Yet having individual doctors administer the vaccine poses a logistical challenge for pharmaceutical companies and the Biden administration, which ships doses to states in large quantities. One vaccine maker, Pfizer-BioNTech, ships 1,170 doses in a single pallet; the other, Moderna, ships packets of 10 vials containing 100 doses.

Those amounts are unsuitable for doctors’ offices and smaller settings, which have been the focus of Alabama’s vaccination effort. Dr. Harris said the vaccine packaging “has been disastrous for us.”

Private employers may be the next pressure point. The private sector is eager to jump in and help educate employees — and even administer vaccines, said Kathryn Wylde, the president of the Partnership for New York City, the city’s leading business organization.

But at this point, mandating vaccination for employees does not seem to be on the table. “Employers feel that Covid has caused such stress on their people, they are reticent to put on any more pressure,” Ms. Wylde said.

Shirley Bloomfield, the chief executive of N.T.C.A. — The Rural Broadband Association, which represents small, rural telecommunications companies, has been working with the White House on pushing her members to get the vaccine. “One of my C.E.O.s is paying everyone $100 to get the vaccine,” she said. “But I think we all have to be a little more creative because we’re seeing that saturation point.”

Even with broad public awareness campaigns, television commercials, and incentives like cash payments and personal time off, Ms. Bloomfield said vaccination rates among staffs at her member companies were topping out at about 50 percent to 60 percent.

On top of that, Ms. Bloomfield said her members reported to her that as many as 15 percent of people in small towns were not showing up for their second shot. She attributed some of that to social media posts about side effects. “That doesn’t help us,” she said.


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