Here’s a strategy to balance the competing objectives: Allocate the next batch to Americans over 65. But also encourage states to take aggressive steps to distribute the vaccines to older people in underserved communities, by, say, locating distribution sites in low-income neighborhoods and offering options for at-home vaccination for seniors who can’t travel.

The CDC can also ask governors, based on their states’ circumstances, to address other populations suffering more from the virus. Some governors have told me they may distribute the vaccine to homeless shelters early in their process. In Rhode Island, Gov. Gina Raimondo may focus early on low-income communities where crowded housing and other hardships have led to an especially high positivity rate.

This will reduce death from Covid while also creating a system that can be rolled out easily. We know who is over 65, and since most of them are covered by Medicare, these patients are relatively easy to find.