After States and counties have been left to handle their share of the first batch of vaccines, distribution became chaotic. 

 In a rural hospital in Arkansas, the 975 doses per tray of Pfizer Covid-19 vaccine contains way too many, but splitting trays into smaller shipments has risks. That is an example of the logistical issues in safely getting the Pfizer vaccine to rural health care workers. Another is once the vaccine is out of the freezer at 94 degrees below zero, the vaccine can only last five days and, thus, must be refrigerated in transit.

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According to Dr. Jennifer Dillaha, Arkansas epidemiologist, since over 40 percent of Arkansas territories are rural and Covid-19 infections are climbing, resolving this delivery dilemma is serious.

Dillaha said, "If their providers come down with Covid-19, there's no one there to take care of the patients." The same difficulties echo with Colorado, Georgia, Indiana, Kentucky, Utah, and Wisconsin. The first drive of the nation's mass Covid-19 vaccination effort, marked by a lack of direction and miscommunication from the federal level, has been muddled.

The national government passed most vaccine-related decisions to state and county officials. They are to weigh where to send vaccines best first and which of the two vaccine manufacturers authorized by the Food and Drug Administration for emergency use makes the most sense for their nursing home, hospital, local health department, and school. For months state officials notified that they lacked the resources to do vaccine distribution. The Centers for Disease Control and Prevention then is set to receive the significant funding chunk of Congress's latest relief bill, $8.75 billion, which they are likely to pass this week.

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The executive director of the Association of Immunization Managers, Claire Hannan, said, "The feat facing public health officials has absolutely no comparison in recent history." And said that the H1N1 swine flu shot lurid logistics in 2009 is not comparable with Covid-19 vaccines.

Hannan said, "It was a flu vaccine. It was one dose. It came at refrigerator-stable temperatures. It was nothing like this."

As the logistical hurdles of the vaccines made by Pfizer and BioNTech were laid within a few days of implementation. The majority of the officials hope that Moderna vaccines will be easier to handle as it comes in containers of 100 doses only and doesn't require deep freezing. It will last for 30 days from the time it's out of the refrigerator.

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According to the chief operating officer of Operation Warp Speed, Army Gen. Gustave Perna, the national government divided the new batch of almost 8 million doses of Pfizer and Moderna's vaccines for distribution this week. 

Perna said he took "personal responsibility" for exaggerating how many Pfizer doses states would receive, while the Federal deferred decisions have directed confusion.

Dillaha said, "Sometimes we don't have information from CDC or Operation Warp Speed until right before a decision needs to be made. 

Other state officials have different opinions of the rollout. Georgia's Coastal Health District health director Dr. Lawton Davis said they disbursed more than $27,000 on two ultra-cold freezers for the Pfizer vaccines and treats them like gold. They manage public health for eight counties.