Thousands of people showed up at sites from the coast to the Tennessee Valley as Alabama began vaccinating senior citizens for the coronavirus that causes COVID-19.

People spent the night in cars waiting for shots in Baldwin County, where health workers began immunizing people early Tuesday. County health workers in Huntsville vaccinated 500 people on Monday although only 300 people had appointments. Other sites opened in cities ranging in size from Birmingham to Rainsville.

The state is offering vaccines to people 75 and older after limiting the initial doses to health workers. Alabama is among the Southern states trailing the nation in the rate of vaccinations.

In Limestone County, Pat White showed up to get her first of two doses of the Moderna vaccine Monday. She said she misses going to church and has done little other than buy groceries to protect against catching the virus.

“We’ve lost many friends to COVID, and we’re older, so that made me think it was probably the right thing to do,” White told WAAY-TV.

Alabama Department of Public Health statistics show about 150,000 have received shots statewide, but the number does not include those who were immunized most recently. More than 600,000 people are currently eligible for vaccinations in Alabama, including 325,000 health care workers and 350,000 people who are 75 or older. The state has so far received 446,000 doses, according to state numbers.

The University of Alabama at Birmingham Hospital has been notifying patients, who are 75 and older, to have them come to get vaccinated.

“At the vaccine site, it’s not uncommon for people just to break down in tears when they receive their vaccine. People are just so tremendously relieved to finally have received the vaccine and have some hope,” Dr. Sarah Nafziger, vice president of Clinical Support Services at UAB Medicine, said.

More than 6,100 people have died of COVID-19 in Alabama, and more than 424,000 people have tested positive for the new coronavirus. Over the past two weeks, the rolling average number of daily new cases has decreased by 881, a decline of almost 24%, according to researchers at Johns Hopkins University.

The virus causes only mild or moderate symptoms in most people, but it is particularly dangerous for the elderly and people with other, serious health problems.

Nafziger said the delivery of the vaccinations is also providing a boost to health care workers who spent much of 2020 battling the pandemic.

“We’ve been in a really rough place, especially in health care. For the last year, it’s been a tremendous burden. We’re exhausted. But just finally having hope has been a tremendous boost for all of us and I hope it is for the community as well,” Nafziger said.

The Alabama Department of Public Health last week disputed rankings that put Alabama last in vaccination delivery, and said that was because some entities had not reported given vaccinations.

Four state senators wrote a letter Tuesday raising concern about the process and asking for updated numbers on vaccinations given. They expressed concern that incomplete reporting could threaten the flow of vaccine to the state if federal officials see the state has unused vaccine on the shelf.

“While the supply pipeline is definitely an issue, our pipeline in Alabama has a kink,” Sens. Jim McClendon, Greg Albritton, Tom Whatley and Randy Price wrote.

The Alabama Department of Public Health responded in a statement disputing the assertion. The department said that the number of COVID-19 vaccine doses allocated to Alabama is based on our population, and “is not determined by how much vaccine is on hand in the state.”

“The biggest obstacle to vaccination in Alabama is the limited supply of vaccine. Alabama currently has approximately 676,000 people in Alabama who qualify to receive a COVID-19 vaccine, but since our state is allocated only around 50,000 – 60,000 primary doses each week, the supply is not available to reach these numbers at this time,” the department said.