D.C. region rolls out coronavirus vaccine amid push to reach priority groups

By Rebecca Tan, Michael Brice-Saddler and Lola Fadulu,

The first doses of a coronavirus vaccine were administered Monday in the Washington region, marking the start of a logistically massive undertaking that officials hope will halt a virus that has infected more than 540,000 residents and killed more than 10,000 in the area.

Governments and hospitals are hosting events this week to show residents getting vaccinated as part of an effort to foster public trust in the vaccine. D.C., Maryland and Virginia are reserving the first shipments for health-care workers, first responders and nursing home residents.

Members of the public, officials said, probably will have to wait until spring. The rollout comes as the seven-day average of new infections approaches 7,000 across the greater Washington region — the most since the start of the pandemic.

“We still have a long way to go,” Maryland Gov. Larry Hogan (R) said to a group of hospital workers who were vaccinated Monday afternoon, “but you guys are the first. And we’re proud of all of you.”

Virginia Gov. Ralph Northam (D) said the vaccine’s arrival is a “much-needed symbol of hope” for the state. Speaking at the Bon Secours hospital in Richmond, which received a batch of doses on Monday, he urged residents to remain vigilant.

“This is the first step in a months-long process to receive, distribute and administer the vaccine as it becomes available,” he said.

Monday’s activity came as advocates for people with intellectual and developmental disabilities are calling on officials to add those individuals to the Phase 1 priority list, especially if they live in group homes. Research shows that they are significantly more likely to die of the novel coronavirus than others in the public, but Maryland and D.C. officials ­haven’t said when people with those disabilities might receive the vaccine.

[Va. group homes for adults with disabilities feel ‘forgotten’ in virus funding]

“We just don’t know where folks with developmental disabilities are [on the vaccine list],” said David Ervin, chief executive for the Jewish Foundation for Group Homes, which operates 29 sites in Virginia and Maryland. “So far, nothing has been articulated.”

D.C. officials said “residential care community residents” would be in the latter part of the first phase of its distribution plan, though it’s not clear whether that would include residents of group homes. First in line are health-care workers and first responders, city Health Director LaQuandra Nesbitt said last week.

As hospitals in the city received their first doses Monday, D.C. Mayor Muriel E. Bowser (D) encouraged residents to beware of misinformation about the Pfizer-BioNTech vaccine, which the Food and Drug Administration authorized last week. She cited the vaccine’s efficacy and reminded residents that it would be normal to experience symptoms such as headaches and sore muscles after receiving it.

Six institutions will receive the city’s initial allotment of 6,825 doses this week. Five employees at George Washington University Hospital, including emergency medicine nurses and anesthesiologists, were among the first in the nation’s capital to receive the vaccine.

Shylee Stewart, a labor and delivery nurse, said she initially was unsure about receiving the vaccine because of possible side effects. “I was hesitant because I was uneducated,” Stewart said. “And then I did my own research and talked to my colleagues . . . and I had no doubt once I educated myself.”

Raymond Pla, an anesthesiologist, was the sole Black worker of the five to get vaccinated. His message to Black Americans was that it didn’t hurt and was supported by robust research.

“If you want the funerals from the covid-19 infection to slow down and stop, you got to get the vaccine,” he said.

Some government workers in the city, including members of the fire department, will be vaccinated this week as part of a campaign to build confidence in the vaccine, particularly among Black and Latino residents.

“My mother died when I was 5,” said Lt. Keishea Jackson, a firefighter who volunteered to be vaccinated. “My father is everything to me — whenever I come home from work every day, I have anxiety about passing [the virus] on to him.”

Like Pla, Jackson said she wants to “send a message to Black and Brown people” about the safety of the vaccine.

“It is my race that is dying at a high rate,” she said.

[Amid history of mistreatment, doctors struggle to sell Black Americans on coronavirus vaccine]

D.C. officials said last week that the city is being shortchanged on vaccine doses. There are nearly 85,000 health-care workers in the city, but because most of them commute from Virginia or Maryland, the city expects to receive only a fraction of the requisite doses in its first shipment from the federal government.

On Monday, Nesbitt said Virginia would provide about 8,000 doses of the vaccine to residents employed as health-care workers in D.C.

Virginia and Maryland are expected to receive 70,000 and 50,000 doses, respectively, of the vaccine in their first shipments. Officials in both states also have said those estimates fall far short of what they need to protect all health-care workers, much less other vulnerable groups such as nursing home residents or those with other health conditions.

Daphne Pallozzi, chief executive of CHI Centers, which operates 17 group homes in Maryland, urged Hogan last week to include group home residents in the state’s vaccine distribution priority list. She cited a recent study that includes data from Maryland and shows that individuals with intellectual disabilities are at least twice as likely as others in the public to die of covid-19, the disease caused by the coronavirus.

The Centers for Disease Control and Prevention says in its vaccine guidelines that states should prioritize long-term care settings.

Erin Beard, a Virginia Health Department spokeswoman, said Monday that group home residents will have the highest vaccine priority in the state. But Charlie Gischlar, a spokesman for the Maryland Health Department, said adults with intellectual disabilities fall under “Phase 1B” in the state’s vaccine distribution plan, meaning they will receive it after hospital workers and nursing home residents.

More details on vaccine distribution will be “fleshed out as more information is received from the federal government,” he said.

Group home providers, who care for thousands of vulnerable individuals in homes of four to six, say they have struggled to get adequate state and local assistance throughout the pandemic.

[Coronavirus cases and metrics in D.C., Maryland and Virginia]

When the virus arrived in the spring, advocates say, they received less help in procuring protective equipment and cleaning supplies than nursing homes. In August, a coalition of providers told Virginia lawmakers that some group homes would close indefinitely without financial relief.

Amid soaring community spread, the virus has made its way back into some group homes, providers say. Without early vaccination, they say these facilities are likely to report more deaths.

The greater Washington region on Monday reported more than 5,700 new infections. Virus-related hospitalizations and deaths have trended upward since mid-November and are likely to continue growing until there is a significant change in transmission rates.

“We’re seeing record case numbers, and they’re continuing to grow, and they’re going to continue to increase,” said Neil J. Sehgal, assistant professor of health policy and management at the University of Maryland.

Dana Hedgpeth contributed to this report.

Read more:

Officials outline plans for coronavirus vaccine distribution in Washington region

D.C. says it is being shortchanged on coronavirus vaccines for health-care workers

Group homes for disabled adults grapple with the spread of coronavirus

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Surgeon general urges vaccine education among communities of color

Surgeon General Jerome AdamsJerome AdamsOvernight Health Care: White House warns COVID-19 cases at dire levels | CDC director: Winter could be ‘most difficult time in the public health history of this nation’ | US plans for 100 million vaccines by March White House moves forward with holiday parties during pandemic The Hill’s Morning Report – Presented by Mastercard – Coast-to-coast fears about post-holiday COVID-19 spread MORE on Monday stressed the need for education about the COVID-19 vaccine in communities of color, specifically in Black communities, which have justifiably low levels of trust in health care institutions.

“Having a vaccine is only the first step. We must now move from vaccines to vaccinations. And it would be a great tragedy if disparities actually worsened because the people who could most benefit from this vaccine won’t take it,” Adams said at a press conference from George Washington University Hospital in Washington, D.C. 

“We know that lack of trust is a major cause for reluctance, especially in communities of color. And that lack of trust is not without good reason, as the Tuskegee studies occurred in our lifetimes. To encourage diverse enrollment in clinical trials, we must first acknowledge this real history of mistreatment and exploitation of minorities by the medical community and the government,” he added.

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Adams, who is Black, was referring to a project also known as the Tuskegee syphilis study, which was started by the Public Health Service in 1932. The premise of the study was to “record the natural history of syphilis.” The Black men who participated in the study were given free medical exams in payment but were never offered treatment for the disease, even after penicillin became the main form of treatment for syphilis.

While all of the subjects agreed to be part of the study, they did so unaware of the nature of the study and were, in fact, misled by researchers. The federal study wasn’t ended until 1972.

Today, disparities in the health care system have significant negative impacts on Black Americans. Black women are nearly three times more likely to die during childbirth than white women. The U.S.’s Black infant mortality rate is more than two times greater than its mortality rate for white infants. 

Lack of access to quality health care has been highlighted as one of the reasons why COVID-19 has disproportionately devastated communities of color.

On Monday, New York City critical care nurse Sandra Lindsay, who is Black, publicly became the first person in the country to receive the vaccine.

Many current and former leaders, including former President Obama, have said that they would receive the vaccine on camera to help promote its safety and efficacy.

Networking – December 2020

Awards and Honors

  • LouAnne Neill of Neill Construction Services LLC, received the Associate of the Year Award from the Building Industry Association of Washington. Neill has served on the Home Builders Association of Tri-Cities board of directors nearly every year since 1997 and has been a BIAW director since 2007. Over her time as a member, she has served on over nine committees between HBATC and BIAW and regularly volunteers at the Regional Home and Garden Show and the Fall Home Show. Neill currently serves as BIAW’s 2020 second vice president.
  • Energy Northwest electrician Levi Dunlap received the Good Samaritan Award from the Washington Public Utility Districts Association for his quick actions in response to clear the airway of a choking coworker. He was recognized for his role in a July 10, 2020, incident when he noticed a coworker, who had been eating a snack, in distress. Dunlap quickly realized the individual was choking and administered the Heimlich maneuver, clearing the coworker’s airway. The association presented its annual awards recognizing the outstanding dedicated service and commitment of individuals serving PUDs at the organization’s annual conference on Dec. 3.
  • Two Pacific Northwest National Laboratory researchers have been elected fellows of the American Association for the Advancement of Science. PNNL’s Janet Jansson and Ron Thom were chosen by their AAAS peers for their efforts to advance science or its applications.

Jansson was selected for advances in the field of microbial ecology. She is chief scientist for biology in PNNL’s Biological Sciences Division and a Laboratory fellow. She has studied complex microbial communities living in soil, sediments and the human gut for more than 30 years. Her research has led to a better understanding of the impact of a changing climate on microbial communities in prairie and arctic ecosystems, including how warming temperatures affect permafrost soil microbiomes and drought on grassland soils. Jansson is a leader of a focused effort funded by the U.S. Department of Energy on the microbiome of the soil, teasing out questions about how drought, temperature and other factors influence the environment. She has authored more than 200 publications and is the editor of two books on molecular microbial ecology and a textbook on soil microbiology. She previously served as president of the International Society for Microbial Ecology and on numerous advisory panels, including the National Academy of Science Committee on Science Breakthroughs for Food and Agriculture by 2030.

Thom was selected for nearly five decades of research on coastal and estuarine ecosystem research. After positions in California and with the Army Corps of Engineers and the University of Washington, Thom joined PNNL’s Marine and Coastal Research Laboratory in Sequim in 1990, working as a research scientist and managing MCRL’s Coastal Ecosystem technical group for more than 20 years. He retired from PNNL in 2013 and is currently an emeritus scientist at MCRL, as well as the outgoing president of the Washington Academy of Sciences. Over his 48-year career, Thom has led and participated in studies on the ecology of seagrasses, seaweed, salt marshes and tide flats; the effects of climate change on estuarine and coastal ecosystems; and the adaptive management of restored ecosystems.

Jansson and Thom will be recognized during a virtual induction ceremony on Feb. 13, 2021. AAAS is the world’s largest multidisciplinary scientific society with a mission to “advance science, engineering, and innovation throughout the world for the benefit of all people.” A designation of fellow is the society’s highest honor. PNNL now has 33 active staff members who hold the rank of AAAS fellow.

  • EHS Today, a national occupational health and safety publication, has named Washington River Protection Solutions as one of America’s safest companies. The designation recognizes companies that exemplify excellence in safety leadership and promote a world-class safety culture. WRPS received several other safety awards in 2020, including the DOE Voluntary Protection Program’s Star of Excellence for the sixth consecutive year. It also received several awards from the National Safety Council, including the Industry Leader & Occupational Excellence award, the Safety Leadership award and the Community Advancement award. In addition, WRPS was recognized by the Council for One Million Safe Work Hours.
  • Marv
    McKenzie
    , a private wealth advisor/financial advisor with Ameriprise Financial Services in Kennewick, recently obtained the certified private wealth advisor designation through the Investment Management Consultants Association. He has more than 35 years with Ameriprise.
  • Edward Jones financial advisor Shelley Kennedy of Richland has been invited to attend Barron’s 2020 Top Women Advisors Summit. This is the second time she has been invited to the invitation-only event. The three-day conference gathers the nation’s top women financial advisors and leading industry decision-makers.
  • The Tri-Cities Hispanic Chamber of Commerce recognized eight outstanding individuals who are positively contributing to the Latino and greater Tri-City community during its Una Tarde de Éxitos awards event in October. They are:

Outstanding Business of the Year: Alisheva Law.

