The US is vaccinating people way too slowly. A top doctor says the federal government is to blame.

• According to analysis from NBC News, it could take the US nearly a decade to vaccinate enough Americans to bring the pandemic under control at its current pace.
• President-elect Joe Biden on Tuesday said the Trump administration is falling "far behind" on vaccinations.
• Dr. Ashish K. Jha, dean of Brown University's School of Public Health, said the problem lies with the federal government, which has bucked the responsibility of vaccine distribution to already overwhelmed state health departments.

Dr. Ashish K. Jha, a top US doctor and the dean of Brown University School of Public Health, on Tuesday shared in a Twitter thread why he believed the rollout of COVID-19 vaccines in the US was flawed, and he said the issue begins with the federal government.

The US Food and Drug Administration in December authorized two different vaccines for COVID-19 - one created by Moderna and the National Institutes of Health, and another created by Pfizer and BioNTech - for emergency use in the US.

While people across the US have already begun to receive the vaccine, a limited supply means the vaccine won't be widely available to all who need it well into 2021, prolonging the pandemic that has so far killed more than 336,000 people in the US, according to data from Johns Hopkins University.

According to an analysis published Tuesday by NBC News, at the current pace, it could take the US nearly a decade to vaccinate enough Americans to meaningfully bring the pandemic under control. The White House previously said it aimed to vaccinate 80% of Americans by the end of June, which would require more than 3 million vaccinations per day, according to the report. So far, the US has vaccinated just about 2 million people in 16 days.

President-elect Joe Biden, who last week received the first dose of the two-shot Pfizer vaccine, on Tuesday said the Trump administration is falling "far behind" on vaccinations.

"As I long feared and warned, the effort to distribute and administer the vaccine is not progressing as it should," Biden said.

"A few weeks ago, the Trump administration suggested that 20 million Americans could be vaccinated by the end of December. With only a few days left in December, we've only vaccinated a few million so far," he added.

The president-elect on Monday said he plans to invoke the Defense Production Act, a wartime production law giving the president authority to pressure US industries to produce supplies, to speed up vaccine production once he takes office in January.

'No plan, no money, just hope that states will figure this out'

In his Twitter thread, Jha first noted that Secretary of Health and Human Services Alex Azar said in October that the US would be prepared to have 100 million doses of the vaccine ready to ship by December, and that Azar later reduced that number to 40 million.

Jha pointed out that Operation Warp Speed, the White House effort centered around the vaccine, had further reduced the estimate, saying there would be 20 million doses ready by the end of this year.

"Now, we'll miss 20M deadline but might be able to get to 20M by sometime in early January," Jha wrote. "But this is really not the worst part. The worst part is no real planning on what happens when vaccines arrive in states."

"No plan, no money, just hope that states will figure this out," he added.

In another tweet, Jha said state departments of health, which are already tasked with "testing, data analysis & reporting, providing advice to businesses, schools, doing public campaigns," will be further stretched to their limits because they have to manage the vaccine distribution.

While the specifics of how vaccines are distributed is up to states, the Centers for Disease Control and Prevention has offered general guidelines.

"Most are super stretched and they are trying to make a plan," Jha said of state health agencies. "They are trying to stand up a vaccination infrastructure. Congress had given them no money."

Read more: 5 public health experts told us what the US needs to do right now to get COVID-19 under control

Jha said public health measures had always been a collaboration between state and federal agencies.

"States are stretched," he said, adding that the same people who blamed states for issues with testing capacity earlier in the pandemic are now going to blame states for issues with the vaccine rollout.

Jha said some states were passing the burden of vaccine distribution plans onto hospitals and long-term care facilities, leaving these facilities "trying to figure out where to set up vaccination sites" and to determine "who can do vaccinations in care facilities."

"To be sure, many states are taking real responsibility," Jha said. "LOTS of overburdened public health folks are still making this work."

He added he found it to be "frustrating" that there "appears to be no investment or plan in the last mile" from the federal government to assist states in creating an infrastructure to distribute vaccines.

But it's not all bad news, Jha said, adding there was "hope" now that the federal government had allocated money for vaccine distribution as part of the COVID-19 relief package passed by Congress last week and signed by President Donald Trump on Sunday.

Jha's entire thread is worth reading to understand the challenges with the US vaccine rollout. It starts here: