They can only do so much. They can't make the virus magically go away. They can't make the sick suddenly better. Like they say, we're all in this together. The US is one of the wealthiest countries on earth. Even our "poor" have so much more than the poor in other countries who are truly dirt poor. I would not be surprised if whatever vaccines we have left over will be donated to poor countries.
Manufacturing and distribution is happening but getting it down to the local levels is where progress slows. For one thing, there are simply not enough health care workers to take care of the sick, take care of the well (as in preventative care) and administer the vaccines. Yesterday, I x-rayed a nurse who used to work in labor & delivery at our hospital who is now retired but she said she is looking into returning to nursing to help give the injections. Most people in healthcare feel a strong sense of duty. Many of those recently retired would be the perfect candidate for something like this. There's no heavy lifting involved, bed baths, etc. Also it's temporary. Sure it may take a year or more but eventually the need for extra help will lessen.
I sent an email to our governor today, reminding him that when we had the H1N1 pandemic my vaccine was given to me by a nursing student. IM injections are the easiest to learn and let's face it, once you do something 10,000 times, you become quite proficient at it. There's no good reason not to ask nursing students and medical students to step up for the cause. It's a win-win situation. They improve their clinical skills and the public gets the vaccine they need.
The other issue is that they need a computer system that can track everything. The government keeps a lot of records of people (IRS, births, deaths, DMV, etc.) but they don't normally keep medical records. They don't already have a system for it. Back when I got the H1N1 vaccine, our county was offering it free and since it was only 1 dose, we got the shot and was given a record of the details, basically a carbon copy with the date, lot # etc. They had no responsibility for follow up for a 2nd dose.
Now they have to make sure that people who get the first dose return for the 2nd one. Also they have to make sure that the 2nd appointment is at the proper spacing, which varies among vaccines, and that the 2nd dose is the same vaccine as the first dose. Their system will need to be able to keep records for contacting patients with reminders. I wonder if they're not also setting up some method for people to give proof of their reason for getting theirs ahead of others. Being over 60 is easy enough to prove but will they make grocery store workers show their paystub to prove where they work? What about those with asthma, heart disease or on dialysis? Will they need to prove it or will they just accept that many selfish people will lie to get it sooner?
It seems to me that despite the manufacturers talking about vaccine progress since March, the state and local governments have been completely unprepared, as if that is a "some day" thing to worry about some time down the road. Well, here it is and they're bumbling with it. Again and again private companies are so much more efficient than anything our governements puts its hands on.