Latino Community Ally of the Year: Donna Kary.

Outstanding Health Care Professional of the Year: Gabriela Araico.

Outstanding Health Care Professional of the Year: Hilda Torres.

Outstanding Community Leader of the Year: Victor Ortega.

Outstanding Community Leader of the Year: Socorro Garcia.

Outstanding Public Servant of the Year: Ray Aparicio.

Outstanding Educator of the Year: Antonio Cruz.

  • The Port of Kennewick’s presented two Friend of the Port awards to recognize outstanding service to the port and the community during a Dec. 8 meeting.
  • Kennewick Police Department was selected as the 2020 Friend of the Port of Kennewick, representing an organization. The KPD leadership team, comprised of police Chief Ken Hohenberg, Cmdrs. Scott Child, Trevor White, Chris Guerrero and Randy Maynard and Lts. Aaron Clem and Christian Walters, received a plaque on behalf of all KPD employees for their compassionate service, rapid response and friendly assistance whenever called, the time and effort their officers spend patrolling and safeguarding the port’s development projects, and for the diligent commitment exhibited by each officer in helping transition Kennewick’s historic waterfront into a destination gathering place.

Kay Metz was named a 2020 “Friend of the Port” for his individual contributions. Metz is a personal steward of Clover Island. Sixty-five years ago, his family created the region’s first marina, and his Metz Mobile Marine is still doing business on the island. In selecting him, port staff said he never hesitates to share his knowledge of boating, maintenance and repair with anyone in need. The port said he keeps a watchful eye on the island and has loaned his pump equipment when boats were sinking. He is a tireless cheerleader for all the port’s endeavors and the go-to resource when the staff has marine-related questions. He has been involved with Tri-Cities Water Follies for 54 years and is a longtime member and a past commodore of the Clover Island Yacht Club. He also was instrumental in helping facilitate a new yacht club building.

New Position

  • Jim Hall, director of communications at Kadlec for the past 26 years, has been selected as Kadlec’s new chief philanthropy officer. Hall joined the Kadlec team in 1994, after working for 12 years in sports and news at a local TV station. Hall will continue to produce and host weekly radio (“Kadlec On Call”) and TV programs (“Community Health Journal,” “2 Minute Take”), working to integrate these communication tools more closely with the work of the Kadlec Foundation

Elections

  • The Historic Downtown Kennewick Partnership has elected four board directors. Directors serve three-year terms to begin January 2021. They are: Theresa Buckendorf, Apollo Mechanical Contractors; Shaun Ehlers, Free Culture Clothing; Jasmine Howell, Banner Bank; and Joel Watson, Just Joel’s.

Donations

  • To help curb food insecurity among college students and especially amid the Covid-19 pandemic, Lamb Weston donated $25,000 to the Washington State University Tri-Cities Cougar Cupboard as part of Giving Tuesday on Dec. 1. The Cougar Cupboard is a food pantry program that allows students to access individual food items or pick up a package of food for themselves and their families. It features both fresh and pre-packaged food and toiletry items. The donation actualizes on the third year of a three-year naming sponsorship totaling $75,000. The $25,000 gift will continue to support costs to run the Cougar Cupboard and provide food to WSU Tri-Cities students and their families throughout the next year.
  • The Kennewick Fire Department and the Kennewick Firefighters Local 1296 teamed up Dec. 5 to build 50 bicycles at this year’s Covid-safe “Bikes for Tikes” event. They will be distributed to children of various ages throughout the Tri-City area by the Heads UP Tri-Cities Foster Kids Committee. Typically, hundreds of volunteers across the Tri-Cities region come together to assist with the annual bicycle build, sponsored by the Plumbers and Steamfitters Local 598. This year, the annual event took a different approach. Organizations were asked to participate as micro-build groups to keep the event safer by limiting the size of each group.

Grants

  • Two Kennewick School District teachers will use grants from the local PSI Chapter of Delta Kappa Gamma Society International to buy materials to enhance student learning. The grants are $250 each. Recipients are Katelyn Berry, a kindergarten teacher at Westgate Elementary School, and Jayme Brackett, pre-physical therapy instructor at Tri-Tech Skills Center. Berry plans to use her grant to buy Math Stackers materials for her class, and Brackett to buy virtual reality materials for her program. The group also selected Southridge High School graduate Bailey Berger as the recipient of its $1,000 scholarship. Berger, who graduated from Southridge High in June 2020, is attending Washington State University and plans to become an elementary school teacher. Delta Kappa Gamma Society International works to promote professional and personal growth of women educators and excellence in education.

Appointments

  • Gov. Jay Inslee announced new board and commission appointments for November 2020. These include: Chaune Fitzergald of Richland, Commission on African American Affairs; Physician Assistant Joel Quiroz of Richland, Board of Osteopathic Medicine and Surgery; and Phil Tracy of Pasco, Developmental Disabilities Council.

New Hires

  • Mark Gomolski, a volunteer and former board member of Eastern Oregon Mission, has been hired as executive director of the organization. Along with volunteering in the food box program and as a board member, he has helped with fundraisers and other functions increasing the community’s awareness of Agape House and Martha’s House, the two outreach programs of the mission.

Gomolski replaces Cathy Putnam, who served as interim director since October 2019 following the retirement of Dave Hughes. Gomolski’s first day was Dec. 1.

Through November, Agape House handed out 9,286 food boxes and more than 11,000 weekend food backpacks for students, a program that was extended to year-round in light of Covid-19.

In October 2020 the board hired Julia Galan as an on-site house manager at Martha’s House, a drug-free transitional housing program. In 2020 the program has assisted 18 families with housing, education, workforce training, mentorship and encouragement.

The Latest: Taiwan sets 60% of population vaccination goal

TAIPEI, Taiwan — Taiwan has set a goal to vaccinate 60% of its population with a COVID-19 vaccine, or 15 million people, a health official said Tuesday.

Taiwan has signed an agreement with COVAX to purchase a COVID-19 vaccine, but is also actively in talks with vaccine companies who have candidates in phase 3 trials for a potential bilateral agreement as well, said Jing-Hui Yang, a deputy director at the Central Epidemic Command Center. COVAX, a global plan to distribute vaccines equally, has not yet started sending out shipments of vaccines.

The island will prioritize frontline health workers and essential personnel to receive the vaccine first, Yang said. Later on, the immunization campaign will target the elderly as well as those who have existing chronic illnesses.

Officials expect the vaccines to arrive early next year. Still, an immunization campaign will take time, and will not be finished in just a month or two, Yang warned.

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THE VIRUS OUTBREAK:

— COVID-19 vaccine shipments begin in historic US effort

— Tens of thousands of new child brides are being married off as their families struggle amid the pandemic’s economic fallout

— London and nearby areas will be placed under the highest level of restrictions starting Wednesday

— AP PHOTOS: Italian health workers still under enormous strain. One says “Christmas I will be here. Just like I had Easter here, just like August here, just like every day.”

— Scientists focus on bats for clues to prevent next pandemic

— After 110,000 virus deaths, U.S. nursing homes face vaccine fears

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Follow AP’s coverage at https://apnews.com/hub/coronavirus-pandemic and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

SEOUL, South Korea — South Korea has reported another new 880 cases of the coronavirus as it slipped deeper into its worst wave of the pandemic yet.

That brought the country’s caseload to 44,364 on Tuesday, which was the 38th consecutive day of triple-digit daily increases. More than 10,000 infections have been reported in the last 15 days alone, mostly from the densely populated Seoul metropolitan area where health workers are struggling to stem transmissions tied to various places, including hospitals, long-term care facilities, restaurants, churches and schools.

The death toll was at 600 after 13 COVID-19 patients died in the past 24 hours. The Korea Disease Control and Prevention Agency said 205 among 11,205 active patients were in serious or critical condition as fears grow over possible shortages in intensive-care units.

Critics say the country’s viral resurgence underscores the risk of encouraging economic activity when vaccines are at least months away. The government had lowered social distancing restrictions to the lowest tier in October out of concerns about sluggish growth rates despite experts warning of a viral surge during winter when people spend longer hours indoors.

The government restored some restrictions over the past weeks, such as shutting down nightclubs, halting in-person school classes and requiring restaurants to provide only deliveries and take-outs after 9 p.m.

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CHARLESTON, W.Va. — West Virginia Gov. Jim Justice became one of the first top elected officials in the country to receive a coronavirus shot on Monday evening, even though the state’s rollout is supposed to prioritize giving the highly sought-after vaccines to health care workers and people in long-term care centers.

The 69-year-old Republican governor said he wanted to demonstrate confidence in the vaccine’s safety.

“It’s as safe as can be,” Justice said at the statehouse room where he hosts regular news conferences. Wearing a mask, he received a jab in his right arm from a state pharmacy board official and promptly received an adhesive bandage — and a sticker. Four other top state officials, including the health officer and head of the National Guard, next rolled up their sleeves and also received shots live on camera.

“Don’t hesitate, you’ve got to get this vaccine,” Justice added.

Many other governors are waiting for health care workers, patients and emergency responders first.

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DES MOINES, Iowa — The state of Iowa is returning $21 million of federal coronavirus aid money it planned to spend on upgrading state information technology systems, Iowa Gov. Kim Reynolds said Monday.

Reynolds said in a statement she has directed the Iowa Department of Management to return the money to the state’s virus relief fund by Friday.

The funds were initially allocated for payments related to the state’s contract with Workday, a cloud-based human resources, finance, and planning system being implemented to modernize the state’s IT infrastructure. Of the allocation, $4.45 million had already been spent.

Reynolds said U.S. Treasury officials initially assured the state the Workday project was an allowable expense but has now determined the payments were not allowed expenditures under the federal Coronavirus Aid, Relief, and Economic Security Act.

Reynolds said the state has spent all but $47.3 million of the $1.25 billion Iowa received from the federal virus relief fund, which must be allocated by Dec. 30.

She confirmed the money will be allocated by the deadline but said an extended deadline would be helpful to “allow time to use the funds to create additional programs and support other needs among Iowans.”

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CAIRO – Egypt on Monday reported its highest daily confirmed cases in months, with 511 new cases. The Health Ministry also added 23 fatalities to its death tally from COVID-19, the disease caused by the virus.

The increase came amid repeated warnings by the government about a second wave in the pandemic. Authorities have been urging people to stick to preventive measures participle face masks and social distancing.

Egypt, the Arab world’s most populous country with more than 100 million people, has reported more than 122,086 confirmed cases, including 6,943 deaths.

However, the actual numbers of COVID-19 cases, like elsewhere in the world, are thought to be far higher, in part due to limited testing.

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OKLAHOMA CITY — An Oklahoma City emergency room nurse has become the first person in the state to be vaccinated with Pfizer’s coronavirus vaccine.

Hannah White, 31, laughed before the vaccination and again afterward as she hugged the person who injected her at Integris Baptist Medical Center while showing no reaction as the needle entered her arm.

“I don’t have any burning at the site, I have no pain. I didn’t feel it,” White said, and encouraged others to receive the vaccination as they become eligible based on the state’s four-phase plan.

The first 33,000 doses of the Pfizer-BioNTech vaccine arrived Monday in the state, according to state health commissioner Dr. Lance Frye.

The plan developed by the state health department calls for frontline healthcare workers to be the first vaccinated. Long-term care providers and residents, paramedics, emergency medical technicians, and pharmacy staff who will administer the vaccine in long-term care facilities are also to be among the first inoculated.

White was the first of 10 Integris employees who each volunteered to receive the vaccine, said hospital CEO Timothy Pehrson. “

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SACRAMENTO, Calif. — Rep. Karen Bass of California, who previously worked in a hospital as a physician assistant, said the vaccine distribution should be concentrated in the areas that have been hardest hit by the pandemic.

