Politico Nightly: “…This will be the largest mass adult vaccination campaign in U.S. history. And it requires two doses. There is no process to make sure that everyone who got their first dose can and will come back for their second doses. There is no central database tracking who got the vaccine and which one they got. Ideally, Hotez said, there would be one federal registry that would track that information, but right now providers largely have to depend on those who got a first dose to remember to get a second shot.

Many patients are struggling to even get a first appointment and there’s no guarantee that they will be able to come back a second time. “Anytime you have a two-dose regimen, some people aren’t going to come back,” said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

Finding people to administer doses, especially in rural or remote locations without health care providers, is also shaping up to be a major obstacle. About 20 states, including West Virginia and North Dakota which have led the country in distributing vaccines, have activated the National Guard to help with vaccine distribution. But in order to meet the pace of 2 to 3 million doses a day, states would need a plan to bring back retired health care workers or train others to administer the vaccine. Some are doing this, even bringing on vets and dentists, but more workers are needed…”