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In Florida, people under 50 with underlying health conditions may be vaccinated unless they have written permission from their doctor.

In Mississippi, more than 30,000COVID The appointment of vaccines were opened Friday - days after the state became the first in the United States contiguous to the shotsavailable for all adults.

InCalifornia - with about 30 other states - people are eligible if they are 65 or older or have certain health conditions or work in high-risk jobs.

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How did that make sense?

"There is no logical justification for the system we have," said Graham Allison, government professor at Harvard University. "We have a crazy quilt system."

Jody Gan, professional lecturer in the department of health studies at the American University in Washington, DC, said that the absence of a national eligibility system reflects the way each state also makes its own health rules public. "This was not a great system to keep, you know, the virus contained," she said.

The federal government has bought hundreds of millions of vaccine doses Covid Pfizer and Johnson & Johnson Moderna - and other vaccines tested yet - but it left a distribution largely to higher states. Some states allow local communities to decide when to switch to broader eligibility phases.

When the first shots were cleared for emergency use in December, almost all states have followed the guidelines of the federal Centers for Disease Control and Prevention and limited use for front-line health workers and the staff of the nursing home and residents.

But since then, States parties in their way. Some States have priority for people aged 75 and over, while others have also allowed people who held some jobs that put them at risk of being infected or have health conditions that put them at risk be included with the elderly for eligibility. Even so, job categories and medical conditions varied across the country.

As vaccine supply increases over last month, states have expanded eligibility criteria. The President Joe Biden promised that on May 1, all adults will be eligible to vaccines and at least a dozen states say they will beat that date or, as in the case of Mississippi and Alaska, already have.

But the different rules between states - and sometimes different rules, even in states - have created a mishmash. This triggered the "vaccine jealousy" as people see friends and family in other states qualify in front of them even if they are the same age and have the same occupation. And it has raised concerns that decisions on WHO are eligible are in the process of doing politics rather than public health.

The Hodgepodge reflects the response of states throughout the pandemic, including large disparities mask mandates and restrictions for indoor gatherings.

"This has caused much confusion and the last thing we want is confusion," said Harald Schmidt, assistant professor of medical ethics and health policy at the University of Pennsylvania.

As a result, some Americans frantically searching online every day for an appointment on the open vaccine, while other vaccines States occur.

The policies with also prompted thousands of people to drive across state lines - sometimes multiple state lines - for an appointment on the open vaccine. Some states have established residency requirements, although enforcement has been uneven and those seeking vaccines are often on the honor system.

Todd Jones, Assistant Professor of the State University of Mississippi, near Starkville, said the confusion indicates a need for a change in the way the government manages the vaccine. "Biden's administration should certainly think about how it might want to change the state-based state allowances," said Jones. "If it becomes clear that some states really do not use much of their doses, I think it would be logical to make nominations of these states to give other states that have higher demand."

Jagdish Khubchandani, Professor of Public Health at the State University of New Mexico, said no one should be surprised to see 50 different eligibility systems because States opposed to a uniform federal eligibility system.

"Many governors do not want to be considered a person who listens to the federal government or the CDC as an indication," he said. Florida Gov. Ron Desantis, Republican, wanted to ignore CDC's advice when he chose to return someone 65 and more eligible from December.

"There are many political positions to decide eligibility," Khubchandani said.

To be sure, governors also wanted the flexibility to respond to specific needs in their states, such as the precipitation of vaccines to agricultural workers or those of large food manufacturing plants.

Jones said the decision to open vaccines to all state adults may seem good, but the Mississippi has one of the lowest vaccination rates of the nation. Part of it is attributed to hesitation in some minority communities and conservatives. "It's a good news that everyone can get it, but there does not seem to be a lot of demand for that."

Jones, 34, was able to go online for a shooting on Tuesday and was vaccinated in a big church a short drive from his home on Thursday morning. "I was very happy," he said.As for yourself: go through this pandemic at your healthier, do not miss these35 places you are most likely to catch Covid.

Kn (Kaiser Health News) is a national press room that produces in-depth journalism on health problems. As well as policy analysis and survey, KHH is one of the three major operating programs ofKff (Kaiser Family Foundation). KFF is a non-profit organization that provides information on health problems to the nation.