“If we have a big surge in cases and deaths after the December holidays and we don’t have the vaccine distribution plan back on course we’re in big trouble,” one senior administration official said.

As part of the conversations about how to quickly improve distribution, officials in task force meetings, in interagency phone calls and in a Camp David summit Tuesday suggested that states should distribute the vaccine—doses that may soon expire—to any individuals who want to get inoculated. These people would get the vaccine, even if they are not frontline healthcare workers, essential workers, over the age of 75 years old. There has been no formal decision to draft recommendations in this vein, officials said they are not against states pursuing this course of action and have transmitted to some local officials that they should embrace the idea. Health and Human Services Secretary Alex Azar and other top Operation Warp Speed officials met at Camp David Tuesday to discuss the next two weeks of the vaccination rollout and the transition to the Biden administration.

“We need to make sure that the critically ill and most vulnerable people are getting this vaccine first,” one senior administration official said. “But after that if there are doses that are just sitting in fridges expiring, we got to get them out there.”