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Barely a month into a mass vaccination campaign to stop the COVID-19 pandemic, the Trump administration unexpectedly shifted gears Tuesday to speed the delivery of shots. The move came after widespread concern over a slow start even as coronavirus cases and deaths reach new highs. Health and Human Services Secretary Alex Azar announced a series of major changes to increase supply of vaccines and expand the age groups eligible as well as locations where people can get shots. Lee County resident Al Gainey has been trying to get answers about when he, and his family will be vaccinated.

As of Monday about 9 million Americans, according to the Centers for Disease Control and Prevention, have received the first dose of a COVID-19 vaccine, which is far below the goal of vaccinating 20 million people by the end of 2020. The slow vaccine rollout is occurring at the same time the United States is enduring record levels of infections and deaths. To accelerate vaccinations, some have proposed to delay the timing of the second dose. Critics of this approach argue that it lacks clinical evidence and may weaken the public’s confidence in vaccine effectiveness.

One way or another, millions more South Carolinians need to acquire immunity from the coronavirus before the disease is at bay. The goal is herd immunity, and it is a moving target. Jane Kelly, assistant state epidemiologist with the South Carolina Department of Health and Environmental Control, said last week that community spread of the disease should stop once 70 percent of the population has acquired immunity. That’s herd immunity. But, she said, public health experts must set the bar higher — up to 85 percent — in places where infections are rampant.

“It’s a marathon not a sprint,” said Alamance County Health Director Tony Lo Giudice talking about the COVID-19 vaccine rollout. Lo Giudice was candid about the obstacles the Health Department faces in getting close to 170,000 Alamance County residents inoculated against the coronavirus – inoculating the public from unrealistic expectations. Right now the biggest one is the meager 975 doses per week the state is allocating to Alamance County. “There is still a trickle of vaccine,” said Julie Swann, head of the Industrial Systems Engineering Department at N.C. State and an expert in how health systems operate, “and high expectations.”

The sluggish rollout of COVID-19 vaccines across the United States highlights the challenges of a decentralized distribution plan that relies on states and localities to handle the complicated last-mile logistics of getting shots into people's arms, reported The Wall Street Journal on Monday. More than 22 million doses had been distributed to states and other jurisdictions as of Friday, according to the Centers for Disease Control and Prevention (CDC), while 6.7 million people had received their first shot by that point. The figures were short of the U.S. goal of 20 million vaccinations by the end of 2020, and communities and states were still reporting bottlenecks this month as they managed their inoculation programs, said the Journal.