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Georgia Gov. Brian Kemp answers questions during a news conference to discuss the state's COVID-19 vaccine distribution plans, Thursday, Feb. 18, 2021, in Atlanta. (AP Photo/John Bazemore)

ATLANTA (AP) — Georgia's failure to open mass vaccination sites earlier and relatively slow expansion of eligibility for shots are to blame in part for the state's dismal COVID-19 inoculation rate, health experts say.

Georgia ranks dead last among states in the percentage of its adult population that has received at least one dose, according the U.S. Centers for Disease Control and Prevention. Roughly a third of the doses delivered to the state are still awaiting injection, second worst among states according to CDC numbers.

Gov. Brian Kemp again disputed those numbers Tuesday, saying Georgia has identified about 250,000 doses that have been injected but not recorded.

"We have confirmed with the CDC and the White House coronavirus team that the doses were administered, but that they were not recorded as administered here in our state," Kemp said. He accused reporters of playing "pandemic politics" by focusing on Georgia's poor rankings.

Sarah McCool, a professor in public health at Georgia State University, said Georgia was slow to open a mass vaccination site in the Atlanta area. In addition to getting the vaccine in more arms, a centralized site could have eased confusion about where to get inoculated, which also hampered the state's rollout, she said.

The Republican Kemp announced last month that Georgia was opening its first four mass vaccination sites on Feb. 22, including one near Atlanta's Hartsfield-Jackson International Airport. Five more are opening Wednesday in Columbus, Emerson, Savannah, Sandersville and Waycross. But of those, only the location in Bartow County's Emerson is close to metro Atlanta.

McCool noted that Arizona had two mass vaccination sites around Phoenix weeks earlier, including an arena that opened Jan. 11.

"I'm surprised that this was not thought out to open earlier," she said.

There are other mass sites being run by county health departments, including a number in metro Atlanta. But people can't make reservations using the www.MyVaccineGeorgia.com address Kemp promotes for sites run by the Georgia Emergency Management and Homeland Security Agency. Instead, the state Public Health Department built a separate centralized reservation system.

Public Health Commissioner Kathleen Toomey said Tuesday that her department had already signed a contract for its site.

"In the ideal world, would we have exactly the same one on a single site? Yes," Toomey said. "But this wasn't an ideal world."

Georgia has also expanded vaccine access more slowly than many other states, said Pinar Keskinocak, a professor at the Georgia Institute of Technology who heads the school's Center for Health and Humanitarian Systems.

Before Monday, Georgia was offering vaccinations to people 65 and older, preschool and K-12 education employees, medical workers, emergency workers, residents and employees of long-term care facilities, intellectually disabled adults, and parents of children with certain complicated medical conditions.

Monday was the first day that people aged 55 to 64 could get shots in Georgia, as well as people with serious health conditions and those who are overweight and obese. Tuesday, Kemp also added judges and court workers, saying they needed protection with jury trials resuming.

Officials say that between 5 million and 6 million Georgians can now seek vaccination. Georgia has about 8.4 million residents 16 and older.

Limiting the vaccine rollout can help ensure the most vulnerable residents get the vaccine, but it also runs the risk of "delaying the protection for the entire community because the vaccine is sitting there and not moving," Keskinocak said.

Appointments are fully booked around Atlanta, but as of Tuesday afternoon, appointments remained available Wednesday in south Georgia towns.

"I would be kidding you if I didn't tell you I'm concerned about the differential that we're seeing in the metro areas versus what we're seeing, specifically in south Georgia, with the availability of appointments, the hesitancy, or lack of initiative, whatever it is, for people to get vaccinated," Kemp said.

On Monday, officials urged Atlanta-area residents to consider driving south. But health experts said many residents won't be able to travel long distances. The state should instead understand where vaccine is not being used and try to address those issues or move it elsewhere, Keskinocak said.

Kemp said his office and the Department of Public Health are sending a letter to every provider stating they must use at least 80% of vaccine doses within seven days of receiving them. The governor said he believes some providers, including hospitals, are still holding back second doses despite repeated instructions to stop.

The governor said future allotments will be decided based on that measure, as well as whether providers are forming community partnerships to vaccinate underserved populations. Black and Latino Georgians remain greatly underrepresented among those inoculated.

"We are going to move those doses to where the demand is and ship those doses to where they are used most effectively," Kemp said.

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