LIBERTY, Mo. (AP) — Some officials in eastern Missouri say vaccination efforts are being hampered because the state is not sending enough doses of the COVID-19 vaccine to a region with a large population.

St. Louis County health officials said in a news release Monday that some vaccinations may be delayed after the state did not send 3,900 vaccine doses it had promised for use this week.

It was the third week in a row the county did not receive vaccination doses directly from the Missouri Department of Health and Human Services. The county health department detailed several times between Jan. 25 and Feb. 4 where state officials said the county would receive thousands of doses.

On Friday, state health officials told the county it would receive thousands of doses through allocations from hospitals. But county officials were told they would not receive 3,900 vaccine doses the state said it had shipped and would not be getting any doses for this week, according to the news release.

The county has received allocation through hospital redistribution and reached an agreement with local hospital groups to receive 1,950 doses later this week.

The county, which opened several mass vaccination sites in anticipation of receiving weekly doses, is prepared to vaccinate more than 5,000 people a week but might have to pause vaccinations and reschedule or cancel appointments because of the lack of doses, officials said.

On Tuesday, Franklin County's presiding commissioner, Tim Brinker, complained in an email to health and legislative leaders that the number of vaccines received in the region that includes his county, St. Louis County, St. Louis, and nine other eastern counties is not receiving enough vaccine for its population.

Brinker, a Republican, said the area has 37% of the state's population but only 15,600 vaccines have been allocated to the region's health care systems — 17% of the vaccines allocated by the federal government.

He said the state has told health care systems those allocations must also be distributed to public health sites and federally qualified health care centers, which generally provide medical care for underserved or rural populations.

Brinker said the allocation for the region did not follow the state's vaccine distribution rollout plan, which separated health care systems from other entities. Based on its population, the region should receive 34,456 doses, said Brinker, who added vaccination clinics have been cancelled in the area because of the distribution.

“Please know that I understand the shortage of available vaccines, but also know that I would not be fulfilling my duties as Presiding Commissioner if I did not request this action be explained or addressed as soon as possible."

The unexpected loss of doses makes it difficult to plan vaccinations and to communicate with thousands of people who are anxiously awaiting the shots, said County Executive Dr. Sam Page.

“More importantly,” Page said, “it puts at further risk the population DPH serves, including people who are uninsured or underinsured, people who do not have a primary care physician, and others who are uniquely at-risk and vulnerable to COVID-19. Many of the people who need the vaccine the most simply will not have access to the vaccine.”

In response to questions about St. Louis County's dosages, Missouri Department of Health and Senior Services spokeswoman Lisa Cox noted the county is receiving doses from hospitals, which she said was a model that had been explained several times in the past.

She did not respond to questions about the 3,900 vaccination doses or Brinker's comments.

Missouri reported Tuesday that 716,0389 people have received at least one dose of a COVID-19 vaccine, which is about 8.9% of the state's population. A total of 467,313 cases have been confirmed since the pandemic began, with 7,149 deaths — an increase of 649 cases and six deaths from the previous day.