The Biden Administration faces major challenges as it seeks to tame the coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities. The roll-out of vaccines for residents and staff plods along, while a big concern may be rising as facility staffing keeps eroding.

The New York Times reported that Walgreens and CVS, the chain pharmacies that the Trump Administration chose to partner with with to deliver vaccine shots to long-term care facilities, have vaccinated 1 million and 1.6 million residents and staff, respectively.

Both companies say the vaccination rollout has been rockier and tougher than expected, with issues in getting required consent for shots for the elderly, sick, and injured, as well hesitancy among staff. Vaccine supplies have been less predictable than would be optimal, though the pharmacies are not reporting shortfalls. Rina Shah, a group vice president at Walgreens, told the New York Times that the logistics and scheduling of vaccinations, with multiple visits at facilities, has required a “monumental effort.”