“Let’s take Alabama, for example,” she told the AP on Monday. “It would be a travesty if in Alabama the vaccine were distributed equally. It needs to be distributed equitably, because you have extreme disproportionate infection and death rate in certain communities.”

Bass, who is Black, said its important for people to know that a Black woman scientist was central to the vaccine’s development.

“Having trusted messengers from community organizations, from the faith community, from the medical community talking to people in the African American community is the way to increase the utilization of the vaccine,” she said.

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WASHINGTON — Health and Human Services Secretary Alex Azar and Surgeon General Jerome Adams stressed the vaccine’s safety and effectiveness, while raising issues of social equity.

The officials spoke Monday at a George Washington University Hospital event Monday to launch the vaccination of health care workers in the nation’s capital.

Adams, who is Black, said it would be a tragedy if the disparate impact of COVID-19 on communities of color got worse because of hesitancy to get the vaccine. “We know that lack of trust is a major cause for reluctance, especially in communities of color,” said Adams.

Azar said the vaccines bring hope, but “all of that hope doesn’t matter if we don’t bridge to that point” where widespread vaccination puts and end to the pandemic. So he called on Americans to double down on practicing responsible behaviors such as avoiding travel and gatherings, maintaining social distance, wearing masks and washing their hands frequently.

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TORONTO — Canada has administered its first doses of COVID-19 vaccine.

Five front-line workers in Ontario are among the first Canadians to receive the vaccine at one of Toronto’s hospitals.

Three personal support workers, a registered nurse, and a registered practical nurse who work at the Rekai Centre nursing home are among the first to receive it.

Ontario received 6,000 doses of Pfizer’s COVID-19 vaccine Sunday night and plans to give them to about 2,500 health-care workers.

Residents of two long-term care homes Quebec will be the first to receive the Pfizer-BioNTech vaccine in that province.

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PARIS — Restaurant and bar owners, hoteliers, waitresses, and other employers and workers from France’s world-famous catering and service industries have protested in Paris for the right to work again during the pandemic.

The government has indicated that restaurants and bars might be allowed to reopen from Jan. 20 if infections don’t surge anew.

But the economy minister said Monday that he couldn’t guarantee that that date would hold.

About 1,000 people protested in Paris, pleading for more financial aid and the right to reopen eateries and watering holes that have been forced to close to curb infections.

Among them, retired chef Michel Solignac fretted that the restaurant that he spent decades developing before handing it over to his son could go under if they can’t reopen soon.

“We have to cling on,” he said. “Psychologically, I don’t know how I would react if I was obliged to shut down. It really would hurt.”

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LONDON — Britain’s health secretary says London and surrounding areas will be placed under the highest level of coronavirus restrictions starting Wednesday as infections rise rapidly in the capital.

Matt Hancock said Monday that a new variant of the virus may be to blame. He added that the government must take swift action after seeing “very sharp, exponential rises” in Greater London and nearby Kent and Essex. He said that in some areas, cases are doubling every seven days.

He told lawmakers that the surge of COVID-19 cases in southern England may be associated with a new variant of coronavirus. He didn’t provide details about the virus variant, but stressed there was nothing to suggest it was more likely to cause serious disease, or that it wouldn’t respond to a vaccine.

“We’ve currently identified over 1,000 cases with this variant predominantly in the south of England although cases have been identified in nearly 60 different local authority areas,” he said. “And numbers are increasing rapidly.”

Hancock said officials are assessing the new strand of the virus, and that the World Health Organization has been notified.

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TAMPA, Fla. — A 31-year-old nurse at Tampa General Hospital rolled up her left shirt sleeve on Monday and became one of the first people in Florida to receive the COVID-19 vaccine.

The vaccination was held during a news conference at the hospital, with Gov. Ron DeSantis looking on. “This is a really, really significant milestone in terms of combatting the coronavirus pandemic,” he said of vaccinations getting underway in Florida.

Florida joined other states across the country to start administering the vaccination.

Earlier Monday, DeSantis and others watched as a FedEx truck pulled up to the hospital with the Pfizer vaccine, which was just approved by the FDA for emergency use last week. The governor signed for the shipment and watched as the vaccines were placed in a deep freeze storage unit, at a temperature of minus 79 degrees. The hospital received 3,900 vials on Monday. Each vial has five doses.

“This is 20,000 doses of hope,” said John Couris, president and chief executive officer, Tampa General Hospital. — This entry has been corrected to show that the nurse in Tampa was among the first to be vaccinated in Florida, but not the first.

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NEW ORLEANS — Louisiana administered its first coronavirus vaccines Monday at a New Orleans area hospital.

Workers at the facility who regularly encounter COVID-19 patients got the vaccine as Gov. John Bel Edwards watched the immunizations.

Dr. Leonardo Seoane, chief academic officer for Ochsner Health, was one of the first employees to get vaccinated. A Cuban American, Seoane called it “a privilege” and urged “all of my Hispanic brothers and sisters to do it. It’s OK.”

Louisiana’s first shipments of an estimated 39,000 Pfizer vaccines this week all will go directly to hospitals to administer. Other hospitals around Louisiana expect to receive their first doses later in the week. Edwards traveled to Jefferson Parish to see the vaccines being administered in person.

“Today is the beginning of the end because I just saw some shots going into arms here,” the Democratic governor said in the livestreamed video.

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SAN DIEGO — A San Diego strip club is still open despite a vow from California’s attorney general vowing to take legal action if it does not close to comply with the state’s stay-at-home order that was issued earlier this month.

The lawyer for Pacers Showgirls International said Monday that a court order issued last month makes it clear the business is protected from restrictions issued by San Diego County and state officials.

A hearing in the case is scheduled for Wednesday. The judge is expected to decide whether the preliminary injunction the issued last month allowing two strip clubs to remain open extends to the new stay-at-home order.

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NEW YORK — Coronavirus vaccinations have begun in New York.

A nurse at Long Island Jewish Medical Center in Queens got what Gov. Andrew Cuomo called the first shot given in the state’s campaign to vaccinate front line health care workers.

“I feel hopeful today. Relieved,” said critical care nurse Sandra Lindsay after getting a shot in the arm.

The head of the hospital system, Michael Dowling, stood over Lindsay as a doctor, Michelle Chester, administered the dose. Cuomo watched via a livestream.

All four applauded after the shot was given. “This is the light at the end of the tunnel. But it’s a long tunnel,” Cuomo said.

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TOPEKA, Kan. — Kansas health care workers have begun receiving the first of the state’s coronavirus vaccines amid an ongoing fall surge in cases that has left hospitals stressed.

Spokeswoman Roz Hutchinson said Monday that five employees of the Via Christi Ascension health care system received shots at its St. Francis hospital in Wichita, including a critical care nurse, a housekeeper for a COVID-19 unit and a respiratory therapist.

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BELGRADE, Serbia — Serbia has tightened border entry rules ahead of Christmas and New Year holidays fearing further surge in new coronavirus infections when thousands arrive from abroad.

Epidemiologists said Monday that starting next week foreign citizens coming to Serbia will need a negative test for the virus while Serbia’s citizens will have to self-isolate for ten days upon arrival or provide the negative test.

The measure aims to prevent additional rise in infections in the Balkan country whose health system is already suffering under the burden of thousands of daily new cases.

Carol Sutton, a Stage and Screen Actress Devoted to New Orleans, Dies at 76

Ms. Jopes said that her sister was drawn to singing and acting from an early age. In high school, she transferred to Xavier University Preparatory School to be closer to a football player she was dating, Archie Sutton.

She briefly attended Xavier University before dropping out to marry Mr. Sutton, who would go on to play for the Minnesota Vikings. They had two children, but the couple later separated.

In her mid-20s, Ms. Sutton became a member of the Dashiki Project Theater, an organization for actors and playwrights that gathered in the auditorium of the St. Francis de Sales Catholic Church, on the corner of Second Street and Loyola Avenue.

The group, which was formed during the Black Arts Movement, fostered a community of artists and was the foundation for Ms. Sutton’s acting career, said Adella Gautier, an actress who was also part of the group and a close friend of Ms. Sutton’s.

“A lot of original work came out of that group, dealing with the Black experience and based in a Black neighborhood,” Ms. Gautier, 72, said. “It allowed people in the area to be exposed to quality artistic experiences.”

About five years after joining the Dashiki Project Theater, Ms. Sutton was cast in her first television film, “The Autobiography of Miss Jane Pittman,” which starred Cicely Tyson and was first broadcast in 1974. Ms. Sutton went on to appear in multiple feature films, including “Steel Magnolias” in 1989, “Ray” in 2004, “The Help” in 2011, and “Poms” last year — all while acting in stage productions in New Orleans. Her many stage credits include productions of “4000 Miles” and “A Raisin in the Sun,” and she appeared on television shows including “Treme” and “Queen Sugar.”

Last year, Ms. Sutton played a family matriarch, Lena Younger, in a production of “A Raisin in the Sun,” a play by Lorraine Hansberry, at the Ashe Power House Theater in New Orleans. In a review, the critic Theodore P. Mahne of The Times-Picayune said her performance was “filled with grace notes” and called Ms. Sutton “a genuine treasure of the stage.”

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‘The weapon that will end the war’: First coronavirus vaccine shots given outside trials in U.S.

“Sandra, you didn’t flinch,” New York Gov. Andrew M. Cuomo (D) told the critical care nurse after the injection was administered, as he watched via live stream from his office.

“It didn’t feel any different than taking any other vaccine,” said Lindsay, seated in a puffy, blue armchair.

But this vaccine is monumentally different. Developed in record time, it is expected, eventually, to help end a pandemic that has crippled much of life in the United States — and globally — for the better part of a year.

“I believe this is the weapon that will end the war,” Cuomo said.

Vaccinations rolled out across the country Monday, with doctors and nurses at hospitals nationwide injecting one another as part of a federal plan to prioritize front-line health-care workers. Some said they had dedicated the experience to the patients they had lost, or to family members they had seldom seen as they battled around-the-clock to save others.

“I just lost my 27th patient today,” said Louisville physician Valerie Briones-Pryor. “So the vaccine I took today was for her family and for the other 26 I lost.”

The immunization campaign will rapidly expand in the days ahead, with some states beginning to include nursing homes. Federal officials leading the effort to manufacture and distribute the vaccines said Monday that they expect 20 million people to get the first of two required doses by the end of the year.

The first batches shipped overnight Sunday following emergency use approval over the weekend, with hospital administrators eagerly checking online tracking tools for arrival updates. In several states, governors were on hand at hospital loading docks as crates of the vaccine, packed in dry ice, were delivered to doctors and nurses who cheered their arrival.

The first inoculation was heavy on symbolism: Long Island Jewish Medical Center, in Queens, was on the front lines of the covid-19 fight this spring. It is part of the Northwell Health System, which has treated more than 100,000 covid patients. Several who were among the first to receive the vaccine, Lindsay included, are Black, a reflection of the virus’s outsize toll in communities of color.

But as Cuomo, Lindsay and others watching live celebrated, they also offered reminders that it will take months for enough people to be vaccinated to influence the broader course of the virus among the public.

“There’s light at the end of the tunnel,” Lindsay said. “But we still need to wear masks and social distance.”

And even with the injection, Lindsay was not fully protected. The vaccine administered Monday — developed by Pfizer with the German company BioNTech — requires two doses to achieve the 95 percent effectiveness that studies have shown.

The initial distribution of 2.9 million doses will come as much-needed relief for medical workers and for residents and staffers at long-term care facilities. But it alone will not arrest the spread of a virus that has never been more prevalent or destructive in the United States than it is today.

The first inoculations Monday came at a time when the United States is averaging more than 200,000 new cases and nearly 2,500 deaths each day. Both are record highs.

Nonetheless, large segments of the population continue to ignore warnings to wear masks and avoid gatherings. A significant segment of the country also says it has no intention of getting immunized: Recent surveys have shown between 42 percent and 61 percent of Americans are willing to get vaccinated.

Monday’s vaccinations — carried out on television and via live stream on social media — were aimed squarely at upping that percentage before the vaccine is made available to the general population, which is likely to happen in the late winter or spring.

“We just have to do it,” Cuomo said. “The vaccine doesn’t work if it’s in the vial.”

