Griffith & Feil Drug has been in business since 1892, a family-owned, small-town pharmacy. This isn’t their first pandemic.

More than a century after helping West Virginians confront the Spanish flu in 1918, the drugstore in Kenova, a community of about 3,000 people, is helping the state lead the nation in COVID-19 vaccine distribution.

West Virginia has emerged as an unlikely success in the nation’s otherwise chaotic vaccine rollout, largely because of the state’s decision to reject a federal partnership with CVS and Walgreens and instead enlist mom-and-pop pharmacies to vaccinate residents against the virus that has killed over 395,000 Americans.

More shots have gone into people’s arms per capita across West Virginia than in any other state, with at least 7.5% of the population receiving the first of two shots, according to federal data.

West Virginia was the first in the nation to finish offering first doses to all long-term care centers before the end of December, and the state expects to give second doses at those facilities by the end of January.

“Boy, have we noticed that. I think the West Virginia model is really one that we would love for a lot more states to adopt,” said John Beckner, a pharmacist who works at the Alexandria, Virginia-based National Community Pharmacists Association, which advocates for pharmacies across the country.

It’s early in the process, but that has not stopped Republican Gov. Jim Justice from proclaiming that the vaccine effort runs counter to preconceived notions about the Mountaineer State.

“Little old West Virginia, that was thought of for hundreds of years, you know, as a place where maybe we were backward or dark or dingy,” Justice said last week.

Instead, it turns out that “West Virginia has been the diamond in the rough,” Justice said on CBS’ “Face the Nation” on Sunday.

Rather than relying on national chains, 250 local pharmacists set up clinics in rural communities. The fact that residents who may be wary of the vaccine seem to trust them makes a difference.

“As my uncle always told me, these people aren’t your customers, they’re your friends and neighbors,” said Ric Griffith, the pharmacist at Griffith & Feil in Kenova, a town near the Kentucky state line.

A chatty raconteur and former mayor of Kenova, he can recall generations of patrons frequenting the shop, which is almost unchanged since the 1950s, with a soda fountain and jukebox in the front and prescriptions in the back.

Griffith, 71, began taking over the pharmacy from his father in the early 1990s and was elected to the House of Delegates as a Democrat last year. His daughter, Heidi Griffith Romero, 45, followed into the family business and is also administering shots.

Holding a vaccination clinic at the town high school, he recalled his uncle telling him he lost four classmates to the 1918 flu pandemic, which killed more than 50 million people worldwide.

“And it was a tragedy that I thought I would never be involved with,” he said, taking a break from giving vaccines to teachers aged 50 and over.

When Mark Hayes, a middle school guidance counselor in Kenova, walked up to receive his first dose, he spotted Griffith, who holds local celebrity status for hosting an extravagant annual Halloween pumpkin-carving party that attracts thousands.

“I recognized him right away,” Hayes said. “‘The Pumpkin King? Are you giving me the shot?’”

Kevin Roberts, a 59-year-old school bus driver in Kenova, said “it makes a difference” for a pharmacist he knows to administer the shots. “I hope that a lot of these skeptics change their mind,” he said.

Officials also credit a 50-person command center at the state’s National Guard headquarters in the capital of Charleston. Inside a cavernous hall, leaders of the vaccine operation and state health officials sit between plexiglass dividers to oversee shipments of the precious doses to five hubs. From there, deliveries go to drugstores and local health departments.

CVS has so far declined to work with state officials on vaccinating people at its stores, but Walgreens is participating and has joined in to hold clinics at some nursing homes, officials said.

The federal partnership involving both companies would have allowed Washington officials to dictate the terms of nursing home vaccinations, said Marty Wright, the head of the West Virginia Health Care Association, which represents health care companies.

“If the state would’ve activated the federal plan, the state would’ve had zero control over the situation,” Wright said.

Secretary of Health and Human Services Alex Azar praised West Virginia’s efforts to vaccinate the elderly.

“Expanding eligibility to all of the vulnerable is the fastest way to protect the vulnerable,” Azar said Tuesday at an Operation Warp Speed meeting. He also highlighted Connecticut as a bright spot in the vaccine rollout.

Given West Virginia’s success so far, leaders are now seeking more doses so they can open vaccinations for more groups. The Griffith & Feil store has had to decline shots for out-of-state customers who caught word of West Virginia’s success.

The governor recently lowered the age of eligibility for members of the general public to 70.

The efforts have not been without errors. The Boone County Health Department was barred from distributing the vaccine last month after it mistakenly gave 44 people an antibody treatment instead of vaccines.

The state began vaccinating school workers aged 50 or older less than two weeks ago. The governor wants in-person learning to resume at as many schools as possible by Tuesday, long before teachers will have received their second vaccine doses.

As of Sunday, over 130,100 first doses have been administered, and 23,066 people have received both shots in the state with a population of about 1.78 million people. Nearly 55,800 of the first doses have gone to residents aged 65 and older.

Mitchel Rothholz, who leads immunization policy at the American Pharmacists Association, said other governors would be wise to enlist local pharmacies.

“Especially at a time when you have vaccine hesitancy and concerns in vaccine confidence, having access to a health care provider like a community pharmacist provides a comfort level to the patients and communities,” Rothholz added.