More than a dozen states have called up the National Guard to help at vaccination sites, and Joe Biden may mobilize Guard units nationally.
On a recent day, the parking lot at Pasquotank High School in Elizabeth City, N.C. was transformed into a kind of vaccine freeway, with four lanes of cars bearing drivers and passengers getting COVID-19 inoculations.
And several of those administering the shots were in camouflage.
President-Elect Joe Biden says he's going to activate National Guard troops to help with the nation's lagging COVID-19 vaccination rollout.
But North Carolina is among more than a dozen states that have already beaten him to it. Gov. Roy Cooper has used National Guard troops from the beginning of the pandemic for things like running testing sites and food banks. Now he's begun calling up even more citizen soldiers to boost the vaccination effort.
Guard officials say there will be 250 troops helping within the next two weeks, inducing up to 20 vaccination teams, plus more soldiers to help with the planning, logistics and administrative work of running the vaccination clinics.
They're already making a difference.
At the high school, the four lines of cars crept toward teams of Guard soldiers working shoulder to shoulder with health department nurses.
Michael Barclift, a behavior coach for the local school system, rolled to a stop and killed his engine as Maj. Hollis Guenther walked up.
"Hi, sir," said Guenther. "Today, you're going to get the Moderna vaccination, which basically means in a month, you're going to want to get the Moderna booster shot."
He gave Barclift additional information about what to expect. Then Barclift pulled forward a few feet, where Tech Sgt. Steven Simpson was waiting with the hypodermic needle.
Simpson swabbed his arm, then warned Barclift the shot would feel like be a slight pinch.
Afterwards, Barclift said he had some initial reservations about the vaccine, but educated himself on it and decided it was wise to get it.
"I've been you know, kind of watching other people and talking to different people and so I feel very confident in it today," Barclift said.
By the end of the day, 400 people were inoculated at the pop-up clinic with the help of the six-soldier "strike team."
Guenther said as an emergency room nurse practitioner in his civilian life, he's worn down from the pandemic - sick of seeing people suffering and dying from it. But helping out with the vaccine effort has given him a lift.
"Working in emergency departments has just been a beating," he said. "So now just trying to ... get up ahead of this infection, get the world back to eating out again and seeing Grandma, and not going to funerals."
As his team worked with health department nurses vaccinating drivers and passengers, other soldiers across town were processing some of the paperwork generated by the appointments, which local officials said takes significantly longer than actually giving the shots.
Battle Betts, director of Albemarle Regional Health Service, said it was a huge relief for his small staff to get the Guard's help.
"They've been phenomenal," he said. "Their training, their background. This is perfectly in their wheelhouse. So it is helping tremendously to pull a lot more people through the lines in a much more efficient process."
His organization is responsible for eight counties. The smaller ones each have just two nurses who can do vaccinations on top of their other work. Already hammered by nearly a year of fighting the pandemic, they face a daunting challenge: vaccinating a population of 160,000 people. Twice.
"So you're really talking about 320,000 immunizations, because you got to get all those folks back for that second dose," said Betts.
These clinics are part of the largest immunization effort in U.S. history, and they come after a year that saw the most Guard troops activated nationally since World War II.
And, like the health department nurses, the Guard has had to cope with pandemic duty while also covering its normal missions. They have to stay trained for combat missions and be ready to help with natural disasters like hurricanes. At the beginning of the pandemic, about 3,000 troops from the North Carolina Guard were on deployment to the Middle East.
And the pandemic has been a major mission for nearly a year.
"At one point in time, we had almost 1,000 soldiers that we called up," said Maj. Gen Todd Hunt, the Adjutant General of the North Carolina National Guard. "And we knew that's not sustainable forever because of the pandemic, and then National Guardsmen and Airmen also have civilian jobs."
Hunt said that while duty for things like hurricane recovery typically lasts a few days or weeks, it was clear from the beginning that the pandemic would be a long effort. So instead of ordering people to duty, the Guard initially called for volunteers.
"We've had to adapt in how we do military business to basically take care of our soldiers and airmen and also the people we're out there supporting," he said.
Nearly 200 volunteers have been on duty since the beginning of the pandemic and are now working on food banks and at COVID-19 testing sites.
The vaccination teams were ordered to duty, though.
It's unclear how long the state will need Guard troops in that role, but Hunt said he doesn't expect it to end quickly.
"I think we'll have a part into it until we get as many vaccinations as the citizens require," he said. "So we're in it for a while."
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.