CDC has issued recommendations intended to ensure that the nation’s vaccines first reach those at higher risk: health care workers who interact with COVID-19 patients, residents and staff at nursing homes. Those groups are followed by individuals age 75 and older. Each state has established their own guidelines, and pressure has been growing for a more flexible approach. Many health care facilities have begun to distribute the vaccine to employees who might not have direct contact with COVID-19 patients or meet the age requirement for this phase. The CDC and FDA have also recently suggested that it might be wise to loosen criteria and distribute the vaccine as soon and widely as possible. With divergence of federal and state guidance, health care facilities are under competing pressures on how to prioritize vaccination distribution.