But health departments that have been underfunded for decades say they currently lack the staff, money and tools to educate people about vaccines and then to distribute, administer and track hundreds of millions of doses. Nor do they know when, or if, they'll get federal aid to do that.
Dozens of doctors, nurses and health officials interviewed by Kaiser Health News and AP expressed concern about the country's readiness to conduct mass vaccinations, as well as frustration with months of inconsistent information from the federal Government.
The gaps include figuring out how officials will keep track of who has received which doses and how they will keep the workers who give the shots safe, with enough protective gear and syringes to do their jobs.
With only about half of Americans saying they would get vaccinated, according to a poll from AP-NORC Centre for Public Affairs Research, it also will be crucial to educate people about the benefits of vaccination, said Molly Howell, who manages the North Dakota Department of Health's immunisation programme.
The unprecedented pace of vaccine development has left many Americans sceptical about the safety of Covid-19 immunisations; others simply don't trust the federal government.
"We're in a very deep-red state," said Ann Lewis, CEO of CareSouth Carolina, a group of community health centres that serve mostly low-income people in five rural counties in South Carolina. "The message that is coming out is not a message of trust and confidence in medical or scientific evidence."
PAYING FOR THE ROLLOUT
The US has committed more than US$10 billion to develop new coronavirus vaccines but hasn't allocated money specifically for distributing and administering vaccines.
And while states, territories and 154 large cities and counties received billions in congressional emergency funding, that money can be used for a variety of purposes, including testing and overtime pay.
Many health departments are so overwhelmed with the current costs of the pandemic — such as for testing and contact tracing — that they can't reserve money for the vaccine work to come.
WHAT'S THE PLAN?
Then there's the basic question of scale. The federally funded Vaccines for Children programme immunises 40 million children each year.
In 2009 and 2010, the CDC scaled up to vaccinate 81 million people against pandemic H1N1 influenza. And last winter, the country distributed 175 million vaccines for seasonal influenza vaccine, according to the CDC.
But for the US to reach herd immunity against the coronavirus, most experts say, the nation would likely need to vaccinate roughly 70 per cent of Americans, which translates to 200 million people and — because the first vaccines will require two doses to be effective — 400 million shots.
Although the CDC has overseen immunisation campaigns in the past, the Trump Administration created a new programme, called Operation Warp Speed, to facilitate vaccine development and distribution.
"With few exceptions, our commercial distribution partners will be responsible for handling all the vaccines," Operation Warp Speed's Paul Mango said in an email.
"We're not going to have 300 million doses all at once," said Mango, deputy chief of staff for policy at the Health and Human Services Department. "We believe we are maximizing our probability of success of having tens of millions of doses of vaccines by January 2021, which is our goal."
OUTDATED TECHNOLOGY COULD HAMPER RESPONSE
Many public health departments will struggle to adequately track who has been vaccinated and when, because a lack of funding in recent decades has left them in the technological dark ages, said Dr Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials.
When Covid-19 vaccines become available, health providers will need to track where and when patients receive their vaccines.
People will need to receive their second Covid-19 dose 21 or 28 days after the first.
The CDC is developing an app called the Vaccine Administration Monitoring System for health departments whose data systems don't meet standards for Covid-19 response, said Claire Hannan, executive director of the Association of Immunisation Managers, a nonprofit based in Rockville, Maryland.
A HISTORIC TASK
Overwhelmed public health teams are already working long hours to test patients and trace their contacts, a time-consuming process that will need to continue even after vaccines become available.
When vaccines are ready, health departments will need more staffers to identify people at high risk for Covid-19, who should get the vaccine first. Public health staff also will be needed to educate the public about the importance of vaccines and to administer shots, as well as monitor patients and report serious side effects.
- AP
