Pennsylvania ordered vaccine providers Thursday to work with agencies that serve older adults to help clear a backlog of people 65 and older who have spent months waiting for COVID-19 shots.

The state has accelerated its overall rollout after a series of early stumbles, but only 35% of older people are fully vaccinated against the coronavirus, ranking Pennsylvania near the bottom nationally. Hundreds of thousands of older adults still need to be inoculated before Pennsylvania plans to expand eligibility.

“We continue to hear from seniors and those with certain medical conditions who are eligible to be vaccinated ... that they are still struggling to sign up,” said Acting Health Secretary Alison Beam.

Beam ordered vaccine providersto collaborate with the area agencies on aging — a network of 52 agencies that serve all 67 counties — as well as Medicaid managed care organizations to schedule appointments for people who want them but haven’t able to get them.

Additionally, providers may not refuse to schedule an appointment for someone who is currently eligible to receive the vaccine, nor are they allowed to advertise that no appointments are available, Beam’s order said. Providers under the state's jurisdiction are supposed to schedule all currently eligible people who request a vaccine — including younger people with high-risk medical conditions — by March 31.

The state wants to finish vaccinating its most vulnerable residents “in short order so that we can continue on the path of making vaccine available for all Pennsylvanians," Beam said.

President Joe Biden has pushed for states to make all adults eligible to be vaccinated by May 1.

Pennsylvania's drive to get older people vaccinated more quickly reflects widespread frustration among them while they try to negotiate the state’s confusing, scattershot registration system.

“We're fielding a lot of calls from very desperate seniors,” said Holly Kyle, executive director of the Union-Snyder Agency on Aging.

Kyle, who is also president of the Pennsylvania Association of Area Agencies on Aging, said she has a good relationship with the few vaccine providers that serve her rural area. But she said colleagues in other rural counties “can't even get a seat at the table" because the supply is so limited, and the demand so high. She said Beam's order could help.

Jason Kavulich, director of the Lackawanna County Area Agency on Aging, said older people who haven’t managed to land a coveted vaccine appointment are experiencing "endless frustration, fear and a little bit of resentment.”

“There's nothing more disappointing when you talk to someone you’re supposed to be serving on the phone, and you don’t have a good answer for them,” he said.

The Department of Health is responsible for distributing vaccine to about 2 million people ages 65 and older. Through March 19, about 1.3 million of them had received at least one dose. Philadelphia gets its allotment directly from the federal government and runs its own vaccine program.

Gov. Tom Wolf, who has been touting Pennsylvania’s recently improved standing compared with other states’ vaccine distribution efforts, acknowledged criticism that his administration hasn’t moved fast enough to make it available to older adults.

“If I’m one of those seniors who haven’t been vaccinated, it’s absolutely fair,” he said Thursday after touring a health center in Scranton.

“The question is given the constraints we operate under, the supply that’s not up to demand, the fact we have logistical challenges, could we have done a better job? I don’t think so," Wolf said. "I think we’re doing the best we possibly can.”

Pennsylvania is racing to vaccinate its population and stay ahead of a recent spike in infections. Daily case counts have risen more than 30% in the past two weeks, while hospitalizations have started to go up.

The state passed the 1 million-case mark on Thursday. Nearly 25,000 people in Pennsylvania have died since the beginning of the pandemic.