Re: vaccine distribution. America is in the awkward position where it's institutions and human capital have utterly collapsed, but expectations have not yet adjusted. The result is constant humiliating failure, followed by finger-pointing.

The Soviets, though dysfunctional, knew after the 30s to not over-promise. Programs like Sputnik came as a surprise to the world. I guess perennial failure to even FEED your population leads to a bit of realism when it comes to evaluating your own capabilities.

Eventually America will degrade to the point where our elites' civilization pitch resembles this:

"Sure, three quarters of the country can't get clean water. BUT, we've still got three carriers and hundreds of jets built in the 80s that can fuck you up if you don't play ball."