The Centers for Disease Control (CDC) has asked states to prepare for massive distributions of Covid-19 vaccines by early November.
Public health officials want the most vulnerable high-risk groups to get the Covid-19 vaccine as soon as late October or early November.
Officials agree that health agencies in all 50 states should "urgently" prepare for a complex effort to distribute the vaccines to "hundreds of millions" of Americans - despite the fact that the death rate is very low.
The CDC sent guidance to every state on the same day President Trump told the Republican National Convention that a vaccine might be ready before the end of the year.
Over a dozen companies have accelerated clinical trials in a race to get their vaccines to market first. The usual safeguards have been waived in order to get the vaccines to market in a matter of months.
The FDA normally requires three years of clinical trials before a vaccine goes to market.
The vaccine contains RNA (Ribonucleic acid) that are designed to alter the body's host cells to produce antibodies against the coronavirus.
Unlike normal vaccines, which contain DNA fragments of dead virus to produce antibodies, RNA vaccines are genetically engineered messenger RNA that contain specific directions to alter human DNA and tell it to create proteins, which in turn stimulates the cells to make antibodies.
RNA vaccines don't require dead pathogens to make antibodies. The human host's own genetic code is theoretically supposed to be altered (changed) by the RNA vaccine. RNA vaccines have been used on animals in veterinary medicine for years.
No RNA vaccines have ever been approved for human use.
Dr. Anthony Fauci and and Dr. Stephen Hahn, who heads the Food and Drug Administration, have said in interviews that RNA vaccines should be made readily available for certain groups, i.e. Black people, the elderly over 65, and "those incarcerated", before clinical trials have been completed.
Doctors and nurses on the frontlines will get the vaccines first, according to Fauci.
With so few Black people willing to step up and volunteer to be guinea pigs, the CDC's guidance acknowledged that its distribution plan is "hypothetical".
Dr. Saskia Popescu, an infection prevention epidemiologist based in Arizona, is concerned that the vaccine is highly politicized.
"It's hard not to see this as a push for a pre-election vaccine," he said.
Further complicating the vaccination effort is the cold storage requirement and the fact that two doses will need to be given 2 weeks apart.
"How are you going to make sure people get both [doses]?" said Dr. Cedric Dark, an emergency medicine physician at Baylor College of Medicine in Texas.