Likely the biggest immediate challenge of the Biden administration is improving the vaccine rollout. His new COVID-19 team has said it aims to administer 100 million shots for 50 million Americans in the first 100 days of office. It’s a plan some are still challenging

“I invoke the Mike Tyson principal. Everyone has a plan until they are punched in the mouth and it feels like we're being punched in the mouth. The rollout has been extraordinarily slow and sluggish,” said an expert during a debate with the Journal of the America Medical Association (JAMA).

Vaccine experts debated with JAMA about the possible benefits and consequences of getting all the doses available into more Americans, resulting in a delay of the second dose.

The concern wasn't necessarily how protected people would be if they delayed getting the second dose by a few weeks. In trials, both vaccines produced higher immunity responses after the first dose than the flu shot overall. The concern was more around the mixed messaging and Americans’ perception.

“What worries me is that there are people who are going to hear this and say, you know, ‘I’m 80-90% effective. That’s not that much different than 95%. I got my dose, I’m good. I hadn’t suffered with that first dose, why bother getting the second dose?’ That worries me,” said an expert.

“That they see this as yet another curve ball and like you told me masks didn't work, then you told me they did, then you told me I needed to clean my mail and now you're telling me I don’t, and I’m just so confused I’m just not going to get vaccinated,” said an expert.

There are also concerns the system for determining who is next to get the vaccine is too complex, actually creating more opportunities for inequity.

“Who is going to be able to figure their way around the system? Who is going to game it or who is going to have the resource and the wherewithal to get to the front of the line? It’s going to be the well-to-do, it’s going to be the privileged. Exhibit a is the tax code,” said an expert.

One proposed idea is that after nursing homes and health care workers, we move to an age system, where we start with 75 and up, 65 and up, 55 and up. And then possibly a lottery after that based on the last number of your birthdate.

That takes the burden of requiring proof of preexisting conditions and essential worker status off those giving vaccines, so they can speed up administering them.

The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.

COLUMBUS, Ohio — The rate of new vaccinations against COVID-19 in Ohio has slowed to a rate not seen since December, according to an analysis of state data.

The seven-day moving average of newly vaccine started Ohioans dipped below 10,000 on Sunday for the first time since Dec. 27 — the tail end of a stretch when some days brought more than 10,000 new infections and 200 deaths from the new disease.

Only 46% of Ohioans have received at least one dose of the vaccine as of Thursday, compared to 52% of the U.S. population.

Average new vaccination rates plummeted in early April as a scarcity of doses gave way to a lack of demand. In mid-May, this trend modestly reversed after the federal government authorized vaccination of children 12-15 and Gov. Mike DeWine announced a series of $1 million lottery drawings for vaccinated Ohioans.

While scarcity defined the early days of the vaccination campaign, spoilage may soon prevail. DeWine said this week that Ohio possesses about 200,000 doses of the Johnson & Johnson vaccine that expire June 23. Ohio has no legal options, he said, for giving the doses to other states or countries.

“For Ohioans who have been waiting to get their vaccine, I urge you to take action now. There are many opportunities throughout the state to get a vaccine,” he said.

“The Johnson & Johnson vaccine is one of those options. It is safe and effective and only requires one shot. In just two weeks, you could be protected from this virus. Getting vaccinated is the quickest way out of the pandemic and the fastest way for us to return to the lives we remember.”

Despite the sweepstakes (still ongoing), vaccination rates began falling by late May.

Estimates vary, but experts believe when somewhere between 70% and 90% of the population is vaccinated, a “herd immunity” effect is produced in which the virus runs out of viable hosts. Thus, people who are medically unable to receive vaccinations or have weakened immune systems are insulated by their vaccinated neighbors.

If Ohioans continue to seek vaccinations at the current race of about 10,000 per day, it will take nearly a year (more than 334 days) until about 75% of Ohioans are vaccinated.

Vaccine coverage is much stronger among older Ohioans than younger.

Some racial groups are underrepresented as well. About 8% of doses have gone to Black Ohioans, who represent about 13% of the state. About 3% of doses have gone to Ohioans who identify as Hispanic or Latino, who represent about 4% of the state.