It's been over a month since Pfizer (PFE -1.07%) and BioNTech (BNTX -0.12%) won U.S. emergency use authorization (EUA) for their COVID-19 vaccine. It's been nearly a month since Moderna (MRNA -2.21%) won U.S. EUA for its vaccine. But not nearly as many Americans have been vaccinated as hoped. In this Motley Fool Live video recorded on Jan. 6, 2021, Healthcare and Cannabis Bureau Chief Corinne Cardina and writer Keith Speights discuss why the U.S. is running behind schedule with its vaccination rollouts.

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Corinne Cardina: Turning now to the US which of course has authorized those same two vaccines, one from Moderna, one from Pfizer-BioNTech. Keith can you give us an update on what is going on in the US. What was the original goal that the U.S. government set for vaccination by the end of 2020 and did we get there at the end of the year?

Keith Speights: No, we didn't get there -- where "there" was the U.S. government was originally stating that they wanted to vaccinate 20 million Americans by the end of the year. Now, when they say vaccinate, they clarified that that meant getting the first dose, which is understandable since the second dose is at least three weeks later for the Pfizer vaccine and four weeks later for the Moderna vaccine. The goal was to get to 20 million by the end of the year. We didn't come close [laughs]. I think the latest number is a little under 5 million, maybe 4.8 million or so, just barely a fraction of that 20 million and there are several reasons behind that.

Cardina: Definitely. I put a vaccine tracker in the chat for y'all at the CDC. The most official, that's the latest number, 4.8 million doses have been administered. However, there have actually been 17 million doses that have been distributed. A little bit of a disconnect in that last mile, getting the vaccine out of the freezer and into people's arms. An NBC report over the weekend actually said that at the current rate of vaccination, and they did a whole analysis, it will take 10 years to vaccinate 80% of the U.S. population. Keith, what do you think about that?

Speights: That doesn't sound encouraging does it? [laughs].

Cardina: It doesn't.

Speights: No. 1 -- that assumes that things won't improve. I think it's important for us to remember that this is still early, that they are still learning how to get the vaccines out to Americans. The other thing is the CDC noted that the numbers probably are under counting a little bit because there's a lag time involved here in terms of how quickly the states can get their numbers into the CDC about how many vaccine has been administered. The actual numbers probably are somewhat higher, how much higher? We don't know. But we're still way behind, there's no doubt about that, but it may not be quite as bad as it looks right now.

Cardina: I think Anthony Fauci had said he thinks the momentum will pick up in January, so we will stay tuned on that front. Let's talk about what some of the challenges are that are actually keeping vaccinations from the speed that we had hoped. There's been some things that the CDC has said is part of the problem, you mentioned data reporting, there's also manufacturing. What do investors need to know about what the hurdles are that we're encountering in logistics and manufacturing.

Speights: Well, I think one thing investors need to realize is just the timing of the initial rollout. We had two holidays: We had the Christmas holiday; we had the new year's holidays. And some of the healthcare workers needed to administer vaccines were taking vacations during this time. And so there were some temporary challenges that shouldn't be an issue going forward. I think that's one thing to remember. I think you'll see the momentum pick up as a result of that.

The other thing is, unlike some of the other countries we might talk about, in the United States there is a federal role, but there is a state role. And ultimately is the states who will be in charge of getting these vaccines out to their citizens, and some states are doing a great job at it and other states aren't.

The other thing to remember is that a lot of these states are just stretched in. The COVID-19 pandemic has really hit them hard; it's hit their healthcare teams hard, it's hit state agencies hard and so they are running into a lot of challenges as a result of that. I think they'll surmount this, but I think some states will do this better than others.

Cardina: Yeah, and if you look at that CDC COVID vaccination tracker, it actually has a map and it tells you -- it really eliminates those differences between the states. Some are much further ahead and the number of people they are vaccinating per 100,000 in the population and others are just really early stages. That is definitely something to keep in mind.

Another thing is manufacturing. There was a Wall Street Journal article over the weekend about COVID-19 vaccines. They are in high demand, but a lot more workers are needed and the article actually called out Emergent BioSolutions (EBS -4.91%). This is a company that makes the AstraZeneca vaccine and they have just been trying to hire people but they are apparently not able to get enough people. How does manufacturing in that capacity play into these challenges?

Speights: That's the under-the-radar story here. We're assuming that all of these vaccines are just going to roll off the manufacturing lines. That particular report shed some light on some of the challenges that Emergent BioSolutions is facing. And it could be that other companies could face some of those challenges as well and so there could be some hiccups.

The other thing to remember is, we're in winter. Especially in some of the Northern states, I think we could run into some weather-related issues with getting the vaccines out.

Murphy's Law can manifest itself in a lot of ways and it probably will. I think we'll see things go wrong, but I think it's important to step back, take a look at the big picture. The vaccines are being produced, they will be distributed, there could be some wrinkles and issues along the way, but we'll get there over time.