The Royal Free Hospital in North London is one of the hospitals that will start administering the Pfizer-BioNTech Covid-19 vaccine on Tuesday.
Credit…Andrew Testa for The New York Times

Britain’s National Health Service was set to begin delivering shots of the Pfizer-BioNTech Covid-19 vaccine on Tuesday, opening a public health campaign with little precedent in modern medicine and making Britons the first people in the world to receive an authorized, fully tested vaccine.

Health workers were preparing to begin administering the shots six days after British regulators leapt ahead of the United States to become the first Western country to authorize a coronavirus vaccine, part of a global sprint to end a pandemic that has killed more than 1.5 million people worldwide.

In its first batch, Britain has received 800,000 doses of the vaccine, the government said. Packed in 975-dose trays at ultracold temperatures, the vaccine has been transported in recent days from a manufacturing plant in Belgium to government warehouses in Britain, and then to hospitals.

Fifty hospitals will be administering the shots until the government can refine a plan for delivering them at nursing homes and doctor’s offices, too. The vaccine must be transported at South Pole-like temperatures, though Pfizer has said that it can be stored for five days in a normal refrigerator before being used. First to receive the vaccine will be doctors and nurses, certain people over 80 and nursing home workers.

Some doctors and nurses have received invitations in recent days to sign up for appointments, with the first shots intended for those at the highest risk of severe illness. The government has indicated that people over 80 who already have visits with doctors scheduled for this week, or who are being discharged from certain hospitals, will also be among the first to receive shots.

Matt Hancock, the health secretary, said on Monday that “all parts of the U.K. now have doses.”

Nursing home residents, who were supposed to be the government’s top priority, will be vaccinated in the coming weeks once health officials start distributing doses beyond hospitals.

Amid concerns about Britain’s looming split from the European Union snarling the transport of the vaccine from Belgium to British warehouses, the government said this week that it was prepared to ask the Army to fly doses over the border.

“This is such an important product, it’s probably perhaps the most important product,” James Cleverly, a Foreign Office minister, said on Monday. “So we will look to ensure that those supplies are available in the U.K. in whatever circumstance.”

A nurse in Wales prepares for work in a Covid-19 Red Zone at Glan Clwyd Hospital in May. Nurses, doctors, nursing home workers and people over 80 years old, will be the first to receive coronavirus vaccines in Britain.
Credit…Christopher Furlong/Getty Images

On Tuesday, a handful of people across Britain — mostly those aged over 80, health care workers and those working in nursing homes — will receive the newly approved Pfizer vaccine. It will be the first day that the inoculations are being administered in any Western nation.

Hilary Morgan, 45, an I.C.U. nurse in Scotland’s Forth Valley Royal Hospital who is also a nurse’s union representative, said it was important to get vaccinated as soon as possible.

“I want to get the vaccine to protect my colleagues, my family, but most of all the patients that we look after,” she said.

She hopes to serve as an example to others in the country, particularly those who may be doubtful of the vaccine’s safety, because she knows the heavy toll the disease has taken.

“I’ve sat with dying patients and had to call their loved ones on the phone,” she said.

“You know I had questions I went away and I read about it,” she said. “I’ve have asked my questions, and I’m satisfied that it is safe.”

Dr. Matt Morgan, 40, who works in the I.C.U. at University Hospital of Wales, Cardiff, has an appointment booked on Tuesday afternoon. He admitted the first Covid-19 patient to his hospital 38 weeks earlier to the day, and said things have come full circle. He was feeling “proud that science, humanity, the power of globalization, reason and truth” have produced a vaccine, ahead of his appointment Tuesday. “It’s been a very long year.”

His hospital is still dealing with new coronavirus patients on a regular basis, and he described the second wave of infections from this fall as more like a marathon than a sprint.

While he was hopeful about the new vaccine, he worried people may mistake the start of vaccination as the end of the pandemic.

“There’s still certainly going to be people who die between now and spring,” Dr. Morgan said. “There’s still going to be families who spend Christmas alone. So, you know, this won’t in one day make everything OK.”

In Britain a card will be given to patients following a vaccination for COVID-19 at Croydon University Hospital in southern London, as vaccinations begin on Tuesday.
Credit…Pool photo by Gareth Fuller

Britain’s National Health Service is set to begin delivering shots of the Pfizer-BioNTech vaccine on Tuesday, opening a public health campaign with little precedence in modern medicine.

Here is a guide to some of the basics.

Britain’s drug regulator is seen as a bellwether agency, and its decisions often have influence abroad. In the case of the Pfizer vaccine, the agency has said that it did not cut any corners, and undertook the same laborious process of vetting the quality, efficacy and manufacturing protocols of the vaccine.

Dr. Anthony S. Fauci, the United States’s top infectious disease expert, said last week that the British had not reviewed the vaccine “as carefully” as the United States was. But he walked back those comments the next day, saying: “I have a great deal of confidence in what the U.K. does both scientifically and from a regulator standpoint.”

Doctors and nurses, certain people over 80 and nursing home workers.

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll be able to vaccinate only a small percentage of their citizens in the first couple of months.

Once enough people get vaccinated, it will become very difficult for the virus to find vulnerable people to infect. Life may start approaching something like normal by the fall of 2021.

Yes, but not forever. The two vaccines that will potentially get authorized this month protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the virus without developing symptoms.

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious side effects. Some have felt aches and flulike symptoms that last less than a day.

