Most states’ vaccine distributions have been slow, confusing, and erratic, with balky signup websites, arbitrary changes in eligibility, and frequent mismatches between supply and demand.

But a few states with smaller populations have fared better. They started planning early, called up the National Guard to help even before they knew how or when to set up mass vaccination sites and scrapped the idea of using big chain pharmacies for distribution, knowing that smaller local drugstores had better handles on their clients’ qualifications and needs.

Alaska has been among the most successful states, according to data from the Johns Hopkins Coronavirus Resource Center. It has vaccinated about 3.3% of its population, exceeded only by West Virginia with 3.8%. South Dakota has vaccinated 3.2% of its eligible population, while Maine, New Mexico, and North Dakota are at 2.9%.

Alaska used planes, amphibious vehicles, and snowmobiles to make itself one of the most successful states so far at getting the COVID-19 vaccine into the arms of its residents. Mountainous terrain and wintry weather further complicated the effort.

“On my first airplane trip, the vaccine froze in the metal part of the needle when I was vaccinating on the tarmac and I had to keep it warm by tucking it between my coat and my shirt until right before we gave the vaccine,” said Dr. Ellen Hodges, Yukon-Kuskokwim Health Corporation chief of staff, in an email.

“We vaccinated people on snow machines, on four-wheelers, in trucks, in airplanes, standing on tarmacs in -20 windchill, in clinics, in houses—basically anywhere we could to get as many people vaccinated as quickly as possible. I feel like we are in a race against this terrible disease.”

Alaska dubbed its vaccine distribution effort “Project Togo,” named after the hardiest husky in the 1925 sled mush to Nome. The dog ran 350 miles of the 1,150-mile trek from Seward, Alaska, to Nome, on the Bering Sea.

Meanwhile, states with larger populations and relatively sophisticated health care systems, including Massachusetts and New Jersey, have been lagging, with 1.3% and 1.4% vaccinated, respectively.

Now some populous states are taking a page from the successful states’ books and changing course, setting up more centralized systems, calling up the National Guard to help with distribution, and revamping signup websites. Massachusetts Gov. Charlie Baker, a Republican, unveiled several steps last month to speed up the rollout, including plans to open a mass vaccination site at Fenway Park, home of the Boston Red Sox, at the beginning of this month.

California Gov. Gavin Newsom, a Democrat, said late last month that his state would streamline the vaccination process by building a statewide vaccine administration network instead of leaving distribution to county and local health authorities. He also said that after the current group of eligible people are inoculated, age will determine vaccine eligibility. And, he said in a news release, a new website will streamline the signup and notification process.

Read the full article about vaccine distribution by Elaine S. Povich at Stateline.