US President Donald Trump promised there would be 100 million doses of Covid-19 vaccines for Americans by the end of the year, but fewer than 3 million have been inoculated with their first dose.
The US, under the Trump administration’s vaccine programme Operation Warp Speed, has supported research, manufacturing and distribution for coronavirus vaccines in record time.
The Food and Drug Administration approved the emergency use of two vaccines only 10 months after the first US case of Covid-19 was confirmed.
The previous record was four years, with the vaccine for the mumps in the 1960s.
But now the challenge is quickly vaccinating as many people as possible, as the country has the largest outbreak in the world.
The outlook for meeting demand and vaccinating Americans is not optimistic.
“We’ll have manufactured at least 100 million vaccine doses before the end of the year and likely much more than that,” Mr Trump said in a September speech.
Health and Human Services Secretary Alex Azar said in October that there would be “enough to cover especially vulnerable populations” by the end of the year.
On December 30, the Centres for Disease Control and Prevention recorded more than 12.4 million doses distributed to health centres across the country.
About the time the Pfizer-BioNTech vaccine was approved by the two health authorities, Pfizer said it had to reduce its goal of 100 million doses by the end of the year because of supply chain problems.
“By the end of December, we expect to have about 40 million doses of these two vaccines available for distribution, enough to vaccinate about 20 million of our most vulnerable Americans,and production would continue to ramp up after that,” Mr Azar said in November.
He was hoping for swift production of the approved Pfizer-BioNTech and Moderna vaccines.
The number of doses are cut in half because both vaccines require two doses, separated by a certain period of time.
Some places, such as Canada's Ontario province, have switched strategies, vaccinating as many people with the first dose as possible and not worrying about the second dose until it arrives.
Either way, the US is not close to meeting the goal of 20 million vaccinations by the end of the year.
The CDC vaccine tracker says just over 2.8 million Americans have received their first dose.
"We would have liked to have seen it run smoothly and have 20 million doses into people today by the end of the 2020, which was the projection," Dr Anthony Fauci, the country's top infectious diseases expert, told NBC on Thursday morning.
"Obviously it didn't happen and that's disappointing."
There is also concern that, because of slow distribution, fully produced vaccine doses could expire soon, wasting opportunities for vaccinations in a country that desperately needs them.
The vaccines are only cleared for 30 to 35 days of storage in normal storage units with regular dry ice refilling, Pfizer said.
The shelf life of the vaccines could be extended to six months if stored in ultra low-temperature freezers, which are rare, and for which many states are making backlogged orders.
Globally, the US is behind in its vaccine drive. Israel, Bahrain and the UK are ahead of America when comparing vaccinations per capita.
Israel's Health Ministry says it has vaccinated more than 7 per cent of its population.
President-elect Joe Biden this week criticised the Trump administration on the status of the vaccine campaign.
“The Trump administration’s plan to distribute vaccines is falling behind,” Mr Biden said in Wilmington, Delaware, on Tuesday.
“As I long feared and warned, the effort to distribute and administer the vaccine is not progressing as it should.”
He has pledged to enact the US Defence Production Act to boost the vaccine effort, activating emergency levels of production, manufacturing and distribution, when he becomes president.
Mr Biden hopes there will be 100 million Americans vaccinated in the first 100 days of his presidency.
“At the pace the vaccination programme is moving now, it would take years, not months, to vaccinate the American people,” he said.