There’s no evidence that it does, and there’s good reason to think that it does not.

Some claims have been floating around the web that coronavirus vaccines can harm a woman’s fertility. The supposed evidence rests on the fact that most coronavirus vaccines work by creating antibodies that attack the virus’s “spike” protein, and this protein has a minor resemblance to a protein crucial for the formation of the placenta.

But that does not mean that the antibodies generated by coronavirus vaccines would attack a pregnant woman’s placenta. The region of the placental protein that’s similar to spike is just too short to give the antibodies a grip.

The Trump administration is said to have turned down an offer from Pfizer to purchase additional doses of its vaccine. 
Credit…Doug Mills/The New York Times

Before Pfizer’s coronavirus vaccine was proved highly successful in clinical trials last month, the company offered the Trump administration the chance to lock in supplies beyond the 100 million doses the pharmaceutical maker agreed to sell the government as part of a $1.95 billion deal months ago.

But the administration, according to people familiar with the talks, never made the deal, a choice that now raises questions about whether the United States allowed other countries to take its place in line.

As the administration scrambles to try to purchase more doses of the vaccine, President Trump plans on Tuesday to issue an executive order that proclaims that other nations will not get the U.S. supplies of its vaccine until Americans have been inoculated.

But the order appears to have no real teeth and does not expand the U.S. supply of doses, according to a description of the order on Monday by senior administration officials.

The vaccine being produced by Pfizer and its German partner, BioNTech, is a two-dose treatment, meaning that 100 million doses is enough to vaccinate only 50 million Americans. The vaccine is expected to receive authorization for emergency use in the U.S. as soon as this weekend, with another vaccine, developed by Moderna, also likely to be approved for emergency use soon.

Britain plans to begin a vaccination drive on Tuesday using the Pfizer-BioNTech vaccine, making it the first Western nation to start mass vaccinations.

On Nov. 11 — two days after Pfizer first announced early results indicating that its vaccine was more than 90 percent effective — the European Union announced that it had finalized a supply deal with Pfizer and BioNTech for 200 million doses, a deal they began negotiating in months earlier. Shipments could begin by the end of the year, and the contract includes an option for 100 million more doses.

Asked if the Trump administration had missed a crucial chance to snap up more doses for Americans, a spokeswoman for the Department of Health and Human Services said, “We are confident that we will have 100 million doses of Pfizer’s vaccine as agreed to in our contract, and beyond that, we have five other vaccine candidates.”

The government was in July given the option to request 100 million to 500 million additional doses. But despite repeated warnings from Pfizer officials that demand could vastly outstrip supply and amid urges to pre-order more doses, the Trump administration turned down the offer, according to several people familiar with the discussions.

In a statement, Pfizer said that “any additional doses beyond the 100 million are subject to a separate and mutually acceptable agreement,” and that “the company is not able to comment on any confidential discussions that may be taking place with the U.S. government.”

The bulk of the global supply of vaccines has already been claimed by wealthy countries like the United States, Canada, Britain and countries in Europe, leading to criticism that people in low- and middle-income countries will be left behind. The United States has declined to participate in a global initiative, called Covax, that is meant to make a vaccine available globally.

The decision to issue the executive order was reported earlier by Fox News.

Credit…Go Nakamura/Getty Images

The United States has recorded its most coronavirus-related deaths over a weeklong period, as a brutal surge gathers speed across the country.

With a seven-day average of 2,249 deaths, the country broke the previous mark of 2,232 set on April 17 in the early weeks of the pandemic. Seven-day averages can provide a more accurate picture of the virus’s progression than daily death counts, which can fluctuate and disguise the broader trend line.

The United States is approaching 300,000 total deaths, with nearly 283,000 recorded, according to a New York Times database. The nation is averaging nearly 200,000 cases per day, an increase of 15 percent from the average two weeks earlier, and has recorded over 15 million total cases.

Much has changed since the previous peak in April. The coronavirus is no longer concentrated in big urban areas like New York City and now envelops much of the country, including rural areas that had avoided it for several months.

Many of the hardest-hit counties on a per person basis are now in the Midwest. North Dakota, where one in every 10 residents has contracted the virus, has the highest total reported cases by population, followed closely by South Dakota, Iowa, Wisconsin and Nebraska.

The latest wave to hit the United States has hospitalized record numbers. Each day since Dec. 2, more than 100,000 Covid-19 patients were in hospitals. That far surpasses the number of people hospitalized during the peaks spring and summer, which at their worst had nearly 60,000 Americans in the hospital daily.

The new peak also comes as the nation prepares for holiday celebrations, and as colder temperatures may push people to congregate indoors. Infectious-disease experts have warned that trends in the United States, which reported a record 2,885 deaths on Wednesday, could continue to worsen over the next several weeks.

Against the warnings of public health officials, millions of Americans traveled over the Thanksgiving holiday, stoking fears that another wave of travel could accompany this month’s celebrations.

And even without traveling far, gatherings between people from different households pose a risk.

“These are going to be perfect scenarios for replication of the virus,” said Dr. Fadi Al Akhrass, an infectious-disease specialist at Pikeville Medical Center in Kentucky.

Dr. Al Akhrass said people seemed more willing to accept the severity of the virus than they were in April, but that “everybody learned the hard way.”

“The value of Christmas is what we give, not what we take — this is something we need to consider this season,” he said. “Giving up on large gatherings will probably be the best gift of them all.”

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