3 reasons West Virginia's COVID-19 vaccination effort is working so well

West Virginia is doing better than probably any other state in vaccinating its population against COVID-19. About 9 percent of West Virginians have already gotten their first dose, better than any state but Alaska, and West Virginia is No. 1 in giving out second doses, The New York Times reports. West Virginia has used 83 percent of the doses allocated to the state, by far the highest percentage.

Part of West Virginia's success is its size: With 1.8 million residents, its population is smaller than several U.S. cities. But the state's population is also older and less healthy than average. "People are dying every day," Albert Wright Jr., CEO of WVU Medicine, the state's largest health-care provider, told the Times. "We just realized, the only way out of this is to vaccinate our way out." The Times highlights three decisions that put West Virginia "at the top of the charts," as former FDA chief Dr. Mark McClellan said:

1. No to the feds: West Virginia decided early on to opt out of a federal program that relied on Walgreens and CVS to vaccinate people in nursing homes and long-term car facilities. Instead, West Virginia created a network of local pharmacies and nursing homes, to great success. "Using your local partners and really having more control over where the vaccine is going, that's what has been successful for West Virginia," Association of Immunization Managers chief Claire Hannan told the Times.

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2. Yes to the National Guard: West Virginia also put the National Guard at the center of its vaccination effort, a step other states have started taking amid slow rollouts. The National Guard "are logistical experts," said Jim Kranz, a vice president at the West Virginia Hospital Association.

3. Only promise what you have: West Virginia, after some mishaps, has also decided to require appointments for people to get vaccinated, and the state won't set up such appointments until they have the vaccines sitting in their own freezers. Other states have over-promised, only to have to cancel appointments when the vaccine ran out.

West Virginia's biggest hurdle now is the scarcity of vaccine supply, something it has no control over. The federal government is expecting hundreds of millions of more doses in the next few months. Read more about West Virginia's success at The New York Times.