In South Carolina, one hospital in the city of Beaufort had to cancel 6,000 vaccine appointments after it received only 450 of the doses it expected. In Hawaii, a Maui hospital canceled 5,000 first-dose appointments and put 15,000 additional requests for appointments on hold.

In San Francisco, the public health department had at one point expected to run out of vaccines this week because the city’s allocation dropped sharply from a week ago and California officials temporarily had to put thousands of doses on hold after a higher than usual number of possible allergic reactions were reported. In New York State, officials in Erie County have canceled thousands of vaccine appointments in recent days after a sharp decline in allocations from the state.

The situation is especially dire in Texas, which is averaging about 20,000 new coronavirus cases a day, fueling concerns over whether officials will be able to curb the spread when they cannot get their hands on the vaccines they desperately need to do so.