Public health departments, which have struggled for months to test and trace everyone exposed to the novel coronavirus, are now being told to prepare to distribute COVID-19 vaccines as early as Nov. 1.

In a four-page memo this summer, the federal Centers for Disease Control and Prevention told health departments across the country to draft vaccination plans by Oct. 1 “to coincide with the earliest possible release of COVID-19 vaccine.”

The CDC’s director, Dr. Robert Redfield, also wrote to governors last week about the urgent need to have vaccine distribution sites up and running by Nov. 1. Redfield asked governors to expedite the process for setting up these facilities. McClatchy first reported Redfield’s letter.

But health departments that have been underfunded for decades say they currently lack the staff, money and tools to educate people about vaccines and then to distribute, administer and track doses to some 330 million people. Nor do they know when, or if, they’ll get federal aid to do that.

“There is a tremendous amount of work to be done to be prepared for this vaccination program and it will not be complete by Nov. 1,” said Dr. Kelly Moore, associate director of immunization education at the Immunization Action Coalition, a national vaccine education and advocacy organization based in St. Paul, Minnesota. “States will need more financial resources than they have now.”

Dozens of doctors, nurses and health officials interviewed by Kaiser Health News and The Associated Press expressed concern about the country’s readiness to conduct mass vaccinations, as well as frustration with months of inconsistent information from the federal government.

The gaps include figuring out how officials will keep track of who has gotten which doses and how they’ll keep the workers who give the shots safe, with enough protective gear and syringes to do their jobs.

With only about half of Americans saying they would get vaccinated, according to a poll from AP-NORC Center for Public Affairs Research, it also will be crucial to educate people about the benefits of vaccination, said Molly Howell, who manages the North Dakota Department of Health’s immunization program.

The unprecedented pace of vaccine development has left many Americans skeptical about the safety of COVID-19 immunizations; others simply don’t trust the federal government.