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WASHINGTON -- President Joe Biden's promise that all of the nation's 255 million adults will be eligible for coronavirus vaccines by May 1 means the U.S. needs to move fast.

Within the next seven weeks, the federal government must deliver doses to hundreds of new vaccination sites and recruit a new wave of health care workers to administer the shots.

Simply distributing the vaccines will not be enough, though. The government also aims to simplify the often-frustrating sign-up process and bring shots to communities that are having the hardest time getting vaccinated.

Here's how public health officials intend to meet the president's deadline and the challenges that lie ahead.

How will US make its 255 million adults eligible for COVID vaccine by May 1?

Simply distributing the vaccines will not be enough, though. The government also aims to simplify the often-frustrating sign-up process and bring shots to communities that are having the hardest time getting vaccinated.

Here's how public health officials intend to meet the president's deadline and the challenges that lie ahead.

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What will happen May 1?

That's the date that Biden wants states to make all adults eligible for the vaccines, but it does not mean everyone will be able to get a shot immediately or even soon after. White House officials expect enough doses to be available for everyone by the end May. How quickly the shots are given will depend on establishing hundreds of new vaccination sites and other distribution points. Some states will move at a faster pace. Michigan's governor said Friday that all adults will be eligible for vaccines beginning in early April. Alaska this week became the first state to open up to anyone 16 or older.

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What will happen May 1?

That's the date that Biden wants states to make all adults eligible for the vaccines, but it does not mean everyone will be able to get a shot immediately or even soon after. White House officials expect enough doses to be available for everyone by the end May. How quickly the shots are given will depend on establishing hundreds of new vaccination sites and other distribution points. Some states will move at a faster pace. Michigan's governor said Friday that all adults will be eligible for vaccines beginning in early April. Alaska this week became the first state to open up to anyone 16 or older.

Is the goal realistic?

The May 1 goal is reasonable, and the administration may be using it to urge states and communities to prepare to administer a lot more vaccine, said Dr. Joshua Sharfstein, a former FDA deputy commissioner and a Johns Hopkins professor.

"The problem is, if you're just waiting to see how much vaccine you have before you schedule the clinic, then you're building in a lot of delays," he said.

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"To say, 'Look, we're going to be able to vaccinate everyone, every adult who wants it,' that's sending a signal to everyone: 'Get ready.'"

How will officials handle the big increase?


The Biden administration is counting on expanding the number of large drive-thru vaccination sites and neighborhood centers. It plans to double the number of federally run mass-vaccination locations and double the number of retail pharmacies enrolled in the federal distribution program to more than 20,000. It also will add more mobile clinics and send doses to community health centers to reach under-served and hard-hit communities.

Who will give the shots?


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Getting millions of doses into the arms of adults will not be possible without a big increase in the number of health care workers and volunteers. Biden's plan calls for allowing veterinarians, dentists, optometrists, midwives, physician assistants, medical students and others to administer the shots. The president also says 4,000 more active-duty troops will be brought in to help with the vaccination efforts. That's in addition to 2,000 who already are assisting.

How will they reach everyone?

People in hard-hit communities and low-income neighborhoods have been falling through the cracks because of language barriers, lack of transportation and lack of access to online registration, among other obstacles. Mistrust of the vaccine also plays a role. The Biden administration's plan is to put more doses closer to where people live through mobile clinics and by sending vaccines directly to another 700 community health centers, bringing the total to 950. "We're ensuring that equity remains at the center of our response," said Dr. Marcella Nunez-Smith, chair of the White House's COVID-19 equity task force.

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What do public health experts say?

Dr. Ashish Jha, dean of the Brown University School of Public Health, said guidance from the White House, conversations with manufacturers and a review of other data indicates that there will be "a huge increase" in the number of vaccines available to the American people over the next month.

Right now, there's still not enough supply, he said. But by late April and early May, the supply will exceed demand.

"Certainly by May, if not earlier, we're going to have plenty of vaccine for anybody who wants it," he said.

