Despite dry runs and contingency planning, a lot can go wrong. Refrigeration problems could ruin doses, and logistical snafus could delay shipments. If hospitals botch the challenge of scheduling a continuous stream of people to get the shots, defrosting doses might go bad. And the pandemic itself could sideline some of the armies of workers involved in the effort.
“Everything has to come together—the packaging, the dry ice, the vials, the material itself. It all has to come together to the same place and have enough of it and exactly the right people there ready to take it,” said Yossi Sheffi, director of the MIT Center for Transportation & Logistics. “Right now, there’s no conductor to the symphony,” just many parts that each need to work.