President Trump — who has repeatedly mocked mask-wearing and other public health measures while touting the virtues of a vaccine — signaled his approval. “First Vaccine Administered,” he tweeted within minutes of Lindsay’s injection. “Congratulations USA! Congratulations WORLD!”

The United States was not the first Western country to administer the Pfizer-BioNTech vaccine. That distinction belonged to Britain, which started inoculations last Tuesday with a shot in the arm of 90-year-old Margaret Keenan.

Approvals in the United States took slightly longer. But many American hospitals on Monday were wasting no time getting the process underway, administering doses nearly as soon as they had been delivered. More than half of states had received their initial vaccine shipments by around midday Monday.

At UPMC Children’s Hospital of Pittsburgh, UPS driver Dallas White wheeled a single box of the vaccine through the hospital’s loading dock and up to the pharmacy first thing Monday.

Once there, Lynn Peffer, an inventory specialist, and Carol Vetterly, the clinical pharmacy director, used tongs, a box cutter and even a cake knife to work their way through the thickly packaged parcel. Beneath a layer of dry ice, they found a container the size of a kitchen tile containing 975 doses of the vaccine.

The doses were administered to front-line workers who interact with covid-19 patients, including emergency room doctors, intensive care nurses, anyone assigned to patient transport and even custodial workers.

Sylvia Owusu-Ansah, an emergency medicine physician, was among them. She said she wanted to take the vaccine to demonstrate to fellow African Americans that it was safe.

“There is a skepticism there that is not unwarranted,” she said, referencing the seed of distrust among Black Americans about experimental medicine — planted with the Tuskegee syphilis experiment, in which Black men in the study were left untreated. “Basically, if I can do it, they can do it.”

In next-door Ohio, Gov. Mike DeWine (R) was on hand when a UPS delivery truck carrying 975 doses of the vaccine arrived outside the Biomedical Research Tower at Ohio State University’s Wexner Medical Center in Columbus at 9:15 a.m.

Just over an hour later, the inoculations were underway.

“Vaccinators, are you ready? Recipients, are you ready? Three, two, one!” Elizabeth Seely, Wexner’s chief administrative officer, announced to a room of 30 front-line health-care workers and vaccinators.

The first six shots were met with cheers and applause.

Robert Weber, 63, chief pharmacy officer and one of those administering the vaccine, said it was a “once-in-a-lifetime opportunity.”

In an appearance at George Washington University Hospital in D.C., Health and Human Services Secretary Alex Azar called the vaccine “a medical miracle.” He said that an additional 30 million Americans are predicted to receive a first dose of the vaccine in January.

Efforts are expected to be bolstered by a vaccine developed by Moderna that is in the process of being reviewed by federal regulators and, officials said, could be available for use starting next week.

For hospitals preparing to start the vaccination process, there was an expectation of desperately needed relief.

“The vaccine will liberate our workforce, the people who are really working, taking care of patients, from worrying about whether they face a death sentence from accidentally getting infected,” said David Lubarsky, chief executive of the University of California at Davis health system.

Nearly 10 months after the UC Davis Medical Center staff treated the first known U.S. case of community transmission, the Sacramento hospital was prepared to receive 4,875 doses of the Pfizer vaccine on Tuesday.

That depended, of course, on a smooth delivery of the shipments. But on Monday, there were no reports of serious delays.

“It’s humbling being a part of this vaccine process, because it’s going to save a lot of lives,” said Byron Bishop, a UPS driver who pulled his truck up to University of Louisville Hospital at 9:40 a.m. He was greeted by applause, plus an elbow bump from Kentucky Gov. Andy Beshear (D).

Beshear said he was feeling “the best I’ve felt since March 6,” the day Kentucky counted its first coronavirus case. “Today is the day we start winning the war against covid.”

Later, he appeared to be fighting back tears as he talked about a close friend who lost his mother to the virus and then had to go into quarantine for two weeks, preventing him from grieving with his family.

On a day devoted to allaying concerns about the vaccine, medical professionals were among those who acknowledged some early concern, given the extraordinary speed with which it was developed.

“My initial thought was, it usually takes years and years to get a vaccine approved for anything, so I was a little skeptical at first,” said David Meysenburg, who directs nursing, emergency and trauma services at University of Florida Health in Jacksonville. “But then the more information I got on it, and the more research I did from credible sources, I felt very comfortable.”

He said he still felt that way after receiving his first dose Monday. He also felt hope.

“This is the first time where you can sense that there’s an end in sight,” he said.

At Ochsner Medical Center in Jefferson, La., the administration of the first doses was streamed live on Facebook. The event was a slick production full of medical details, such as how five doses are carried in each vial.

Chief Medical Officer Robert Hart hosted interviews with a diverse group of staffers as they got their shots, sending them off with “CV-19 vaccinated” stickers.

“She is in the middle of it day in and day out,” he said of one nurse, Mia Yepez, who works in a covid-19 unit.

Yepez said it was especially important for her to be there because she is African American. She encouraged her colleagues and others in her community to get vaccinated.

“We want to be able to stop the many admissions,” she said.

Louisiana is one of the many states where the Black community was hit hard by initial waves of the outbreak and where news of the vaccine has been greeted with some skepticism.

When the presidents of two historically Black colleges in Louisiana — Walter M. Kimbrough of Dillard University and C. Reynold Verret of Xavier University — announced in early September that they had volunteered to test one of the vaccines, many reacted on social media with alarm.

On Monday, some of that hesitation showed up on Ochsner Medical Center’s Facebook page, with people commenting that they may eventually get the vaccine but have decided not to at the moment.

Anesthesiologist Raymond Pla was the only Black employee of George Washington University Hospital to be vaccinated Monday. His message to Black Americans was that the shot did not hurt and is supported by robust research. “If you want the funerals from the covid-19 infection to slow down and stop, you got to get the vaccine,” he said.

At the site of the first injection — Long Island Jewish Medical Center in Queens — Yves Duroseau, emergency medicine chair at Manhattan’s Lenox Hill Hospital, was the second person to receive his shot. Michelle Chester, director of employee health services for Northwell Health, administered vaccines to both Duroseau and Lindsay.

“This is the beginning of the end of covid,” Chester said. “Together, as a community, as a nation, we can end this.”

Chester donned purple gloves and gave Duroseau a swift jab with a slender syringe.

“Ready?” she said.

“Please,” Duroseau said.

“Let’s do this!”

Duroseau said he had seen the “devastation” of covid-19 in his family, with the death of an uncle. Another family member is in the hospital with the disease.

“Everyone was waiting for this day,” he said. “It could not have come soon enough.”

Cha and Witte reported from Washington. Wood reported from Louisville. Nick Keppler in Pittsburgh; Lori Rozsa in West Palm Beach, Fla.; Jasmine Hilton in Columbus, Ohio; Rachel Lerman in San Francisco; and Amy Goldstein and Lola Fadulu in Washington contributed to this report.

Nation Of Islam Leader Louis Farrakhan Calls The Vaccine ‘Toxic Waste,’ Refers To White People As ‘Crackers’

Nation of Islam leader Louis Farrakhan advised his followers against coronavirus vaccination in a speech Saturday, calling the breakthrough vaccine “toxic waste” that would harm the black community.

Farrakhan, 87, also sprinkled several anti-white pejoratives throughout his 70-minute speech, referring to white people as “crackers” and “devils.”

“We are so frightened over this Covid, now they’re getting us ready for this vaccine,” Farrakhan said at a virtual event for the National Afrikan/Black Leadership Summit.

“How could you allow him to stick a needle into you, saying he’s helping you?”

Farrakhan’s diatribe came a day before Pfizer began shipping millions of doses of its coronavirus vaccine to health facilities across the country. The first shots were administered to health care workers on Monday.

Health experts have expressed concerns that members of minority groups, who have tended to be at higher risk of serious illness from coronavirus, will avoid taking the vaccine due to distrust of the medical profession and the government. (RELATED: Farrakhan Accuses Fauci And Bill Gates Of Plotting To ‘Depopulate The Earth’ With Coronavirus Vaccine)

Surgeon General Jerome Adams on Monday called for a program aimed at alleviating fears in minority communities about vaccines.

“We know that lack of trust is a major cause for reluctance, especially in communities of color,” Adams, who is black, said at a press conference on Monday, according to The Hill.

“And that lack of trust is not without good reason, as the Tuskegee studies occurred in our lifetimes.”

Adams was referring to the Tuskegee syphilis studies, a research program that ran from the 1930s through the 1970s in which the U.S. government infected African-Americans with syphilis to study the disease.

According to a poll released by Pew Research on Dec. 3, just 42% of black Americans plan to get the coronavirus vaccine, compared to 61% of whites and 83% of Asians.

The Food and Drug Administration granted emergency authorization on Friday to distribute the Pfizer vaccine. Clinical trials found that the vaccine prevented illness from coronavirus in more than 95% of test patients. Pfizer also said that there were no serious side effects in patients during the trials.

Farrakhan dismissed the research findings, and urged his followers who work in health care to reject the vaccine.

“Those of you who are health professionals, they want you to take it first,” he said.

“You notice they’re offering you money now? This devil…offers you $1,000 or $1,500 to take a shot. They give you free shots of toxic waste.”

Farrakhan appeared to be referring to a proposal from former Democratic presidential candidate John Delany to pay people $1,500 to get vaccinated.

Farrakhan referred to white people as “devils” earlier in his remarks.

WATCH:

In his speech, Farrakhan mocked proposals to require children to receive vaccines in order to return to school.

“What a blessing,” Farrakhan said.

“Tell the cracker: I ain’t coming to your school,” he added, using a common anti-white pejorative.

Farrakhan, a longtime vaccine skeptic, advised his supporters against vaccination for coronavirus during a speech on July 4. He said the vaccine was part of a plot orchestrated by Anthony Fauci and Bill Gates to “depopulate the earth.”

During his speech Saturday Farrakhan said that YouTube had removed video of his anti-vaccine remarks from the July 4 event.

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‘Our first real hope’: Florida’s health care workers start to get vaccinated.

Sandra Lindsay, a nurse at Long Island Jewish Medical Center, is inoculated with the Pfizer-BioNTech Covid-19 vaccine by Dr. Michelle Chester in Queens on Monday.
Credit…Pool photo by Mark Lennihan

The first shots were given in the American mass vaccination campaign on Monday, opening a new chapter in the battle against the coronavirus pandemic, which has killed more people in the United States — over 300,000 — than in any other country and has taken a particularly devastating toll on people of color.

Shortly after 9 a.m., the new Pfizer-BioNTech vaccine was administered in Queens, the first known inoculation since the vaccine was authorized by the Food and Drug Administration late last week. It was a hopeful step for New York State, which the virus has scarred profoundly, leaving more than 35,000 people dead and severely weakening the economy.

“I believe this is the weapon that will end the war,” Gov. Andrew M. Cuomo said Monday morning, shortly before the shot was given to Sandra Lindsay, a nurse and the director of patient services in the intensive care unit at Long Island Jewish Medical Center. State officials said the shot was the first to be given outside of a vaccine trial in the United States.

Ms. Lindsay, who has treated patients throughout the pandemic, said that she hoped her public vaccination would instill confidence that the shots were safe.

“I have seen the alternative, and do not want it for you,” she said. “I feel like healing is coming. I hope this marks the beginning of the end of a very painful time in our history.”

President Trump posted on Twitter: “First Vaccine Administered. Congratulations USA! Congratulations WORLD!”

Shortly afterward, Mayor Bill de Blasio of New York City said at a news conference: “To me, we were watching an incredibly historic moment, and the beginning of something much better for this city and this country.”

While the first dose of the vaccine was administered in New York, people across the nation began receiving it on Monday as well. There was plenty of applause and some tears as news cameras captured the mundane rituals of an injection, underscoring the pent-up hope that this was the first step in getting past the pandemic.

“Today is the first day on the long road to go back to normal,” Mona Moghareh, a 30-year-old pharmacist, said after administering the first dose at a hospital in New Orleans.

But the joy was tempered by the harsh reality of the devastation the virus continues to inflict. The United States surpassed 300,000 virus-related deaths on Monday, and cases continue to surge across the country.

