part about living in a small community is we have resources to reach out to our most isolated residents, and everyone has been willing to work together.”

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Nora Shelly can be reached at or 406-582-2607.