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Jha said the country currently has the capacity to give 2.5 million to 3 million shots per day, and now states need to be working to make sure they have distribution capacity and can vaccinate at a national rate of 4 million to 5 million a day.

What about the sign-up frustrations?

Securing a slot to get the vaccine has been maddening for many. And that's with only a sliver of the population eligible. A new poll from The Associated Press-NORC Center for Public Affairs Research shows that about 4 in 10 Americans think the process has been poor. Biden says his administration will have a nationwide website up and running by May 1 to show people where the vaccine is can be found. There will be a phone center available by that time too to assist with tracking down doses. The federal government will also work with local agencies to improve their sign-up sites. The president says the goal is "no more searching day and night for an appointment."

Where does the vaccination effort stand right now?

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More than 100 million Americans have already received at least one shot, and nearly 66 million are fully vaccinated. Many more will have received shots by May 1, somewhat alleviating the bottleneck that expanded eligibility is likely to create.

What's the endgame?

Biden is targeting the Fourth of July as the date when the nation could mark significant progress. But he tempered his optimism by warning that getting there will rely on people following public health guidelines and getting vaccinated soon after they are eligible.

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After savoring the passage of his $1.9 trillion Covid-19 relief package in the Rose Garden last week, President Joe Biden begins the tough work of enacting what he called a "transformational" piece of legislation, while also trying to sell Americans on the progressive goals the bill embraced.

As stimulus checks are rolling into the bank accounts of Americans, the President and first lady and Vice President Kamala Harris and the second gentleman are all hitting the road this week for a "Help is Here" tour, including stops in New Jersey, Pennsylvania, Colorado, Georgia and Nevada. They'll explain how they will achieve the goals Biden laid out in a speech to the nation last week, including making all adult Americans eligible for the vaccine by May 1 -- a move he hopes will set the stage for small gatherings with friends and family by July Fourth.

But with ambitious timelines comes risk. Those benchmarks are now the criteria against which the administration will be measured at a precarious time with a pandemic that has defied many predictions and prognosticators over the past year.

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The President's Covid-19 response team said in a briefing Friday that they believe they will have enough vaccine supply in place for all American adults by the end of May after securing commitments for 200 million doses from Moderna, an additional 200 million doses from Pfizer and another 100 million doses from Johnson & Johnson.

But White House Covid-19 response coordinator Jeff Zients acknowledged Friday that the administration still has a great deal of work to do in expanding the number of vaccination sites and vaccinators to ensure there's the infrastructure to vaccinate all Americans who want to get their shots by the end of May. The administration has repeatedly touted that it has doubled the amount of vaccine going out to the states during Biden's first seven weeks in office -- and are now averaging about 2.2 million shots per day, but major challenges remain.
For starters, availability of the vaccine doesn't mean Americans will get it.

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The number of Americans who are still hesitant to get the vaccine remains high, even as confidence in the vaccines has improved. And though the White House is focused on improving vaccine equity, data shows that White Americans are still getting vaccinated at much higher rates than Latinx and Black Americans, even though those communities have shouldered a much higher share of the cases. A Kaiser Family Foundation analysis earlier this month of available US Centers for Disease Control and Prevention data showed that among people who had received a first vaccine dose -- in instances where data about race and ethnicity was known -- two-thirds were White, 9% were Hispanic, 7% were Black and 5% were Asian.

The political complications for Biden in convincing reluctant Americans to get the vaccine also came into sharper focus last week with a new CNN poll showing that 28% of Americans said they do not plan to get a coronavirus vaccine, compared with 69% who said they will (or already have gotten a dose of the vaccine).

Among that 28% who said they don't plan to get it, 46% were Republicans, 32% were independents and 7% were Democrats. Experts say generally that in order for America to achieve herd immunity, between 70% and 85% of the population must be protected.

Georgia Gov. Brian Kemp, a Republican, highlighted that problem during a press briefing Friday after visiting a vaccination clinic in Atlanta where he said hesitancy among "White Republicans" remains a concern and suggested expanding partnerships between pharmacies and "local churches, civic clubs and others to continue to build up the confidence and convince people that, look, this is the right thing to do."