DES MOINES, Iowa -- Amid lagging demand, Iowa officials are encouraging anyone who's eligible to get a COVID-19 vaccination. Community pharmacies hope their connection with local residents will convince those on the fence to sign up.

This week, Gov. Kim Reynolds said the state has had to reduce requests for vaccine shipments as more counties decline them.

Lindsey Ludwig, executive director of the Community Pharmacy Enhanced Services Network, which works with independent pharmacies and smaller chains, said the slower pace isn't only because some people refuse to get a vaccination.

"Say, county road workers, they're working a ton of overtime right now, and they just don't have the time to find a place to get vaccinated," Ludwig explained. "Or, they don't have the time to be off work if they do, you know, have a day of side effects."

She added some farmers, busy with spring planting, might want to get a vaccination but can't right now.

For those who want more assurance about vaccine safety, Ludwig said local pharmacists and providers have accurate information. A number of locations in her group's network are expanding vaccination clinic hours to meet more flexible scheduling needs.

State health officials are no longer advising those who had their first shot to go back to the same location for the second one. They're free to take their vaccination card to any pharmacy or provider.

Ludwig hopes moves like this will boost demand, like the state saw earlier this year.

"We know it works, and we just need to improve the confidence level for those that might not be ready yet to receive the vaccine," Ludwig urged.

The network has more than 120 pharmacies in Iowa providing shots.

Meanwhile, groups like AARP Iowa said getting vaccinated is still a crucial step to protect vulnerable populations, such as people over age 50.

Iowans who don't have access to or don't use a computer can call 211 and work with a vaccine navigator to schedule an appointment.

LAS CRUCES, N.M. -- A new study showed people who do not have a close friend or family member who has experienced a run-in with COVID-19 are more likely to express vaccine hesitancy than those who know someone who has been sick.

Jagdish Khubchandani, public health sciences professor at New Mexico State University, one of the researchers to probe vaccine hesitancy and reasons for it, said study participants were asked if someone in their social circle had been infected, hospitalized or died due to COVID-19.

"And those who said yes are more likely to accept a vaccine," Khubchandani reported. "So those who do not know anyone who has died in family or friends or hospitalized are two times more likely to deny a vaccine."

The study was published last week in the International Journal of Environmental Research and Public Health. It included 1,600 participants, with about 80% reporting they received at least one dose of a COVID-19 vaccine. Of the remaining participants, 10% said they planned to get it, while 11% said they would not.

Khubchandani said vaccine refusal in the study group was higher among non-Hispanic Black people, political conservatives, independent-leaning voters, suburban dwellers, people with less than a college education and non-married individuals.

He believes hesitancy has been caused in part due to inconsistent messaging from the federal government about vaccines and about wearing masks.

"Vaccine hesitancy is a very complicated topic," Khubchandani acknowledged. "I've always said global health crises are also information and communication crises. We have no strategy to deal with the issue."

The Biden administration has avoided vaccine mandates until last week, when it announced vaccinations or proof of weekly testing will be required for federal government employees, including those in the health-care sector.

SEATTLE - Washington state's largest union of public workers has reached an agreement with the state on Gov. Jay Inslee's vaccine mandate.

The deal ensures access to and education about the shot on work time as well as an additional day of leave so workers can get vaccinated. The Washington Federation of State Employees filed a lawsuit in August to compel the state to negotiate in good faith on the details of the mandate.

Union president Mike Yestramski said the agreement is a win for public health and due process.

"This entire bargaining process and that lawsuit that we had filed," said Yestramski, "all of that was about impact bargaining and the fundamental right of unions to bargain workplace conditions."

The Washington Federation of State Employees is withdrawing that lawsuit.

The agreement also includes options for people near retirement and a consistent and equitable process across workplaces for employees seeking a medical or religious exemption.

More than 80% of members voted in favor of the agreement.

Yestramski said the union has continued to push for safety measures in the face of this virus.

"We've been pretty vocal," said Yestramski, "pretty open from the beginning of this pandemic that vaccination, masking, social distancing, all of those things are incredibly important pieces to end this pandemic and to keep our communities safe."

The Washington Federation of State Employees' includes 47,000 public service workers in state agencies, higher education and behavioral health.

INDIANAPOLIS -- Indiana officials are conducting a survey to better understand the unmet needs of caregivers across the state, which they say will also help more Hoosiers age at home.

Darcy Tower, director of consumer success, strategy and operations for the Indiana Family and Social Services Administration Division of Aging, said the COVID-19 pandemic has spotlighted long-standing gaps in the care system, such as national shortages of care workers and high turnover.

She pointed out caregivers have faced unique challenges and stressors, from fear of exposing loved ones to the virus to dealing with the effects of social isolation.

"Most Hoosiers, they want to age at home," Tower reported. "And Indiana is working to give more people over age 60 on Medicaid this choice by really making long-term services and supports more effective and better coordinated."

Tower added long-term services and supports include in-home personal care, adult day centers, support for caregivers, assisted living and nursing-home care. She noted they promote the health and well-being of people who need assistance with day-to-day activities because of their long-term condition, disability or cognitive impairment.

Tower emphasized the Division of Aging has waiver services that allow Medicaid to pay caregivers, but she contended they need to expand the program to support needs that may not be financial, including education and training, or respite services.

"So many of these folks live under the assumption that caregiving is just really something that you do for the people who are important to us," Tower observed. "Of course, that is incredibly commendable. These are also people who need support."

Tower hopes the survey will help Indiana better meet those needs. She stressed if you are a family member, friend, neighbor or community volunteer providing care, companionship, transportation or financial or medical help to somebody 55 or older without the expectation of pay, her agency wants to hear from you, either at 800-258-7691 or at survey.indiana.edu/caregiver/volunteer.