JOHNSTON, Iowa (AP) — As Iowa ramps up vaccinations to include everyone between age 16 to 64 with underlying health conditions, the state has turned to the honor system with no validation required when someone claims to qualify for a shot due to a health issue. The state is allowing adults Iowans to get vaccinated if they have any one of several conditions including cancer, lung disease and heart disease that create a higher risk for severe illness if they get a coronavirus infection.

Obesity and smoking also qualify. Iowa health officials say the system is relying largely on Iowans being honest about their health when arranging for a vaccine. Gov. Kim Reynolds says the process is working well.