(CNN)State officials are skeptical that President-elect Joe Biden can meet his goal of 100 million coronavirus shots in his first 100 days, with a week to go before his start date and a slew of unanswered questions still swirling around his plan.
Multiple state officials and sources familiar with the Biden transition team's outreach told CNN in recent interviews that they are unclear on major details of the Biden team's plans -- including those for mass vaccination sites, vaccine supply issues and funding for local governments.
CNN previously reported that the incoming administration is still deliberating major details of its national vaccination plan. Biden is expected to unveil his plans for vaccines on Thursday, along with a major Covid relief package that his advisers have told allies in Congress is expected to be in the ballpark of $2 trillion, according to two people briefed on the deliberations.
The Biden team has been leaning heavily on individual states to provide critical Covid-19 data during the transition, due largely to a lack of cooperation and transparency from the outgoing Trump administration.
But states have questions, too, starting with a critical one: Will there even be enough vaccines to pull off 100 million shots in the first 100 days?
"It's definitely aggressive," Claire Hannan, the executive director of the Association of Immunization Managers, told CNN.
Hannan said she has been in contact with Biden's transition team about the challenges of vaccine distribution and that she isn't yet convinced the vaccine supply will be able to keep up with Biden's ambitious goals.
The Biden transition team declined to comment.
The lack of clarity has made it difficult for states to map out their vaccination campaigns -- and they're unsure whether the situation will improve under Biden. Sources familiar with planning in both Republican- and Democratic-led states spoke with CNN.
Multiple sources told CNN that the Biden team has said it shares the concerns about vaccine supply and speed of distribution. Biden's team has also been asking state-level officials why there hasn't been more Covid-19 testing, the sources say.
CNN previously reported that Biden himself is deeply worried about the array of public health challenges his administration is about to acquire, and his senior-most advisers are in a sober mood over it.
While many state officials have raised concerns, sources have also described a widespread sense of relief. They note a stark contrast between the outgoing Trump administration's and the incoming Biden team's handling of matters related to the coronavirus. Multiple people described the Biden team as, so far, noticeably more engaged and willing to listen to local officials.
"What the states have been doing is fly the plane a bit as they build it" is how one source familiar with the Biden team's outreach to states described their Covid-19 relief work under the Trump administration's watch.
Both Biden's pick for surgeon general, Dr. Vivek Murthy, and his choice to lead the US Centers for Disease Control and Prevention, Dr. Rochelle Walensky, have been particularly active in their outreach, said two sources familiar with the Biden team's outreach to states.
In addition, an effort is underway to enlist Republican governors in the attempt to publicly push Congress for more funding to help with distribution and other Covid-19 mitigation, sources said.
They have also raised the possibility of establishing mass vaccination sites, one development that has raised questions among some state officials.
Biden has said he will look into tapping the CDC, the Federal Emergency Management Agency, the National Guard and the military to launch vaccination sites in school gyms and football stadiums and to set up mobile units to reach disadvantaged communities. His transition team has discussed the potential use of the US military and the National Guard in Covid mitigation efforts with governors and the Department of Defense, a transition official said.
CNN first reported last week that the Biden team plans to release nearly all doses of the Covid-19 vaccine to immediately administer more shots. The Trump administration has since announced that it will follow suit.
One Democratic state official said they worried that while a more federalized approach like this may be innovative, it may not solve the problem of slow vaccinations.
"Just giving us the vaccine doesn't necessarily help, because we still need more people to administer it," the official told CNN.
This official noted that under some state plans, medical providers are supposed to reach out to their patients to give the vaccine. But many smaller practices lack enough staff for this responsibility, and they don't have the resources to hire.
While the Trump administration has come under fire for the lack of a federal infrastructure to help states distribute the vaccine, this official, whose state has not been in regular contact with the transition team, raised the possibility that changing the process now could cause more harm than good.
"A lot of that sounds very Pollyanna, because I hear the phrase 'mass vaccination site,' and I think to myself, OK, what operating system are they using to register all these people?" the official said. "It's all very pie-in-the-sky."
For his part, Biden has publicly stressed the need for Congress to make more funding available for Covid-19 relief.
His team is also grappling with how best to quickly ramp up vaccination rates without driving people away -- particularly those in communities of color -- who might be fearful of visiting sites run by, for instance, the National Guard.
"There would, hopefully, be a lot of tailored approaches to different communities," said Dr. Nicole Lurie, a volunteer adviser to Biden's team and a former assistant secretary for preparedness and response at the US Department of Health and Human Services. "Some may want and need help standing up mass vaccination sites; others may not."
