Four months to the day since Hawaii’s first COVID-19 vaccinations were given to health care workers at The Queen’s Medical Center, the state hit 1 million doses administered across the islands, according to the Department of Health.

But even while announcing that milestone Thursday, public health officials expressed concern about a sudden drop in vaccination demand in some areas and are urging residents to take advantage of the ample opportunities to get inoculated against the virus that has sickened 31,075 and killed 473 in Hawaii.

Preliminary DOH data shows 1,007,966 vaccine doses administered statewide as of Wednesday. Health officials also reported 98 new infections, with no new coronavirus-related deaths. The new cases include 59 on Oahu, 24 on Maui, 14 on Hawaii island and one on Molokai.

Statewide, 33% of residents have received at least one dose so far, compared with 38% nationally. Kauai is leading the way, with at least 43% of its residents getting at least one dose, followed by Maui and Hawaii counties at 36% and 35%, respectively, and Oahu at 32%. Those percentages do not include doses from federal pharmacy programs or federal agencies.

Oahu is offering vaccinations to residents age 50 and older and will expand eligibility to those age 16 and older starting Monday. Neighbor island counties moved into that final phase of the state’s vaccination program April 5.

Although next week’s projected federal vaccine allotment to Hawaii is 73,120 doses, down from 76,060 doses this week and 90,080 the previous week, some vaccination sites are reporting far more doses available than there are people seeking vaccinations.

Kauai District Health Officer Dr. Janet Berreman said residents “who were eagerly waiting were happy to make appointments and come in and get vaccinated” once eligibility was expanded. “But the urgency of demand is certainly slowing down a little bit. … There’s also increased availability in the community, so for any one site there’s not the overwhelming demand that there was before. People either aren’t making it a super-high priority or they don’t feel a sense of urgency. And there is some level of concern to see how it goes.”

Despite the apparent hesitance, Berreman said she looks at the current situation as “glass half empty, glass half full.”

“The District Health Office has 650 available appointments, and we’re not filling all those but we’re still vaccinating 1,500 people a week, and that’s meaningful progress that will continue to get us to where we need to be,” she said.

On Maui, District Health Officer Dr. Lorrin Pang said appointments at DOH vaccination “pods” were “way down” in the past week even as vaccine availability and the convenience of getting a shot have increased.

“Normally, we have 900 appointments in one six-hour session, and we are filling maybe half of those,” he said.

Pang said he spoke informally with people who came in for shots about why family members and friends may not be getting vaccinated, and found that while a small number of the unvaccinated may have “extreme” positions on immunizations or have succumbed to conspiracy theories or prefer to rely on unproven “holistic” prevention methods, many others have an understandable “wait and see” attitude about possible long-term effects.

Both Berreman and Pang said recent federal action to pause distribution of the one-dose Johnson & Johnson vaccine to assess a possible link to six cases of rare and severe blood clots out of 7 million doses should actually reassure the public.

“That tells us the safety system is working really well, and the federal response to that was exactly what it should be,” Berreman said.

Another argument for getting vaccination, according to Pang, is that 30% of COVID-19 infections in young and old result in serious, prolonged symptoms. “People don’t really have knowledge of ‘long COVID’ and the five or six months of symptoms that occur. We have to push hard on these things,” he said. “You certainly don’t want brain fog.”

Perhaps the best persuasion, he said, is to promote the idea that getting vaccinated will make it easier to travel, attend sporting events and other public activities, and otherwise circulate.

“Once somebody dangles the carrot of (‘vaccination passports’) for inter- island travel, that might bring on a lot of people who have been waiting,” he said.

DOH spokesman Brooks Baehr agrees that “getting the next million will be more of a challenge.” The Health Department plans to boost outreach to community, business and church leaders on vaccination benefits and opportunities, he said.

“What we are seeing is that people may not be taking as much advantage as we would like of getting vaccinated through the federal pharmacy program” at CVS/Longs Drugs, Safeway, Walgreens and other neighborhood locations, Baehr said.

“We certainly hope that people do not think, ‘Now that it’s open to me, there’s no urgency.’ Get it as soon as you can to not only protect yourself and your family, but all of us. You’re helping our airlines and hotels and all of us to get back to something we all long for: life as it was in ‘the olden days.’”

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