The vaccinations started after the F.D.A.’s emergency authorization of the Pfizer-BioNTech vaccine on Friday night. On Sunday, trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine had fanned out across the country, as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour. But the rollout is less centralized in the United States than in other countries that are racing to distribute it.

According to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites were set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.

A majority of the first injections given on Monday are expected to go to high-risk health care workers. In many cases, this first, limited delivery would not supply nearly enough doses to inoculate all of the doctors, nurses, security guards, receptionists and other workers who risk being exposed to the virus every day. Because the vaccines can cause side effects including fevers and aches, hospitals say they will stagger vaccination schedules among workers.

Ms. Lindsay emphasized the symbolic importance that she was the first American to receive the vaccine — as a Black woman, she is among the demographic most disproportionately devastated by Covid-19. African-Americans also have long been subjected to unethical medical research, raising some concern that they may be more hesitant to take the vaccine.

“I want people who look like me and are associated with me to know it’s safe,” she said. “Use me as an example. I would not steer the public wrong.”

Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin receiving vaccinations next week. But the vast majority of Americans will not be eligible for the vaccine until the spring or later.

One of the more than 300,000 coronavirus deaths in the U.S., a patient who died at United Memorial Medical Center in Houston, was covered before being removed from the ICU.
Credit…Callaghan O’Hare/Reuters

The number of people with the coronavirus in the United States who have died passed 300,000 on Monday, another wrenching record that comes less than four weeks after the nation’s virus deaths reached a quarter-million.

Covid-19 surpassed heart disease as the leading cause of death in the United States, the Centers for Disease Control and Prevention director Robert Redfield said in public remarks last week, referring to a breakdown of deaths for a week in early December. Almost the same number of Americans are being lost to the disease each day as were killed in the Sept. 11 terror attacks or the attack on Pearl Harbor.

The surge in deaths reflects how much faster Americans have spread the virus to one another since late September, when the number of cases identified daily had fallen to below 40,000. A range of factors — including financial pressure to return to workplaces, the politicization of mask-wearing and a collective surrender to the desire for social contact — has since driven new cases to more than 200,000 per day. Preventable deaths on a staggering scale, many experts said, were sure to follow.

“There’s no need for that many to have died,” said David Hayes-Bautista, a professor of medicine at the University of California, Los Angeles. “We chose, as a country, to take our foot off the gas pedal. We chose to, and that’s the tragedy.’’

Three hundred thousand is more than the number of Americans who died fighting in World War II. It is roughly half the number of total cancer deaths expected this year. It is the population of Pittsburgh.

But the worst is yet to come.

The first 100,000 U.S. deaths were confirmed by May 27; it then took four months for the nation to log another 100,000 deaths. The latest 100,000 deaths occurred over a span of about three months. The next 100,000 Americans to die, many public health experts believe, may do so in closer to one month.

“I am floored at how much worse it is than what I expected,” said Ashish Jha, the dean of Brown University’s School of Public Health.

The Food and Drug Administration’s approval of a highly effective vaccine last week offers a new tool to slow — or even stop — the virus’s onslaught if it becomes widely distributed early next year. But “the people who are going to die in late December and early January will already have been infected by then,” Dr. Jha said. “It’s going to be very hard to avoid hitting 400,000 within a month after hitting 300,000.”

The proportion of Americans who die roughly 22 days after being diagnosed with the coronavirus has remained at about 1.7 percent since May, Trevor Bedford, a genomic epidemiologist at the Fred Hutchison Cancer Research Center in Seattle, noted recently on Twitter. As a result, about three weeks worth of future deaths are “essentially ‘baked into’ currently reported cases,” Dr. Bedford wrote.

Since the number of reported cases has approached an average of 200,000 per day over the last 22 days, an average of more than 3,000 deaths are likely to occur daily for the next 22, according to Dr. Bedford’s back-of-the-envelope calculation.

Many of the 300,000 who died from Covid-19 had an underlying health condition, like diabetes, hypertension or obesity. A large fraction were residents of long-term care facilities. About a third were over the age of 85.

But it is wrong to conclude that these were deaths that would have happened anyway, epidemiologists said. Nationwide, deaths have been almost 20 percent higher than normal since mid-March, when the World Health Organization declared the coronavirus outbreak a pandemic.

Roughly 60,000 of the 300,000 were under the age of 65. A disproportionate number were Black, Latino and Native American — with the highest disparities at younger ages: Black Americans from ages 30 to 49 died at nearly six times the rate of white people in the same age group, while Hispanic people died at nearly seven times the rate of white people in the same age group, according to an analysis by Philip Cohen, a University of Maryland sociologist.

Will the coronavirus death toll exceed 400,000? Much will depend on whether a majority of Americans chooses to take the vaccine, experts said. Nicholas Reich, a biostatistician at the University of Massachusetts who has been assembling statistical projections of Covid-19 deaths from researchers around the country, said many of the models have performed poorly during the recent climb in cases, in part because human behavior was so variable.

“Actions taken collectively can really change the course of what is happening,” Dr. Reich said. “One reason this is hard to predict is to some extent the power is in our hands.”

Alex M. Azar II, left, the health secretary, and Dr. Jerome Adams, the surgeon general, at George Washington University Hospital in Washington on Monday.
Credit…Pool photo by Jacquelyn Martin

Five health workers at the George Washington University Hospital were vaccinated Monday afternoon in a small auditorium at a national ceremonial “kickoff event” staged by the Department of Health and Human Services.

Alex M. Azar II, the health secretary, and Dr. Jerome Adams, the surgeon general, spoke at the event and observed the vaccinations, the first of which went to Barbara Neiswander, an emergency department nursing supervisor who said that she was on duty when she received the vaccine.

The second hospital employee showcased at the event, Raymond Pla, a Black anesthesiologist in the emergency department, spoke after he was vaccinated about the pandemic’s burden on communities of color, and about the mistrust of vaccines that runs deep in African-American communities.

Dr. Pla said it was important for others to see him vaccinated, “to see someone who looks and walks and understands the stories, and understands what’s going on,” he said.

“Take that step forward, take that leap,” he said. “Because this is not just the best way forward. This is the only way forward.”

The event was careful to highlight the procedural elements of the vaccinations, including the workers confirming they had consented to the vaccine and were aware it was cleared by emergency authorization.

The five people were selected by an algorithm the hospital used to assign the first doses, the result of a survey hospital employees filled out that asked about age and underlying medical conditions.

“Receiving the Covid-19 vaccine, as exciting as it is, is just like getting any other safe and effective vaccine that Americans receive to protect us from illness,” Mr. Azar said.

On “CBS This Morning,” Dr. Moncef Slaoui, the chief adviser for the Trump administration’s Covid-19 vaccine program, called Monday an “amazing day,” and an “extraordinary achievement” by thousands of people involved in developing and distributing the vaccine.

Asked about his worries during the start of the mammoth logistical effort, he noted that his biggest concern “is the level of hesitancy in the country” from those who are skeptical or unwilling to take the vaccine.

In an interview with MSNBC on Monday, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, laid out a timeline for a return to normalcy that stretched well into 2021. He stressed that until then, social distancing and masks will remain crucial in the fight to stop the spread of the virus.

He predicted that the average person with no underlying conditions would get the vaccine by the end of March or beginning of April. If the campaign is efficient and effective in convincing people to get the vaccine, most people could be vaccinated by late spring or early summer, he said.

“I believe we can get there by then so that by the time we get into the fall, we can start approaching some degree of relief, where the level of infection will be so low in society we can start essentially approaching some form of normality,” he said.

Until then, he stressed, the standard public health measures — distancing, masks, avoiding indoor gatherings — remain necessary.

“A vaccine right now is not a substitute for the normal standard public health measures,” he said, adding, “Only when you get the level of infection in society so low that it’s no longer a public health threat, can you then think about the possibility of pulling back on public health measures.”

The Trump administration is rushing to roll out a $250 million public education campaign to boost confidence in the vaccine. The rollout was delayed for weeks because of concerns that the campaign had become politicized.

President Trump, meanwhile, said on Sunday night that he would delay a plan for senior White House staff members to receive the coronavirus vaccine in the coming days. In an interview with MSNBC, Dr. Fauci said that plans to vaccinate Mr. Biden were “under discussion.”

Health care workers surrounding a patient who died from Covid-19 at United Memorial Medical Center in Houston on Saturday.
Credit…Callaghan O’Hare/Reuters

Mary Smith heard the news that a coronavirus vaccine was being administered to Americans for the first time outside clinical trials. It had not come soon enough for her husband, Mike, who died from the virus at age 46 in November after rapidly becoming fatigued, short of breath and feverish.

“It was so close,” Ms. Smith said. “It was so close.”

Ms. Smith, who lives outside Peoria, Ill., also contracted the virus, but her case was mild and felt more like a sinus infection, she said. His case sent him to the hospital three times, where he was eventually placed on a ventilator and died within days.

Mr. Smith was only a year or two away from retiring from his work at Caterpillar, a manufacturer of construction equipment. The couple had planned to use the extra time to visit their five grandchildren, who were “the love of his life,” Ms. Smith said.

Ms. Smith has endured comments from skeptics who have said they don’t trust the vaccine.

“These people who say, ‘I’m not getting it’ — all I can say is, ‘Why? Have you lost your mind?’” she said. “Have you not seen how many people have died? This is real.”

The news of people receiving the vaccine was also bittersweet for Petrice Brown of Charleston, S.C., whose husband, Keith, was an emergency medical technician. He died from the virus in September.

“He would have been first in line,” Ms. Brown said. “And you know why? Because he would have done whatever he could do to not get the virus, so he could continue to work. He filled in if people were sick.”

She said she was relieved to have work as a distraction from all the media attention to the vaccine’s arrival.

“It’s hard, because when it comes on the news, I think, ‘That could have been Keith getting the vaccine,’” she said. “It wasn’t years too late, it was months. It could have saved not just my husband’s life, but a lot of lives.”

Derek Thompson, left and Anita Quidangen, personal support workers at the multi-lingual, non-profit Rekai Centre nursing home in Toronto, after they received the first Covid-19 vaccines in Ontario, on Monday.
Credit…Brett Gundlock for The New York Times

The start of Canada’s vaccine campaign on Monday was an emotional one, with the first precious doses going to people from nursing homes: health care workers in Toronto, and residents in both Montreal and Quebec City.

That was recognition that nursing homes have been ground zero in Canada when it comes to both Covid-19’s cruel ravages and the storm of criticism over the country’s lack of preparation for it. More than 460,000 people have tested positive for the coronavirus in Canada, and 13,400 have died from it.

“We have never distributed so many Kleenex boxes as the last few days,” said Sue Graham-Nutter, chief executive officer of the Rekai Centres, which runs two nursing homes in Toronto tapped to receive the country’s first vaccinations. “We have the images of what happened on the floors.”

Less than a week after Canada became the third country in the world to approve the vaccine created by the American drugmaker Pfizer and a German firm, BioNTech, the first shipment arrived to a Montreal airport on Sunday night. From there, kicking off the country’s largest largest-ever inoculation program, the boxes of frozen vials were dispersed to 14 sites across most of the country that were equipped with special freezers for the vaccine, which needs to be kept at ultracold temperatures.

With a relatively small population of just 38 million, Canada has agreed to buy up to 76 million doses from Pfizer and 414 million doses of other potential vaccines from other companies. Anita Anand, Canada’s minister of public services and procurement, described that as “the most number of doses per capita of any country in the world” at a news conference Monday.

The first inoculations were a moment of triumph for the Canadian government, and it could not have come at a more welcome time: The virus is raging across the country in its second wave, and much of Canada is in lockdown.

Shipping containers holding the Pfizer-BioNTech Covid-19 vaccine are unloaded at Luis Munoz Marin International Airport in San Juan early on Monday.
Credit…Ricardo Arduengo/Agence France-Presse — Getty Images

Puerto Rico’s vaccination efforts hit a logistical snag on Monday when the government received half the number of doses it expected, and had to scramble to adjust its distribution plan.

It was not clear why only about 16,000 doses of the vaccine reached the island on Monday, instead of 32,500, said Daniel Colón-Ramos, a professor of cellular neuroscience at Yale University and one of the chairs of a scientific panel that is monitoring the vaccination plans closely. He said the rest were now expected to arrive Tuesday and Wednesday.

