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JOHNSTON, Iowa (AP) — As Iowa ramps up vaccinations to include everyone between age 16 to 64 with underlying health conditions, state officials acknowledged Wednesday they would rely on an honor system with no validation required when someone claims to qualify for a shot due to a health issue.

The state is allowing adults to get vaccinated if they have any one of several conditions the U.S. Centers For Disease Control and Prevention considers higher risk for severe illness if they get infected. The list includes cancer, heart conditions, lung disease, pregnancy, type 2 diabetes and obesity. Smokers also qualify.

Iowa Department of Public Health Director Kelly Garcia acknowledged Wednesday the system is relying largely on Iowans being honest about their health conditions when scheduling a vaccine.

Gov. Kim Reynolds was asked Wednesday why the state doesn’t allow all adults to get vaccinated since the current system has no way to confirm whether someone has a qualifying health issue, making it possible for anyone willing to be untruthful to get a shot.

“I think we have a good process in place. As we see those numbers continue to increase and we continue to open up and vaccinate more and more Iowans we’ll take that next step,” she said.

The state’s use of an honor system came as officials said in response to an inquiry from The Associated Press that they had suspended activities of the Infectious Disease Advisory Council. The group of appointed medical professionals and advisers was tasked with deciding what groups would be given priority, but it hasn’t met since Jan. 25.

“IDAC has concluded their meetings. If, for some reason, vaccine manufacturing and distribution does not meet the expectation that there be enough for all Iowans who want one by the end of May, we would consider reconvening IDAC to prioritize distribution in Iowa,” said Iowa Department of Public Health spokeswoman Sarah Ekstrand.

Iowa has given 969,877 doses of vaccine as of Wednesday afternoon and will have vaccinated 1 million by the end of this week. Reynolds said 27% of the population has had a shot as of Tuesday, which places Iowa 10th in the nation. Iowa is 27th in the country for people fully immunized with two doses of vaccine, at about 13% of the population.

Reynold said the federal government expects a significant increase in vaccine production by late March or early April, which will allow the state to consider expanding those who qualify for a vaccination.

While Reynolds has lifted virtually all efforts designed the slow the spread of the virus, Iowa averaged about 500 new confirmed cases and 10 additional deaths a day in the past week.

The state reported Wednesday 879 new confirmed cases and 27 additional deaths for a total of 5,601.

The state’s death count is the 17th highest per capita at 176.6 deaths per 100,000 people.

Iowa is one of 10 states in the U.S. where the positivity rate is climbing. In Iowa the seven-day rolling average of the positivity rate was up over the past two weeks from 13.18% on Feb. 21 to 18.08% on March 7, according to Johns Hopkins University. State health departments are calculating positivity rate differently across the country, but for Iowa the AP calculates the rate by dividing new cases by people tested using data from The COVID Tracking Project.