A vaccine protester among supporters of President Trump at a rally in Woodland Hills, Calif., in May.
Credit…David McNew/Getty Images

As the United States begins the most ambitious vaccination drive in its history, with images of relieved health care workers getting a shot in the arm flashing across TV screens and news sites, fresh data revealed that more than one-quarter of Americans say they probably or definitely would not take a coronavirus vaccine.

That is according to a survey released on Tuesday by the Kaiser Family Foundation, which found that Republican, rural and Black Americans are among the most hesitant to be vaccinated.

The skepticism, while not totally unanticipated, still represents a challenge as the country tries to tamp down exploding infections, hospitalizations and deaths. On the same day as the first inoculations were administered, the United States passed 300,000 deaths — more than any other country.

The country is averaging more than 2,400 deaths a day, even more than in the spring. More than twice as many deaths are being announced each day than just a month ago.

The survey was conducted between Nov. 30 and Dec. 8 among a nationally representative random sample of 1,676 adults ages 18 and older (including interviews with 298 Hispanic adults and 390 non-Hispanic Black adults).

It is the first report from a new “Covid-19 Vaccine Monitor” that the Kaiser foundation has established to deeply examine the public’s views about coronavirus vaccination, and to track experiences in getting shots. Such information will be essential for public health experts who are trying to encourage vaccination.

Over all, 71 percent of respondents said they definitely would get a vaccine, an 8 percent increase from what Kaiser found in a September survey. Roughly a third (34 percent) now want the vaccine as soon as possible.

Another 39 percent said they would wait to see how the vaccine works out for other people before getting it themselves. Nine percent would get the vaccine only if it is required for work, school or another activity. Twelve percent said they would probably not take a vaccine, and 15 percent said they would definitely not get vaccinated — even if it was free and determined to be safe by scientists.

Different groups are hesitant for different reasons, the survey found. Black Americans appear most worried about side effects, or that they could get Covid-19 from the vaccine.

Nearly one in four Republicans “don’t want to get vaccinated because they don’t believe Covid poses a serious threat,” said Mollyann Brodie, the executive vice president of the foundation.

“It will be a real challenge to undo Covid denialism among this slice of President Trump’s political base,” she added.

Hundreds of medical workers received the United States’ first coronavirus vaccines on Monday, including Kenzie Frankl, a clinical care leader with Sanford Health in Fargo, N.D.
Credit…Tim Gruber for The New York Times

Some of the medical centers that have endured the worst of the coronavirus outbreak in the United States found the gloom that has long filled their corridors replaced by elation and hope on Monday as health care workers became the first to take part in a mass vaccination campaign aimed at ending the pandemic.

Hundreds of those who have been on the front lines of fighting Covid-19 — a nurse from an intensive care unit in New York, an emergency room doctor from Ohio, a hospital housekeeper in Iowa — received inoculations in emotional ceremonies watched by people around the country.

“I feel like healing is coming,” said Sandra Lindsay, a critical care nursing director who was among the first health care workers to be vaccinated on Monday morning, at Long Island Jewish Medical Center in Queens.

The vaccinations came as the nation surpassed 300,000 coronavirus deaths, a toll larger than any other country. Even as applause rang out at hospitals, many intensive care units remained near capacity.

Plunking down in chairs and rolling up their sleeves were physicians, nurses, aides, cleaners and at least one chief executive who said he was getting the vaccine early to encourage everyone on his staff to do the same.

Dr. Jason Smith, the first Kentuckian to receive the Covid-19 vaccine, showed off the smiley-face Band-Aid a health care worker applied to his arm. “Didn’t even feel it,” he said.

A group of nuns in Sioux Falls, S.D., blessed the vaccine as it arrived, before it was whisked into a freezer.

Seth Jackson, a nurse in Iowa City, found himself crying on the way to the hospital to get his shot. Robin Mercier, a Rhode Island nurse, rejoiced in feeling one step closer to being able to kiss her grandchild.

For many Americans who have lost loved ones to Covid-19, the vaccination rollout was bittersweet. It did not come soon enough for Mary Smith’s husband, Mike, who died from the virus in November at the age of 64.

“It was so close,” Ms. Smith, who lives outside Peoria, Ill., said on Monday.

She voiced frustration with people who said they did not trust the vaccine. “These people who say, ‘I’m not getting it,’ all I can say is, ‘Why? Have you lost your mind?’” Ms. Smith added. “Have you not seen how many people have died? This is real.’”

Dr. Lyudmila Soboleva, 38, received the Sputnik V shot in Moscow last week. The government-funded coronavirus vaccine is based on genetically modified common cold viruses.
Credit…Sergey Ponomarev for The New York Times

Russia has released additional results from a clinical trial of its leading coronavirus vaccine, called Sputnik V, showing an efficacy rate of 91.4 percent, similar to results obtained by Western vaccine makers.

Unlike in the West, the Russian authorities have taken a different path on vaccination, promoting the government-funded shot, which is based on genetically modified common cold viruses, before testing was complete. Moscow approved Sputnik V for emergency use in August, before wide-scale clinical trials to prove its efficacy and safety had even begun.

The World Health Organization and independent experts criticized the move as risky, noting that it undermined confidence in the vaccine, which Russia plans to market in more than 70 countries.