The delay caused last-minute changes to the National Guard’s plans to deliver vaccine to the handful of locations on the island that have the ultracold medical freezers required for storing it, along with backup generators to keep them working on an island with a notoriously unstable power grid, Mr. Colón-Ramos said.

The Guard’s adjutant general, José J. Reyes, said that in all, 205,000 doses of the Pfizer-BioNTech vaccine are expected in the next three weeks (not 250,000 doses, as an earlier version of this item said).

The island’s first recipient was scheduled to be Yahaira Alicea, a respiratory therapist who cared for Puerto Rico’s first coronavirus patient back in March, an Italian woman from the Costa Luminosa cruise ship. Ms. Alicea’s vaccination at Ashford Hospital started out being scheduled on Tuesday, then was moved up to Monday, with reporters invited to cover the event.

But the governor’s press office requested that it be pushed back to Tuesday again, a change that caused an uproar on social media, where critics accused Gov. Wanda Vázquez Garced of delaying public safety for the sake of a photo opportunity.

In a statement, the governor said the vaccination was always supposed to be on Tuesday, with cameras rolling. “We want the people to see the vaccination, and give them confidence,” she said.

Mr. Colón-Ramos acknowledged that Puerto Rico has a “very recent history” of mishandling major logistical operations, including the discovery in January that supplies meant for earthquake survivors had sat unused in local warehouses.

“The challenge is implementation,” Mr. Colón-Ramos said of the vaccination effort. “People, including me, are very nervous about the implementation.”

Angela Mattingly, a housekeeper at University of Iowa Hospital, on Monday.
Credit…via Angela Mattingly

Monday marked a turning point after so many months of misery for frontline health care workers as they began to receive the first clinically authorized vaccinations as part of America’s mass vaccination campaign.

“I’m so ecstatic,” said Angela Mattingly, a housekeeper at the University of Iowa Hospital, in Iowa City, who has been cleaning the rooms of people with Covid-19 since the beginning of the pandemic. “This is the marking of getting back to normal.”

On Monday morning, Ms. Mattingly was fifth in line as shots were dispensed. She was told to wait for 15 minutes in case she had an adverse reaction, and then she headed back downstairs to finish her shift.

Many Americans breathed a sigh of relief as TV screens that for so long recounted the rising toll were filled with images of supply trucks fanning out and doses being administered. For those who work in the health care industry, it was a pleasant turn in what has been a devastating year.

The moment was heavy for Mona Moghareh, a 30-year-old pharmacist, on Monday morning as she administered the first shots at the Ochsner Medical Center in New Orleans.

“We have been waiting for this,” she said, as journalists and state officials looked on. “This is really for all of those patients that unfortunately didn’t make it, all those patients still coming through the doors.”

In Ohio, pharmacists were greeted with cheering and applause as they carried in doses for about 30 physicians at Ohio State University’s Wexner Medical Center.

Credit…The Ohio State University Wexner Medical Center

Dr. Mark Conroy, 41, the medical director of the Ohio State University Hospital emergency department, was one of the first to receive the vaccine.

“It’s been a long 10 months of work and protecting ourselves and protecting our patients, and so to have the opportunity to be a little bit safer going forward means a lot to me,” said Dr. Conroy, who said he had been anxious about the prospect of bringing the virus home to his family.

He added that he would continue to wear a mask and practice social distancing.

“We still are learning a lot about how this vaccine works and how people respond to it,” he said, “so I certainly don’t want to take any chances and see myself get sick.”

In Kentucky, Dr. Jason Smith, the chief medical officer at University of Louisville Health, was the first person in the state to receive the vaccine.

“Didn’t even feel it,’’ Dr. Smith said, laughing as a health care worker applied a smiley face Band-Aid to his arm.

Gov. Tim Walz of Minnesota, right, followed the delivery of Covid-19 vaccines at the Minneapolis Veteran Affairs Hospital on Monday.
Credit…Pool photo by Aaron Lavinsky

A 96-year-old World War II veteran in Massachusetts was the first patient at a U.S. Department of Veterans Affairs facility to receive the Covid-19 vaccine on Monday.

The veteran, Margaret Klessens, a resident of the Veterans Affairs Bedford Healthcare System, was vaccinated just after noon, according to the hospital’s Twitter page.

The Department of Veterans Affairs will be distributing vaccines at 37 locations across the country, giving priority to residents of long-term care facilities and health care workers.

According to an article in The Boston Globe from 2015, Ms. Klessens enlisted in the Women’s Army Auxiliary Corps in 1943, when she was 19. She worked in a clerical job at Fort Oglethorpe, Ga., until the end of the war.

The department selected its 37 locations based on the number of people each site could vaccinate and their ability to store the vaccine at extremely low temperatures. As supplies increase, Veterans Affairs will dole out the vaccine to additional veterans who are at risk of severe complications from the virus.

“V.A. is well prepared and positioned to begin Covid-19 vaccinations,” Veterans Affairs Secretary Robert Wilkie said in a news release. “Our ultimate goal is to offer it to all veterans and employees who want to be vaccinated.”

Dr. Christian Arbelaez, an emergency room physician, was the first to be vaccinated at Rhode Island Hospital in Providence on Monday.
Credit…Cody O’Loughlin for The New York Times

From a hospital housekeeper to a chief medical doctor, here are some of the people who were first (or close to first) to receive a Covid-19 vaccination at hospitals across the country on Monday.

  • Dr. Christian Arbelaez, an emergency room physician, at Rhode Island Hospital in Providence, R.I., in a state that’s been hit especially hard in recent weeks. He breathed a deep sigh of relief, thanked the person who administered the dose and received a green sticker that said “COVID-19 vaccine” with a black check mark.

  • Second in line there was Fernando M. Pires, 60, who works in housekeeping in the emergency room and has been at Rhode Island Hospital for 24 years. He volunteered to be among the first because he has asthma and diabetes, but he said having the news media watching made him nervous: “I’ve never been on camera before.” (Because of an editing error, an earlier version of this item misspelled his surname.)

  • Dr. Patricia Winokur, 61, a professor at the University of Iowa and a principal investigator on the clinical trial for the vaccine. “This is the culmination of a lot hard work,” she said. “Our team has worked hard, and I am so proud to have been a part of it.’’

  • Leon Haley Jr., chief executive of UF Health in Jacksonville, Fla. Not a frontline medical worker himself, he said it was important to show his employees that he believed in the safety of the vaccine.

  • The director of emergency services at UF Health, David Meysenburg, 45, a nurse who went back to work after getting his shot. Though he does not work directly with Covid-19 patients, he said, he manages nurses who do and wanted to set an example.

  • Vanessa Arroyo, 31, a nurse in the Covid-19 unit at Tampa General Hospital. Gov. Ron DeSantis of Florida was on hand to cheer her on.

Credit…Jon Cherry/Getty Images
  • Dr. Jason Smith, chief medical officer at the U of L Health in Louisville. “Didn’t even feel it,” he said.

  • Charmaine Pykosh, 67, an advanced nurse practitioner at the UPMC Children’s Hospital of Pittsburgh. She was chosen by a vote of her colleagues.

  • Teresa Mata, 51, who cleans rooms in the emergency department at Methodist Dallas Medical Center. She cheered and raised her hands after getting the shot, and said she wanted her fellow Spanish speakers in Texas to be sure to get vaccinated.

  • Barbara Neiswander, an emergency department nursing supervisor at George Washington University Hospital in Washington. She said was on duty at the time.

  • Dr. Aamina Akhtar, 47, chief medical officer at Mercy Hospital South in St. Louis and an infectious disease specialist who works with Covid patients. “It was the first time in a long time we had smiles,” Dr. Akhtar said. “We had laughter, we had amazing energy, because everyone understands what this means to us.”

  • Faye Williams, 65, a retired nurse who volunteered to return to work Duke Hospital in Durham, N.C., at the start of the pandemic.

  • Christopher Miller, the acting defense secretary, received the coronavirus vaccine at Walter Reed National Military Medical Center in Bethesda, Maryland.

  • Kevin Londrigan, a respiratory therapist at the UCHealth Poudre Valley Hospital in Ft. Collins, Colo., who has underlying health conditions. “This has been a long, exhausting time coming,” he said before being inoculated.

  • Sandra Lindsay, an intensive care nurse at Long Island Jewish Medical Center in Queens, believed to be the first recipient anywhere in the country outside a clinical trial. “I feel like healing is coming,” she said. “I hope this marks the beginning of the end of a very painful time in our history.’’

Paul TenHaken, the mayor of Sioux Falls, S.D., said city officials have been advising that the first vaccines will be available for frontline workers and vulnerable, older citizens.
Credit…Benjamin Rasmussen for The New York Times

In Sioux Falls, South Dakota, the arrival of the vaccine is feeding the impassioned debate over extending the city’s already contentious mask mandate until March.

Those who have been opposed to masks all along use the vaccine to argue that there is no need to keep masks past early January, when the mandate is due to expire.

“It is creating a narrative that Covid is over and the cavalry is here,” said Paul TenHaken, the Republican mayor of Sioux Falls, noting city officials have to fight the misinformation by stressing that for the coming weeks the vaccine will be available only for frontline workers and vulnerable, older residents.

At the Avera Medical Group, founded by Benedictine nuns, sisters blessed the vaccine as it arrived Monday and it was then whisked into a deep freeze, with the first shots given out in the afternoon.

Despite some of the highest rates of infection in the country, South Dakota’s Republican governor, Kristi Noem, has refused to mandate masks or any other public mitigation measures, calling them an individual responsibility.

That sentiment initially doomed a mask mandate in Sioux Falls in November, but it was eventually passed by the city council after all penalties were removed and the city’s two medical centers endorsed it.

Residents opposed to extending the mask mandate packed a council meeting last week, and the mayor expects the arrival of the vaccine will inspire even more to attend this week.

Aside from those skeptical of the government imposing health restrictions, there is another contingent that has expressed skepticism about the efficacy of the vaccine itself. “There is a skepticism all around — about the science of this virus, both on the mask side and on the vaccine side,” said Mr. TenHaken.

Pharmacy workers unpacked the first shipment of vaccine at the Christus St. Vincent Regional Medical Center in Santa Fe, N.M., on Monday.
Credit…Christus St. Vincent Regional Medical Center, via Associated Press

“I’ve worked in health care since I was 18 — I’ve seen a lot of people die,” said Yvonne Bieg-Cordova, a radiology department manager at the Christus St. Vincent Regional Medical Center in Santa Fe, N.M. “But over the last nine months, the amount of people who have died from Covid has been horrendous.”

“It’s been tough,” she said.

Ms. Bieg-Cordova, now 42, received her first dose of the Covid-19 vaccine on Monday, a bright moment in one of the most difficult times to be a health care worker in the United States.

The past several months have tested the ability of nurses, technicians, doctors and others to maintain a healthy divide between their work and their lives at home, Ms. Bieg-Cordova said. Children still need their mother, she said, no matter what she saw at the hospital that night.

“There’s that time where you just want to get in the shower and you cry for your 10 minutes, to get out what happened at work today,” she said. “Then you get out and you go on with your life, because you have to go home and take care of your family.”

Ms. Bieg-Cordova said the past couple of months had been especially trying, but that the vaccine did provide the hope that an end is coming. One of her colleagues told her that she danced into the hospital Monday morning.

“Today definitely feels a little bit more upbeat,” she said. “I definitely see that light.”

The vaccine made by Pfizer and its German partner, BioNTech, being prepared for use at the University of Iowa Hospital in Iowa City on Monday.
Credit…Kathryn Gamble for The New York Times

The Centers for Disease Control and Prevention on Monday advised clinicians to reassure their patients of the safety of Covid-19 vaccines.

“Safety standards for vaccines are high,” Dr. Tom Shimabukuro, the agency’s vaccine safety team lead, said on a conference call with clinicians.

But trials “may not detect all types of adverse events, especially ones that are rare or take longer to occur,” Dr. Shimabukuro added, reiterating the importance of continuing to monitor vaccinated people for any rare or unexpected side effects.

On Friday, a vaccine manufactured by pharmaceutical company Pfizer became the first to receive an emergency green light from the Food and Drug Administration. The first shots of the vaccine were administered on Monday to health workers in several states.

A vaccine very similar to the Pfizer-BioNTech shot, made by a competitor, Moderna, is expected to receive emergency clearance by week’s end.

