Often overshadowed by the metropolis to its northeast, Peoria outshines Chicago and much of Illinois when it comes to coronavirus vaccinations.

Peoria County tops all 102 Illinois counties in pushing vaccines to its most vulnerable residents. As of March 4, according to the Illinois Department of Public Health, 84 percent of county residents 65 or older had received a first dose, two times the rate for Chicago and Cook County. Some 51 percent of Peoria seniors had been fully vaccinated as of that date, well above the statewide rate of 20 percent.

Surprised? So was Monica Hendrickson, public health administrator at the Peoria City/County Health Department, at a Feb. 24 event when Gov. J.B. Pritzker announced that “if Peoria County were a state, it would be No. 2 in the nation for total doses administered per 100,000 residents.”

“I’m very happy I had a face mask on, on live TV,” Hendrickson says. “Otherwise, my shock would be more expressive.”

Planning, partnership, outreach and centralization appear to be key factors boosting vaccination rates in Peoria and neighboring Tazewell and Woodford counties, especially among seniors. Most patients are within 15 miles of major health care providers. East Peoria in Tazewell County was designated as a regional vaccine distribution site, meaning doses were close by. And the local health department has strong ties to large hospitals in the area.

“They have all of the pieces: supply, great partnerships, great efficiency in how to register people. It was centralized,” says Courtney Hedderman, the associate state director of advocacy and outreach at AARP Illinois.

Chicago’s and suburban Cook’s total populations are each more than 13 times the size of Peoria, and more diverse, making their rollouts more complex, health officials say. Dr. Kiran Joshi, co-lead of the Cook County Department of Public Health, added that in suburban Cook, hundreds of thousands of health care workers, first responders and essential workers outnumbered seniors in the first phases of the vaccine rollout. Seniors got priority bookings at the United Center mass vaccination site, which serves both jurisdictions. Meanwhile, the city declared March as “Senior Month,” as part of a push to catch that population up.

While larger jurisdictions like Chicago and Cook County had to coordinate vaccination campaigns with multiple hospitals, clinics, community groups and government-run sites, Peoria relied on a small number of trusted local organizations with broad reach.

Two big hospitals—OSF and UnityPoint—are located right in the middle of the tri-county area, and Heartland Health Center, a federally qualified health center, is nearby. So when health officials convened the three and crunched patient data, they found roughly 90 percent of the county’s seniors were already in their systems.

Each had different attack plans for getting patients signed up, and Hendrickson’s team pushed doses to all three to accelerate vaccinations. OSF and UnityPoint also enlisted independent physicians—who are often left out of the loop elsewhere in Illinois—reaching out to ask for lists of patients they could get booked for shots.

“As you can imagine with two large health care entities, we’re fairly competitive with each other,” says Dr. John Miller, the vice president of medical affairs at UnityPoint Health, noting the chain’s downtown Peoria hospital stands just across the highway from OSF St. Francis Medical Center. “But our key to success was cooperation, not competitiveness.”

UnityPoint staffed a call center with just under a dozen people to contact patients. At the Methodist Atrium in downtown Peoria, staffers deployed from UnityPoint primary care clinics can jab up to 700 people per day, Miller says. OSF can inoculate a similar number at a vacant Peoria nursing home converted into a vaccination center. Both facilities are accessible by bus and don’t have stairs for seniors to climb.

OSF ranked their oldest patients and reached out first to those with the biggest health risks, booking them through an electronic system. “Patients would call it their golden ticket. They could self-schedule at our clinics and make second-dose appointments. Then we did calls, and we’re now starting text-based messages to say, ‘Hey, we’re waiting to hear from you,’ ” says Sarah Overton, OSF’s chief nursing officer and vice president of clinical services.

AARP’s Hedderman says two of the biggest challenges for Illinois counties have been managing public expectations about shot availability and ensuring equitable distribution of vaccines.

Peoria is working on the latter. Hendrickson called on nonprofit ambulance service Advanced Medical Transport to bring shots directly to people not connected to a health center.

“We have the people, the vehicles. We have the ability to take the show on the road,” says Josh Bradshaw, AMT’s community resource manager. AMT sends vaccine strike teams to homeless shelters, affordable housing buildings and senior-living facilities. The service expects to have fully vaccinated 1,420 people by the end of March.

Bradshaw says AMT already had a years-long working relationship with Hendrickson’s department, including collaboration on a testing site for first responders earlier in the pandemic. “By the time we got to the vaccine, we had partnerships, relationships, supply channels, so many things figured out that, I don’t want to say it was easy for us, but it wasn’t insurmountable that we could make this happen in an efficient manner.”