The much-anticipated US vaccine distribution is off to a slower start than expected, with <a href="https://www.thenationalnews.com/world/more-than-two-thirds-of-vaccine-doses-in-us-left-unused-1.1140629">more than two thirds of the initial batch of doses unused</a> as of this week. The underwhelming start to the US vaccine distribution programme makes president-elect Joe Biden's promise <a href="https://www.thenationalnews.com/world/the-americas/joe-biden-criticises-trump-administration-s-handling-of-covid-vaccine-programme-1.1137086">to vaccinate 100 million Americans against Covid-19 within his first 100 days in office</a> all the more challenging. But even if Mr Biden succeeds in the lofty goal of vaccinating an average of 1 million Americans a day, they still may not be able to return to their pre-Covid lives until 2022. And it could be even longer should the incoming administration falls short in its distribution efforts. "I don't think we're going back to normal even with a big roll-out campaign for at least another year or more," Dr Arthur Caplan, head of New York University's division of medical ethics, told <em>The National</em>. Because of the urgency for developing the vaccines, scientists have not been able to confirm whether they will prevent recipients from transmitting the virus in the same way other vaccinations do. This lack of certainty would mean the continued use of masks and social distancing for some time after their vaccinations. “You still need to keep wearing your mask because we don’t know if the vaccines stop transmission,” Dr Caplan said. “They stop people from getting sick, but it’s not clear that they could stop you from being a silent spreader.” But he does believe it is feasible to vaccinate 100 million Americans within the first 100 days of the Biden administration. “We could push something out quickly but it’s going to take a much more concerted and planned effort than anything the Trump administration did,” Dr Caplan said. “They utterly failed to prepare for the roll-out despite promises that they would.” “State, counties and municipalities are not prepared to distribute. They weren’t set up to do it. They’ll have to make that happen.” Mr Biden’s transition team has yet to reveal what he will do differently to speed up vaccine distribution. New York Governor Andrew Cuomo and Florida Governor Ron DeSantis – a Democrat and Republican – have responded to the delays by threatening to penalise hospitals that do not distribute the vaccines they receive within a week. And while the first doses of the vaccine have largely been reserved for front-line healthcare workers and residents of long-term care centres, a California hospital administered 600 doses within two hours on Tuesday after its freezer broke. “We have all these rules about who goes first, but my attitude is let’s just get it into people’s arms,” Dr Caplan said. “I don’t care who should go first. It shouldn’t be sitting in a warehouse. “We spent a lot of time arguing about rationing but we didn’t spend as much time trying to get stuff out to as many people as we could.” And while a rapid vaccine distribution programme will not provide a golden ticket back to immediate normality, it could still yield some much-needed growth for the US economy. A <a href="https://www.thenationalnews.com/business/economy/global-economy-to-grow-4-in-2021-amid-vaccine-rollout-world-bank-says-1.1141007">World Bank report</a> published on Tuesday estimates that US economic growth is forecast to recover by 3.5 per cent in 2021, thanks in part to vaccine distribution. The report predicts that growth will be “held down in the early part of the year by subdued demand amid renewed restrictions and a broad-based resurgence of Covid-19". “Activity is expected to strengthen in the second half of this year and firm further next year, as improved Covid-19 management, aided by ongoing vaccination, allows for an easing of pandemic-control measures.” While the report says that “additional fiscal support and improved pandemic management” could propel growth past 3.5 per cent, that rate could be much lower should the Biden administration fail in its vaccine distribution programme. “It would mean a major economic engine is still sputtering,” Dr Caplan said. “It means that schools are still falling behind in terms of educating students. It means that mental health issues are worsening.” “The number one priority of this administration has to be getting to those 100 million vaccinations in 100 days. "It’s going to be crucial. Everything else is secondary.”