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By BRYAN ANDERSON Associated Press/Report for America

RALEIGH, N.C. (AP) — Lawmakers said Tuesday in a meeting with North Carolina’s top public health official that the state lacks organization, flexibility and needs to give better instructions to counties on how to administer the coronavirus vaccine.

Data from the Centers for Disease Control and Prevention on Monday ranked North Carolina as the 10th slowest state in the country per capita in administering doses. A fourth of the more than 820,000 doses distributed thus far to North Carolina have been administered, according to state data shared with the CDC.

Mandy Cohen, secretary of the state Department of Health and Human Services, praised Iredell and Robeson counties for exhausting their supplies and not keeping any doses on the shelf but acknowledged other systems have unnecessarily reserved extra supply out of fear the federal government will fail to ship secondary doses.

North Carolina’s slow pace is not unusual, given many states are have vaccinated around 2% to 3% of their populations. Production will only continue ramp up, with vaccines being more widely available by the late spring or early summer.

A number of factors have contributed to North Carolina’s rocky rollout. Cohen pointed to ever-changing federal guidance complicating matters.

A CDC advisory panel urged states to give higher priority to adults 75 years or older a week into vaccine distribution.

President Donald Trump’s administration is expected to once again update its guidelines to expand preference to those who are at least 65 years old. The administration also plans to stop holding back millions of second doses.

“I’m all for course corrections in the middle, but understand course corrections mean that we have to change what we’re doing and it means the plans that were put in place do need to adjust,” Cohen said. “We’re going to incorporate new guidance as fast as we can and keep moving forward and continue with that sense of urgency of wanting to get vaccine out.”

During a Tuesday afternoon news conference, Democratic Gov. Roy Cooper signaled his support for the changes.

“Dr. Cohen and her advisory committee will work very quickly to make sure that we adjust our recommendations accordingly,” Cooper said.

She also said the fact that the Pfizer and Moderna vaccines come in bundles of 975 and 100, respectively, has “hamstrung” the state’s ability to more flexibly distribute the vaccine. The state has sent vaccines to all 100 counties, which improved regional access but added logistical hurdles. Navigating a new IT system also has challenged some local health departments.

Adding to the delays is vaccine hesitancy among nursing home workers and the absence of a statewide system for scheduling vaccine appointments.

State Sen. Jim Burgin, a Harnett County Republican, worries counties and hospital systems have had to go it alone in creating scheduling systems. Among his concerns is reports he’s heard in his community of elderly people having to wait in long lines of cars for appointments offered in person on a first-come-first-serve basis.

“You don’t have one plan. I know we have to be flexible because this is a moving target, but I still see that this was ripe for confusion to begin with,” Burgin said.

Cohen said she didn’t want to create “an additional layer of bureaucracy over an appointment system.”

“It seems to me it shouldn’t be difficult to have a plan for how you adjust your distribution,” said Rep. Hugh Blackwell, R- Burke.

Some counties have been overwhelmed by calls coming into their public health departments to schedule appointments, others lack an online sign-up portal and a few have been forced to turn away people due to limited supply.

Cohen reported more than 257,000 doses were administered by Monday throughout the state.

Lawmakers want the state to give more directions to local officials.

“It would be helpful to give some marching orders, even though they may not follow it, to some of the health departments so they have some sense of how to do this,” said state Sen. Gladys Robinson, D-Guilford.