Yes, fall’s vaccine recipe seems set. But much more needs to happen before the nation can be served a full immunization entrée. “It’s July, and we just heard that the FDA would like to see a bivalent vaccine,” with the spike of BA.4 and BA.5 mixed with that of the OG SARS-CoV-2, Schwartz told me. When, exactly, will the updated shots be ready? How effective will they be? How many doses will be available? We just started prepping for this new inoculation course, and are somehow already behind.

Then, once shots are nigh, what will be the plan? Who will be allowed to get one, and how many people actually will? Right now, America’s appetite for more shots is low, which could herald yet another round of lackluster uptake.

There’s little time to address these issues. Fall “is, like, tomorrow,” says Jacinda Abdul-Mutakabbir, an infectious-disease pharmacist at Loma Linda University, in California. Autumn, the season of viral illnesses and packed hospitals, already puts infectious-disease experts on edge. “We dread fall and winter season here,” says Yvonne Maldonado, a pediatric-infectious-disease specialist at Stanford University. The system has little slack for more logistical mayhem. The world’s third COVID autumn, far from a stable picture of viral control, is starting to resemble a barely better sequel to the uncoordinated messes of 2020 and 2021. The coming rollout may be one of America’s most difficult yet—because instead of dealing with this country’s vaccination problems, we’re playing our failures on loop.