But neither vaccine is fully approved or licensed. Although panels of experts have deemed the vaccines both safe and effective, more data must be collected before the products can receive an official stamp of approval from the F.D.A.

Part of that process will involve keeping close tabs on people who receive the vaccines in the coming months. Some side effects are so rare that they may not appear until hundreds of thousands of people get the vaccine. And certain groups of people, including young children and pregnant women, have not been rigorously studied in vaccine trials. But the government has noted that women who are pregnant or breast feeding can still opt to get the vaccine, and people as young as 16 were included in the F.D.A.’s authorization for emergency use.

Dr. Shimabukuro encouraged clinicians to report all “clinically important or medically significant adverse events following vaccination, even if it’s not clear if the vaccination caused the adverse event.”

To ease the process, the C.D.C. is rolling out a smartphone app called v-safe, which will use texts and web surveys to check in with vaccine recipients in the weeks and months after they get their shots.

Based on data gathered from months of clinical trials, people receiving vaccines like Pfizer’s might expect to experience mild symptoms like fevers, fatigue, headaches and chills that clear up within a couple days. Anything more anomalous or prolonged should prompt a conversation with a health care provider.

Registered nurse Cheryl Birmingham, left, administered the Pfizer-BioNtech Covid-19 vaccine to registered nurse La Tanya Forbes at a pharmacy in Miramar, Fla. on Monday.
Credit…Scott McIntyre for The New York Times

A group of ten frontline workers in Miramar, Fla. — including a critical care doctor, an anesthesiologist, a registered nurse and a pharmacist — were among the first in the state to receive the coronavirus vaccine.

Their employer, the Memorial Healthcare System, was one of five health systems designated as a vaccine host in Florida. Dr. Aharon Sareli, Memorial’s chief of critical care, received the system’s first vaccine.

“This is our first real hope in changing the epidemiology of the virus,” said Dr. Sareli, noting that the lightning fast prick to his left arm felt no different than an influenza shot.

Florida has recorded over one million cases and is nearing 20,000 confirmed deaths, according to a New York Times database. Over the past week, the state has averaged nearly 10,000 cases per day, an increase of about 25 percent over two weeks earlier, as it approaches its July peak.

By Tuesday, the state is expected to have nearly 100,000 vaccine doses, Gov. Ron DeSantis said on Monday as he announced the arrival of a shipment to Tampa General Hospital.

A nurse from the hospital’s Covid-19 unit, Vanessa Arroyo, received the first dose. Ms. Arroyo, 31, wore a mask as Rafael Martinez, another nurse, administered the shot to her left arm.

“I don’t think I can put into words what I’ve seen,” she said. “But if I could think past through the past nine months, we’ve been through innumerable challenges. Despair. Grief. Watching families say goodbye to their loved ones over FaceTime was devastating. Not being able to have visitors while patients were gravely ill was devastating. And, truly, the thought of having to go through another surge like that is heartbreaking.”

Dr. Charles Lockwood, the dean of the University of South Florida medical school, who was in attendance, called the inoculation a “magic moment.” He compared it to watching the astronaut Neil Armstrong walk on the moon.

Across the state in Jacksonville, Leon Haley Jr., the C.E.O. of UF Health Jacksonville, rolled up his sleeve to receive the first vaccine dose at his organization. Afterward, he donned his white lab coat.

Though Dr. Haley Jr. is not a frontline medical worker, he said he felt it was important to get the vaccine himself to show his staff that he believes in its safety.

“We want people to feel comfortable with taking the vaccine, because we do have some of our staff who are a little bit cautious,” he said. “So we’re trying to let them know that we feel comfortable with the science and the process.”

Phillip Grudowski was one of the first to receive the Covid-19 vaccine at Ohio State’s Wexner Medical Center on Monday.
Credit…Brian Kaiser for The New York Times

COLUMBUS, Ohio — Phillip Grudowski works in the intensive care unit at an Ohio State hospital that has been converted to treat only people with Covid-19.

His patients at Wexner Medical Center have to be sedated, paralyzed and flipped on their stomachs to better oxygenate their bodies. The disease attacks their organs; many require dialysis for kidney failure, and a host of scans and medications for heart and liver failure.

The nurses spend three or four hours at a time in patient rooms, covered in personal protective gear. Even bathroom breaks are difficult.

“There’s a lot of overtime available, but a lot of us are exhausted and stressed, and we don’t want to pick up that overtime,” Mr. Grudowski, 40, said. “But the patients keep on coming, whether we have space for them or staff for them.”

On Monday, Mr. Grudowski became one of the first people in Ohio to receive Pfizer’s newly approved coronavirus vaccine. “I feel very privileged to get it,” he said. “I know there’s a lot of nervousness around vaccines. But it’s gone through the processes.”

Kristen Dinardo, 35, also works with Covid patients in the intensive care unit. One of her earliest patients there — whom she remembers clearly months later — was a man on immunosuppressive medications; he and his wife got the virus at around the same time.

“He obviously got super sick from it,” Ms. Dinardo said. “She did not. And I was trying to set up a Zoom call, so she could see him, because he hadn’t been doing well, and she could not get Zoom to work on her end. So I remember telling her on the phone, just let me call you, and I’ll walk into the room and I’ll hold the phone to his ear. I want you to talk to him before something bad happens.

“And the minute I had turned to walk into the room, because I had started to get my gear on, they had already started to do chest compressions because his heart stopped. Because he was so sick. So I had to put it on speakerphone, and hold it to his ear, and had her tell him, ‘I love you, goodbye,’ as they were actively doing CPR on him. She told him that she loved him and that she was sorry,” Ms. Dinardo said.

She stopped, unable to speak, then continued: “When you do this for a long time, there’s a certain part of you closed off to a lot of that, because you can’t take it home with you. But there’s a lot about this that has made that hard to do. “

Ohio hospitals have strained in recent weeks under an escalating number of hospitalizations, and the number of confirmed cases in the state since the start of the pandemic reached 570,602 on Monday.

Wexner Medical Center received enough of the vaccine for 975 people and went through a small test run on Monday to ensure it could process shots efficiently, said Dr. Andrew Thomas, who ran the program. Those in the Covid ward got priority.

“The people who got vaccinated today,” Dr. Thomas said, “for the last nine months they’ve gone to work every day with a little voice in the back of their head that says, ‘Am I going to get Covid today?’ They work in our intensive care units with our sickest of the sick patients with Covid. They are very contagious. I want those people to be able to sleep at night.”

GLOBAL ROUNDUP

People blew whistles as they demonstrated outdside the Dutch prime minister’s office as he announced a five-week lockdown to slow the spread of coronavirus.
Credit…Bart Maat/Agence France-Presse –– Getty Images

Amid rising cases in the Netherlands, Prime Minister Mark Rutte ordered non-essential businesses to close for the next five weeks as protesters jeered his decision outside of his office in The Hague on Monday.

Mr. Rutte’s announcement came as other European leaders also ordered new restrictions over the holiday season, highligting the continent’s struggles to rein in the pandemic even as the vaccine provided new hope.

Mr. Rutte said that non-essential businesses, such as hair salons, gyms and museums would have to remain closed through Jan. 19. From Wednesday, all schools and universities will have to switch to remote learning. People may only host two visitors a day — three from Dec. 24 to 26 — according to the Guardian.

“We have to bite through this very sour apple before things get better,” Mr. Rutte said during a nationally televised address, according to the A.P. “The reality is that this is not an innocent flu as some people — like the demonstrators outside — think.”

In other news around the world:

  • Officials in South Korea have ordered schools in the Seoul metropolitan area to move all classes online starting Tuesday until at least the end of the year. Additional measures may be announced this week as the country struggles to contain its worst outbreak yet. South Korea, which has a population of about 50 million, reported 718 new cases on Monday, down from a record 1,030 the day before.

  • Japan is also struggling with an uptick in coronavirus cases and will hit pause on a nationwide campaign to encourage travel and tourism. With hospitals under increasing pressure from a recent, steady growth in new infections, the program, called “Go To Travel,” will be halted from Dec. 28 through at least Jan. 11, covering the most important holiday of the calendar, New Year’s, when many people travel home. The program had provided substantial discounts to consumers to encourage them to support the country’s beleaguered tourism and service sectors.

  • Singapore on Monday became the first Asian country to approve a coronavirus vaccine made by the American drug maker Pfizer, announcing that the first shipment would arrive this month and be given free to Singaporeans and long-term residents. Singapore has also agreed to buy vaccines from the American drug maker Moderna and the Chinese company Sinovac. “If all goes according to plan, we will have enough vaccines for everyone in Singapore by the third quarter of 2021,” Prime Minister Lee Hsien Loong said in an address to the natio

Gov. Andrew M. Cuomo of New York on Monday. A healthcare worker in Queens was vaccinated at Long Island Jewish Medical Center in Queens on Monday.
Credit…Pool photo by Mark Lennihan

Just a few hours after the first Covid-19 vaccine was administered in New York, Gov. Andrew M. Cuomo warned that the state could be subject to sweeping shutdowns if hospitalizations continued to increase.

“If we do not change the trajectory, we could very well be headed to shutdown,” said Mr. Cuomo, a third-term Democrat. “A shutdown is something to worry about.”

The grim notice, on the same day as the vaccine’s much-anticipated rollout in the United States, was a somber reminder of the coronavirus’s resurgence in New York, where tens of thousands more people are expected to be infected until the vaccine is widely available next year.

Mr. Cuomo did impose new restrictions — ranging from limiting capacity at houses of worship to 50 percent to limiting restaurant dining to four people per table — in certain parts of upstate New York.

Those new restrictions were limited to parts of Genesee, Niagara and Oneida Counties after each of those areas met certain hospitalization and positivity rate to trigger a “yellow zone” under the state’s plan. (An earlier version of this item referred imprecisely to the areas of Batavia, Rome and Utica, which are facing new restrictions. They are cities, not counties, in New York.)

Mr. Cuomo again warned that hospitals could become overwhelmed and New York City, where he recently barred indoor dining, could see a broader shutdown, a so-called red zone, come January “if nothing changes.” At the current rate, he said, the number of Covid-19 patients in hospitals could double to 11,000 in one month, and an additional 3,500 people could die from the disease.

The governor’s forewarning of economically-detrimental shutdowns of nonessential businesses is part of a recent shift in his rhetoric, now increasingly focused on deaths and hospitalizations, to coax New Yorkers into changing their behavior to curb the spread.

Specifically, Mr. Cuomo has been warning of a worsening forecast as people gather for the holidays and he has urged residents against convening in groups at homes, where he says “living room spread” is leading to a sharp increase in cases.

“The problem in the spring was going out,” he said. “The problem in the winter is staying home and inviting people over. That is what we’re dealing with in the holiday season.”

Even though he was optimistic about vaccinations, Mayor Bill de Blasio also warned that the city still had difficult weeks and months ahead as it endures a second wave of the virus, and advised New Yorkers to prepare for the possibility of a shutdown.

“We need to recognize that that may be coming,” he said. “And we’ve got to get ready for that now.”

Dr. Patricia Winokur, the principal investigator on a clinical trial of the Pfizer Covid-19 vaccine, received a dose on Monday.
Credit…Kathryn Gamble for The New York Times

IOWA CITY — For Dr. Patricia Winokur, receiving the vaccine on Monday was in part thanks to her own work. She is a principal investigator on a clinical trial of the Pfizer vaccine, which is the first being rolled out across the United States.

“This is the culmination of a lot of hard work,” she said while tearing up.

The trial that Dr. Winokur, 61, helped run started in July and ran through October at the University of Iowa Hospitals and Clinics, with 270 volunteers. Some had tested positive for the coronavirus, but others had not; they received the vaccine to study the body’s response.

No one in the trial suffered severe reactions, she said, but there were side effects similar to vaccines for the flu, including fatigue, headache and body aches.

One unusual side effect the volunteers reported: pronounced back pain. But most people tolerated the vaccine, and the adverse symptoms went away after a few days, Dr. Winokur said.

Members of the study will receive regular follow-ups for the next two years to determine if they have any lasting adverse reactions, and how long the vaccine remains effective against contracting Covid-19.

“I am so proud to have been a part of it,” Dr. Winokur said.

