Public health officials: More support needed,

Public PROVIDENCE, R.I. — health officials sounded the alarm for months, complaining that they did not have enough support or money to get COVID-19 vaccines quickly into arms. Now the slower-than-expected start to the largest vaccination effort in U.S. history is proving them right.

As they work to ramp up the shots, stateandlocalpublic health departments across theU.S. cite avarietyof obstacles, most notably a lack of leadership from the federal government. Many officials worry that they are losing precious time at the height of the pandemic, and the delays could cost lives.

States lament a lack of clarity on howmany doses they will receive andwhen. They say more resources should have been devoted to education campaigns to ease concerns among people leery of getting the shots. And although the federal government recently approved $8.7 billion for the vaccine effort, it will take time to reach places that could have used the money months ago to prepare to deliver shots more efficiently.

Such complaints have becomeacommonrefrain in a nationwhere public health officialshave been left largely on their own to solve complex problems.

“Therecurringthemeisthe lack of a national strategy,” said GianfrancoPezzino, who was the public health officer in Shawnee County, Kansas, until retiring last month.

Operation Warp Speed had promised to distribute enoughdosestoimmunize20 million people in the U.S. in December. Itmissed that target, andasofFriday, about6.6 million people had received their first shot, according to the Centers forDisease Control and Prevention.About 22 mllion doses have been delivered to states.

The American Hospital Association has estimated that 1.8 million people need to be vaccinated daily from Jan. 1 toMay 31 to reach widespreadimmunityby thesummer. Thecurrentpaceismore than 1 million people per day below that.

President-elect Joe Biden on Friday called the rollout a “travesty,” noting the lack of a national plan to get doses into arms and reiterating his commitment to administer 100 million shots in his first 100 days. He has not shared details and was expected to discuss the effort thisweek.