In my state there's state guidance but counties have discretion and some wiggle room. The state wants them to generally follow them and thus has announcements but as the health director put is they don't have to be "lockstep" in line. If you have excess vaccines and have checked surrounding counties for their needs you can proceed ahead. Presently my state is in Phase 2 with leftover Phase 1 to get through.
Right now due to supply my county opted to do age 80+ last week (which is technically not in the state's plan it was simply 65+) after starting with healthcare workers, this week is 65+ and teachers and the priority with the teachers is the state's School for the Deaf and special education teachers. My state has 5 phases and various tiers within them. Presently I would qualify under Phase 4, my husband right now Phase 5. We plan to get them. As for our family members....that's worrisome. I told my husband it's going to be an issue if our social circle largely opts out though I was happy to hear that despite initially saying no father-in-law did get his first dose a few weeks ago (he works for a main health system in the metro). That is the only person in my immediate social circle I know that has gotten it. I have a friend several hours away from me that is an EMT who did get his.
In the States healthcare workers and LTC were first for basically all states. What was considered a healthcare worker varied some though between the states.
Phase 1 in my state was (and they are still finishing those up):
• Health care workers
• Residents or patients in long-term care facilities and senior housing
• Workers critical to pandemic response continuity
Phase 2 in my state has the following and represents about 30-33% of the state's population:
• Persons aged 65 and older
• High-contact critical workers necessary to maintain systems, assets, and activities that are vital to the state security, the economy or public health, or who interact with large numbers of contacts and job-related COVID-19 exposure. COVID-19 risk is associated with the likelihood of infecting oneself or spreading the virus. Factors that increase risk include proximity, type of contact, duration of contacts and challenges to implement protective measures. This includes:
o Firefighters, police officers, first responders, and correction officers
o Grocery store workers and food services
o K-12 and childcare workers, including teachers, custodians, drivers, and other staff
o Food processing, including meat processing plants
o Large-scale aviation manufacturing plants
o Transportation workers
o Workers in retail, agriculture, supply of critical services or materials for COVID-19 response, the U.S. Postal Service, and Department of motor vehicles
• Those living or working in licensed congregate settings and other special care or congregate environments where social distancing is not possible, including:
o Homeless shelters
o Congregate childcare institutions
o Emergency shelters or safe houses
o Corrections facilities
o Behavioral health institutions
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What has come to light in recent weeks is the Federal program partnership with CVS and Walgreens for long-term care facilities seemed like a good idea but it hasn't lived up to its expectations and is considered too slow in getting one of our most vulnerable groups of people vaccinated. It is allowable now to pull excess vaccine from CVS and Walgreens and redistribute it within a state. The state next to me is doing this to try and help get more people vaccinated and has pulled 25,000 doses to be "re-routed to county health departments, medical hospitals and clinics, and hundreds of other state-approved vaccinators." I don't know if my state is doing that and I haven't heard of dissatisfaction with the Federal program from my governor but it's abundantly clear it's an issue in general with it.
West Virginia has been in the news quite a lot for being very successful in distributing their doses. Of special note, part of their success is they are the only state in the U.S. to NOT sign up for the Federal program for CVS and Walgreens for long-term care facilities and have opted to do their own distribution with pharmacies in part due to low number of CVS and Walgreens located within that state and instead they have more of independent pharmacies. I know not everyone is a fan of letting states do their own thing but it's been my opinion throughout this pandemic that some decisions are truly best left up to a state. It always reminds me of my insurance call center days. Decisions made too high up always resulted in problems for us lowly folks. The high up folks never knew what it was actually like to take the phone calls and there were a lot of times we sat there wondering how they could have possibly thought this was going to go over well for xyz to occur. Resources shouldn't be left up to the states though.
Childcare will reopen. Also stores will be allowed for click and collect at the stores. 
I'm really hoping that date changes for the better as soon as vaccines start coming into Canada faster.