Dr. Sylvia Owusu-Ansah received the Pfizer vaccine on Monday.
Credit…Kristian Thacker for The New York Times

PITTSBURGH — For all it portended as the end of a year of misery and death, the operation was stunningly mundane. A little trickle of blood here or there, followed by small talk and cotton swabs, and Pittsburgh’s first Covid-19 vaccinations outside of clinical trials had been administered.

The recipients at the UPMC Children’s Hospital of Pittsburgh were frontline health care workers from four different hospitals around the city, ranging in age from 29 to 67: a nurse practitioner, an emergency physician, an intensive care unit nurse, a transporter, an environment services supervisor.

Some of them spoke at a news conference about the thinking and procedures that led to them being the first recipients in the city — and certainly the highest-profile ones.

“African-Americans have suffered quite the repercussions of Covid-19,” said Dr. Sylvia Owusu-Ansah, 42, an emergency physician, who is Black. “I wanted to share with my community that it is OK, that this vaccine is the thing to do to keep us safe to keep us healthy and to keep us alive. And I wanted to set that example, not only for my family, but for my community as well.”

Tami Minnier, a nurse and the chief quality officer at the University of Pittsburgh Medical Center, compared the moment to the introduction of the polio vaccine: “Over 65 years ago, on April 12 of 1955,” she said, “Dr. Jonas Salk took some of these very same steps. And we all know the benefit that humanity has seen from that.” Dr. Salk was a University of Pittsburgh researcher.

The hospital received 975 doses of the Pfizer vaccine on Monday, hospital officials said, and would be giving the necessary second round of shots to the recipients in two weeks’ time.

Dr. Graham Snyder, medical director of infection prevention and hospital epidemiology, said he thought the UPMC system’s entire work force — there are about 60,000 frontline health care workers in the network — could be vaccinated “within a couple months.”

Tim Ostgarden, right, unloaded a carton of Covid-19 vaccine doses on Monday at Sanford Health in Fargo, N.D. as Nathan Aamodt photographed the arrival.
Credit…Tim Gruber for The New York Times

FARGO, N.D. — Tim Ostgarden was working on the hospital loading dock early Monday morning when a FedEx truck pulled up bearing just one package: a bulky white box slapped with PRIORITY labels that had been trucked and flown from a vaccine plant in Michigan to a shipping hub in Memphis before landing at the medical center in downtown Fargo, where Mr. Ostgarden handles incoming packages.

“History, is what it is,” he said, looking at the box.

Inside, buried under a bed of dry ice, were three trays containing nearly 3,000 doses of the Pfizer-BioNTech vaccine, one of a cascade of thousands of vaccine shipments that began landing at hospitals and health departments across the United States on Monday.

All weekend, pharmacists and other staff from the Sanford Health hospitals here in North Dakota, a state devastated by the virus, had been checking their emails and following a FedEx tracking number as they watched the first vaccines course across the country. At precisely 7:02 a.m. on Monday, their first shipment arrived.

The first vaccinations are set to start here on Monday afternoon, and are being doled out to high-risk doctors, nurses and others who work directly with Covid-19 patients and face the highest risks of exposure to the virus that has killed 1,158 people across this lightly populated state on the northern plains.

Before that could start, the hospital’s pharmacy staff had to unpack the vaccines and move them into an ultracold freezer — a delicate, timed dance that needed to happen in under five minutes to ensure the vaccine would stay at the low temperatures needed to ensure its effectiveness.

Credit…Tim Gruber for The New York Times

Monte Roemmich, the hospital’s pharmacy manager, pried open the box and checked a temperature sensor to ensure that the vaccine had stayed sufficiently chilly on its daylong journey from the Pfizer plant in western Michigan to North Dakota. Everything looked good.

He slipped on a pair of thick blue cold-resistant gloves and, one by one, scooted the trays into a new freezer that will keep the vaccines at some 94 degrees below zero until they are ready for use. Hospital workers have already been signing up for vaccination slots over the next several days.

As deaths eclipsed 300,000 nationwide, many hospitals do not yet have enough vials of Pfizer’s vaccine to inoculate all their workers, to say nothing of vulnerable patients or the general public. Still, the few pharmacy workers clapped as Mr. Roemmich slid the just-delivered vaccines into the freezer.

“It’s even better than Christmas,” said David Leedahl, the director of pharmacy. (An earlier version of this item misspelled his surname.)

The University of Florida in Gainesville received 10,000 doses of the Pfizer vaccine on Monday for distribution to frontline health care workers.
Credit…Charlotte Kesl for The New York Times

Colleges have been hot spots for spreading the coronavirus since students returned to campus this fall. Now, with universities and their health care centers playing a crucial role in distributing the vaccine, many are relishing a chance to redeem themselves.

“The Covid-19 vaccine is about to be here,” crowed an email sent early Monday morning to students, faculty and staff of the University of Florida, calling it “a true testament to the power of science.”

The email announced that the university’s medical system in Jacksonville would be among the first in the country to receive doses of the Pfizer vaccine. Ten thousand doses arrived on Monday, with another 10,000 expected on Tuesday, said Dr. Leon L. Haley Jr., chief executive officer of UF Health Jacksonville and dean of the College of Medicine.

He expects more doses of both Pfizer’s and Moderna’s vaccines to follow in the coming weeks.

American universities have been the source of significant coronavirus spread, with more than 397,000 cases since the pandemic began, according to New York Times tracking data. And deaths in communities that are home to colleges have risen faster than in the rest of the nation.

But now universities across the country are poised to be major distribution centers of the vaccine, bringing a sense of normalcy back to campuses and society. The University of Iowa Hospital, which conducted a clinical trial of the Pfizer vaccine, was among the first places in the country to receive and administer it on Monday morning; the first dose was injected into the arm of David Conway, 39, an emergency-room nurse.

The University of Kentucky health system was expecting 1,950 doses to be delivered on Tuesday, and planned to begin vaccinating more than 9,000 health care workers, starting with emergency departments at UK Chandler Hospital and UK Good Samaritan Hospital, as well as the Covid unit at UK Chandler. The system now has about 90 patients infected with the coronavirus, including about 25 in intensive care.

Distribution of the vaccine to universities depended to some degree on their ability to store it at subfreezing temperatures. The University of Kentucky purchased four negative-80-degree freezers to store the vaccine when it is available for faculty and students on campus, as well as the wider community.

“We want to be prepared for broader distribution whenever that is announced,” said Jay Blanton, a university spokesman; officials predicted that would probably not be until spring or summer.

Likewise, the University of Florida will be rolling out vaccines for frontline health care workers first, sharing its shipment with other Jacksonville hospitals, Dr. Haley said.

“The state’s going to help us be real aggressive about taking care of health care workers across the next couple of weeks,” he said. “After that, we can roll it out to faculty and students. I don’t think it’s unreasonable, depending on what we start to get, that we may get to the general public as early as January.”

The West Wing of the White House on Friday.
Credit…Oliver Contreras for The New York Times

Crede Bailey, the director of the White House security office who was hospitalized for months with the coronavirus, had his foot and the lower part of one of his legs amputated as he battled the infection, a friend of his wrote on a GoFundMe page dedicated to his medical bills.

Mr. Bailey was hospitalized in September, a time when President Trump and a number of his advisers were exposed to the coronavirus. A friend, Dawn McCrobie, established the fundraising page to help him pay for costs associated with his treatment.

At least 50 people with close links to the White House have contracted the virus since the start of the pandemic, in addition to guests and others, and the president himself. Mr. Bailey’s case appears to have been the most severe among them.

Mr. Bailey’s condition was first reported by Bloomberg News.

On the GoFundMe page, which Ms. McCrobie posted in November, she provided a status update about his health.

“Crede beat Covid-19 but it came at a significant cost: his big toe on his left foot as well as his right foot and lower leg had to be amputated,” she wrote, adding that he is “attending physical therapy multiple times a day to regain and build muscles and learn how to thrive without his foot/leg.”

The White House has never commented on Mr. Bailey’s case. The Bloomberg report said he has tried to keep it confidential and on the webpage, Ms. McCrobie made clear Mr. Bailey does not want to talk with the media about his condition.

A Covid-19 unit at United Memorial Medical Center in Houston over the weekend.
Credit…Callaghan O’Hare/Reuters

A Houston-based lawyer representing bar owners who sued Gov. Greg W. Abbott of Texas over the state’s coronavirus restrictions said the lawsuit will proceed even as Texans began receiving the vaccine.

“It appears that even with a vaccine in place he has not shown any willingness to back off these orders,” said Jared Woodfill, who is president of the Conservative Republicans of Texas.

Mr. Woodfill accused the governor of overstepping his authority by using executive orders to implement Covid-19 mitigation measures. After aggressively moving to allow bars and restaurants to reopen with limited capacity in May, Governor Abbott ordered bars shut down a month later and expressed regret that the quick reopening helped fuel a rise in cases in Texas. The new shutdown received heavy criticism from bar owners.

Mr. Woodfill filed suits in both federal and state courts on behalf of what he called hundreds of small businesses harmed by the arbitrary nature of the closure orders. He is determined to pursue the cases to try to ensure that the measures implemented this year under the Texas Disaster Act do not become a legal precedent for sidestepping the state legislature.

Despite the legal wrangling, the first doses of the vaccine fueled excitement across the state.

“Whoo hoo,’’ Teresa Mata, 51, said Monday as she cheered and raised her hands after getting the vaccine. Ms. Mata, who cleans rooms in the emergency department at Methodist Dallas Medical Center, was the first employee at the hospital to receive the vaccine.

A mother of four daughters, she said she wanted to protect her family and her work family at Methodist.

“I’m very excited,’’ she said. “I don’t feel bad. I feel good. I don’t have pain.”

She added that she wanted her fellow Spanish speakers in Texas to take the vaccine.

The Methodist Health System planned to vaccinate more than 100 employees on Monday and that number again on Tuesday morning. It has a total of 5,850 doses to administer across the system over the next few weeks.

Dr. Yves Duroseau received the vaccine at Long Island Jewish Medical Center in New Hyde Park, N.Y., on Monday.
Credit…Brendan Mcdermid/Reuters

There has never been a Monday quite like this one — an unmistakable, if unpredictable, coinciding pivot for the presidency and a pandemic that has killed nearly 300,000 Americans.

State by state, the typically unobserved clockworks of American democracy began to click into place as electors ratified the victory of the 46th president of the United States, Joseph R. Biden Jr., despite attempts by the 45th president to subvert the results by strong-arming local Republicans to overturn the will of voters.

Around 10 a.m. Eastern, electors in Indiana, New Hampshire, Tennessee and Vermont had gathered for the formal process of affirming Mr. Biden’s clear national victory. There was no doubt about the outcome — despite President Trump’s efforts to encourage the belief that there was — and the president-elect was expected to pass the necessary threshold by early evening.

In a sign of a new abnormal ushered in by Mr. Trump’s behavior, electors in some states have had to deliberate in tight security, sometimes in out-of-the-way locations, after they have been threatened for simply doing their constitutional duty.

At the same time, other machinery — more industrial than ceremonial — was set into motion as the first batches of Pfizer’s coronavirus vaccine, which left a plant in Michigan Sunday evening to the cheering of onlookers, began arriving in virus-ravaged cities around the country.

Federal officials said 145 sites were set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday. A majority of the first injections are expected to be given to high-risk health care workers on Monday, although the relatively small amount of vaccine delivered will fall short of offering protection to all those who are eligible to get it.

But it could signal the beginning of the end.

On Monday, Dr. Anthony S. Fauci, who will continue on as a central federal architect of the virus response under Mr. Biden, said he believed most Americans who wanted the vaccine could probably get it by later March or early April.

In an interview with MSNBC, Dr. Fauci said that plans to vaccinate Mr. Biden were “under discussion” amid reports that White House officials had planned to vaccinate top-level Trump administration officials.

Mr. Trump, whose efforts to downplay the severity of the pandemic were a focus of the election, began the day, as he often does lately, posting a tweet laden with falsehoods about the “Rigged Election.” The message was flagged by Twitter.

Yet, the president, who remains eager to take credit for the unprecedented scientific effort to rush the development of the vaccine, could not deny himself a victory lap on the day his political defeat was to become formal.

“First Vaccine Administered. Congratulations USA! Congratulations WORLD!” he wrote.