The U.S. is entering the second month of the biggest vaccination drive in history with a major expansion of the campaign, opening football stadiums, major league ballparks, fairgrounds and convention centers to inoculate a larger and more diverse pool of people.
After a frustratingly slow rollout involving primarily health care workers and nursing home residents, states are moving on to the next phase before the first one is complete, making shots available to such groups as senior citizens, teachers, bus drivers, police officers and firefighters.
"Every shot in the arm is a step closer to ending this pandemic," Michigan Gov. Gretchen Whitmer said.
Similarly, in Britain, where a more contagious variant of the virus is raging out of control and deaths are soaring, seven large-scale vaccination sites opened Monday at such places as a big convention center in London, a racecourse in Surrey and a tennis and soccer complex in Manchester.
Across the U.S., where the outbreak has entered its most lethal phase yet and the death toll has climbed to about 375,000, politicians and health officials have complained over the past several days that too many shots were sitting unused on the shelves because of overly rigid adherence to the federal guidelines that put an estimated 24 million health care workers and nursing home residents at the front of the line.
As of Monday morning, nearly 9 million Americans had received their first shot, or 2.7% of the U.S. population, according to the Centers for Disease Control and Prevention. Experts say as much as 85% of the population will have to be inoculated to achieve "herd immunity" and vanquish the outbreak.
Many states are responding by throwing open the line to others and ramping up the pace of vaccinations, in some cases offering them 24-7.
Arizona, with the highest COVID-19 diagnosis rate in the U.S., planned to dispense shots beginning Monday in a drive-thru, round-the-clock operation at the suburban Phoenix stadium that is home to the NFL's Arizona Cardinals. Shots are being offered to people 75 and older, teachers, police and firefighters.
In Texas, vaccine megasites opened Monday at the Alamodome in San Antonio and on the Texas state fairground in Dallas. In Houston, nearly 4,000 people were vaccinated Saturday at Minute Maid Park, the home of baseball's Houston Astros.
Detroit is turning its TCF convention center into a vaccination center starting Wednesday, with officials planning to schedule 20,000 appointments over the next month for people 75 and older. Police officers and bus drivers can also start to get vaccinated there at the end of the week.
"We are going to keep ramping up our vaccinations to the maximum extent the supply allows," Detroit Mayor Mike Duggan said.
The slow first stage of the campaign has been blamed in part on inadequate funding and guidance from Washington and a multitude of logistical hurdles at the state and local level that have caused confusion and disorganization.
As Colorado moves into its next phase of vaccine distribution for people 70 and older, frustration is growing among senior citizens who say they have received little or no direct communication from local public health officials.
Joyce Ballotti, 85, and her 94-year-old husband went to a vaccination site in Pueblo, Colorado, on Monday that was supposed to begin at 9 a.m. But around 8:45 a.m., they were turned away because it had run out of vaccine.
"When we saw that exit locked, we said, 'Uh-oh, the city has screwed up again,'" Ballotti said.
A police officer managing traffic waved them away, and they received no guidance on other vaccine sites. Ballotti said she is angry and frustrated about the process.
"I'm about ready to get it not at all," she said, noting that the couple's son had taken off from work to drive them. "I can't ask my son to spend his time on fruitless errands."
In California, one of the deadliest hot spots in the U.S., authorities opened a drive-thru "vaccination superstation" Monday in a parking lot near the ballpark where the San Diego Padres play. The goal is to inoculate 5,000 health care workers a day. They will remain in their vehicles while they are given a shot, and will be asked to stay there for 15 minutes so they can watched for any reactions.
"It really truly was a hassle-free experience," said Julieann Sparks, a 41-year-old nurse who got a shot. She received a text message almost immediately asking her to make an appointment to get the second dose.
Dodger Stadium in Los Angeles will also be pressed into use by the end of the week, with city officials saying it will be able to vaccinate 12,000 people per day when it is fully running.
At the same time, California hit another gloomy milestone, surpassing a death toll of 30,000. It took the state six months to record its first 10,000 deaths but barely a month to go from 20,000 to 30,000. Over the weekend, California reported a two-day record of 1,163 deaths. Hospitals are reaching the breaking point.
About 584,000 doses have been administered in California, or about 1.5% of the population.
Florida, the longtime retirement haven with one of the biggest concentrations of elderly people in the country, is using Hard Rock Stadium in Miami Gardens to dispense shots.
A little over 402,000 doses have been administered in Florida since mid-December, or just under 2% of its population.
Rather than wait for the first designated group of recipients under the federal guidelines to get their shots, Gov. Ron DeSantis has moved to open up vaccinations to people 65 and over.
The move has been met with huge demand, with senior citizens standing in line in the overnight chill or sleeping in their cars. DeSantis said drive-thru sites will be ramped up in the coming days.
In New York City, the epicenter of the outbreak last spring, two 24-7 sites opened and several more are expected to be up and running over the next two weeks. Appointments for the midnight-to-4-a.m. shift on Tuesday were snapped up quickly.
In "the city that never sleeps, people are immediately grabbing those opportunities to get vaccinated," Mayor Bill de Blasio said.
As of Monday, the state began offering vaccines to people over 75, teachers, transit workers and other front-line workers.
Saad Omer, director of the Yale Institute for Global Health, said it is reasonable to speed things up and move on to the next group of people as long as health workers and nursing home residents continue being given shots at the same time.
"Our country should be able to walk and chew gum when comes to its immunization program," he said.
Pane reported from Boise, Idaho, and Watson reported from San Diego. Nieberg, based in Denver, is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.