Of the 13.1 million doses of coronavirus vaccine distributed thus far, only 32 percent — about 4.2 million — have been administered. The alarming delay is largely due to the Trump administration’s lack of leadership.

The administration seems to believe its responsibility ends once vaccines are shipped to states. But that’s wrong. Here’s what the federal government should do to infuse urgency into the vaccination efforts.

Set expectations for an all-hands-on-deck, 24/7 operation. With thousands of Americans dying every day, there is no excuse for lifesaving vaccines languishing in freezers. The federal government needs to give states strict parameters for when their vaccine allocation must be administered before it’s diverted elsewhere. States, in turn, should impose similar requirements to their distribution sites: Use it, or lose it.

Some have attributed delays to the holidays and initial logistical challenges, but plenty of entities have run efficient operations. In West Virginia, all 214 long-term care facilities have completed delivering their first dose of their vaccinations. Some hospitals in Texas provided shots around-the-clock until all employees received them. The federal government can highlight best practices and emphasize that vaccines are a lifeboat that many are desperate to access.

Establish targets and help locales meet them. The federal government should set ambitious targets for each region and ask state and local health departments what they need to reach them. Let’s say a region’s goal is to vaccinate 10,000 residents per day by March 1. What will it take to do this? The stimulus package just passed by Congress will provide many needed resources, but it’s coming months later than it should. How can the federal government provide support in the meantime?

For example, if it’s too difficult for local health departments to maintain all their other pandemic operations on top of scaling up a vaccination program, can the National Guard take over testing? If there are vulnerable residents in hard-to-reach areas, can the federal government supply and staff mobile vans?

Recruit an army of vaccinators. It makes no sense to have already exhausted hospital workers take on the job of vaccinating their communities. Instead, we should be enlisting community health workers, retired health professionals, and medical, nursing and dental students. It’s much more efficient to have the federal government work through national associations than each state figuring out recruitment on their own. The federal government can also remove licensing barriers and cover liability protection to quickly deploy this workforce.

Pilot mass vaccinations in select cities. Rather than distributing vaccines solely on a per-capita basis, the federal government should identify cities and counties that can immediately launch mass vaccination programs. New York City, for example, has one of the most well-funded public health systems in the country. Its mayor, Bill de Blasio, has said the city can vaccinate a million people by the end of January. The federal government can select, say, 10 regions with the highest likelihood of success. Give them a month to distribute a million doses each.

To those who say it’s not fair to favor areas that already have more resources: This is not the time for the lowest common denominator. There are other ways to aim for equity, for example, by allocating the next round of funding based on the federal government’s social vulnerability index. Let the pilot cities work through the roadblocks and write the playbook for everyone else.

Build community vaccination centers. The last place that vaccinations should be done are overcrowded hospitals. Existing pharmacies and clinics will also not provide the scale and speed that’s needed. Germany has already set up dozens of mass vaccination centers capable of inoculating thousands every day. Italy has established pop-up vaccination pavilions. Some states have plans to do this, too. The federal government can expedite this process of repurposing stadiums, athletic fields and parking lots.

Streamline processes. Getting the shot takes seconds; it’s the paperwork that takes time. Why not require the paperwork be completed in advance? Imagine if everyone who wants to be vaccinated must first watch an informational video, complete an online registration form and sign a consent form. Those with questions could call a phone hotline. Everyone would then be told when and where to show up. When they arrive, the only thing they need to do is to get the shot. (Those without online access can have phone or in-person registration options.) Israel has designed an app that accomplishes exactly this purpose. That’s partly why Israel has already vaccinated 11 percent of its population, including 41 percent of those over 60.

Developing a safe, effective vaccine was a moonshot. Now, we need a similar all-out effort to turn vaccines into vaccinations. We are at war with the virus, and it’s time for the federal government to step up to lead a wartime mobilization. This is our best hope for ending the pandemic, and the American people deserve nothing less.

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