The tribe in Oklahoma is facing a problem that is likely to become more commonplace across the country: how to vaccinate everyone not eagerly lining up for a shot.

By Jack Healy

TAHLEQUAH, Okla. — As people across the United States jockey and wait to get vaccinated, a surprising problem is unfolding in the Cherokee Nation: plenty of shots, but not enough arms.

“We’re running out of people to vaccinate,” said Brian Hail, who helps oversee the tribe’s vaccination efforts. He winced as he pulled up the day’s schedule one recent morning: Vaccinations were open to basically everyone across the reservation, but 823 appointments sat unclaimed.

It is a side effect of early success, tribal health officials said. With many enthusiastic patients inoculated and new coronavirus infections at an ebb, the urgency for vaccines has gone distressingly quiet.

Now, the tribe is confronting what looms as a major hurdle for the entire country as vaccine supplies swell to meet demand: how to vaccinate everyone not eagerly lined up for a shot.

It is a dizzying public health challenge that cuts across the country. It encompasses persuading skeptics, calling people who do not realize they are now eligible, and making vaccines accessible for homebound patients, overstretched working families and people in rural areas and minority communities.

The Cherokee Nation has administered more than 33,000 doses at nine vaccination sites across its reservation, which spreads from cities through rural woodlands, cattle pastures and poultry farms in northeastern Oklahoma. After vaccinating health care workers, Cherokee-speaking elders and essential workers, the tribe opened appointments to anyone who qualifies, tribal member or not, living in its borders.

Still, hundreds of slots have gone unfilled, health officials said. Cherokee-speaking vaccine schedulers hired to set up appointments are waiting for their phones to ring.

“Those initial waves of people that really wanted and needed the vaccine — we worked through that,” said Mr. Hail, deputy executive director of external operations at Cherokee Nation Health Services. The tribe counts 141,000 citizens on the reservation and 380,000 worldwide. “We’re struggling to get people to come in.”

Dennis Chewey, 60, gave his brother and sister the tribe’s vaccination hotline and urged them to call. Mr. Chewey’s wife was at high risk because of her job as a casino housekeeper, and he knew several people who had died, including a health worker who had helped him treat his diabetes. But none of them had called.

“They’re leery of taking it,” Mr. Chewey said, a few minutes after he and his wife, Clara, got their second dose at the tribe’s gleaming new outpatient clinic. “They’re my family. I can’t make anybody do anything.”

Public health teams across the country are refocusing their energy and resources on bringing vaccinations to people.

They are plunging into New York neighborhoods to reach homebound people, and visiting rural communities where unreliable internet makes it difficult to sign up for appointments or log into vaccination websites. They are driving long dirt roads to reach families without the cars or gas money to visit vaccination clinics.

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