The financial company promoting the vaccine, the Russian Direct Investment Fund, released on Monday data from the interim result of its Phase 3 study, based on 22,714 participants receiving either the vaccine or a placebo. A total of 78 people across the two groups contracted Covid-19, the disease caused by the coronavirus.

It showed that among those who received the vaccine, none became severely ill with Covid-19 and that 91.4 percent were protected from mild or moderate cases. Twenty severe cases were recorded among the placebo group.

Kirill Dmitriev, the chief executive of the fund, praised the result as “astonishing” and said it would help Russia apply for registration for Sputnik V in potential export markets. He said the fund intended to apply in Argentina this month, and in other Latin American nations and countries in Asia and Africa in January.

So far, Russia has shipped about 320,000 doses of the vaccine and inoculated about 200,000 people outside of the clinical trials.

The vaccine this month received a vote of confidence from AstraZeneca, the British-Swedish pharmaceutical giant, when it opened talks with Russian vaccine scientists about combining efforts.

The AstraZeneca vaccine, developed at the University of Oxford, England, showed encouraging but perplexing results: Two doses of the vaccine provided stronger results (90 percent efficacy) when the first dose was only at half strength than when two full-dose shots were injected (a 62 percent efficacy). The joint efforts will explore whether that vaccine can be made more effective if recipients also receive a shot of Sputnik V.

The Russian trial is scheduled to continue until May, but Mr. Dmitriev said that regulators might halt it on ethical grounds as the vaccine had been proved effective. The efficacy rate was similar to what the Russian group had reported earlier but based this time on a larger, more statistically relevant sample. The results were comparable to those of the Pfizer vaccine, which reported a 95 percent efficacy and has already been approved for use in several countries, and of Moderna’s, which reported a 94.1 percent efficacy rate.

Police officers detained a woman taking part in an anti-vaccination and anti-lockdown protest in Parliament Square, London, on Monday.
Credit…Stefan Rousseau/Press Association, via Associated Press

Prime Minister Boris Johnson was already facing a treacherous week as he weighs whether to strike a Brexit trade deal with the European Union. Now, he faces pressure on another front, after his government on Monday imposed tighter restrictions on London to curb a virus flare-up.

That abrupt decision, announced in Parliament by the health minister, Matt Hancock, will close pubs and restaurants in London, effective Wednesday. The move comes just 10 days before Christmas, and could drive away the shoppers who normally throng Oxford and Regent Streets at this time of the year.

Mr. Hancock said the British health authorities had identified a new, faster-growing variant of the virus, which he said might explain why the number of cases was rising so quickly in London, as well as in parts of southern and eastern England.

But that sobering news did not prevent grumbling from some members of Mr. Johnson’s Conservative Party, who warned that the new restrictions would deal another blow to the beleaguered hospitality and retail industries.

Medical experts said the discovery of a new variant was not, by itself, all that surprising. The variant, which has been found in roughly 1,000 people after first being detected in Kent, in southern England, is similar to that in other countries. Experts said that it served mainly to underscore the need for more robust border controls.

More baffling, they said, was the government’s on-again, off-again plan for dealing with the surge in cases. Under the new restrictions, pubs and restaurants in London will be closed, except for takeout service, while people from different households will be forbidden from socializing indoors.

Yet under a previously announced plan for Christmas, the government will temporarily lift the restrictions again a week later to allow up to three families to mix indoors. The break will begin Dec. 23 and last until Dec. 27 in most parts of Britain (those traveling to and from Northern Ireland can travel on Dec. 22 and 28). After that pause, London and the other affected regions would presumably go back under tighter restrictions.

Mayor Sadiq Khan of London has encouraged the government to rethink the holiday break, warning families, “This virus doesn’t respect Christmas.”

“We heard from Matt Hancock yesterday that it appears the government is looking at this again,” Mr. Khan told BBC Radio 4’s Today show on Tuesday morning. “I would encourage them to do so if they are.”

Two leading medical journals in a joint editorial published on Tuesday also criticized the British government’s decision to loosen measures over Christmas, warning that the move could lead to hospitals becoming overwhelmed by new cases.

Delivering doses of the vaccine to the University of Pittsburgh Medical Center Children’s Hospital on Monday.
Credit…Kristian Thacker for The New York Times

As a growing number of vaccines advance through clinical trials, wealthy countries are fueling an extraordinary gap in access around the world, laying claim to more than half the doses that could come on the market by the end of next year.

Many poor nations may be able to vaccinate at most 20 percent of their populations in 2021. But some of the world’s richest countries have reserved enough doses to immunize their populations multiple times.

With no guarantee that any particular vaccine will come through, these countries have hedged their bets on a number of candidates. But if all the doses they have claimed are fulfilled, the European Union could inoculate its residents twice, Britain and the United States could do so four times over, and Canada six times over, according to a New York Times analysis of data collected by Duke University, Unicef and Airfinity, a science analytics company.

The United States has provided billions of dollars to back the research, development and manufacturing of five of the most promising vaccines against Covid-19, pushing them forward at a speed and scale that would otherwise have been impossible. But the support came with a condition: that Americans would get priority access to doses made in their country.

Other wealthy countries joined the United States in placing large orders, often with clauses in their contracts that would allow them to acquire even more if they desired, undermining many other nations’ ability to make timely purchases.

How quickly the wealthy countries will achieve full coverage is uncertain, in large part because the candidates are in varied stages of progress. Pfizer’s vaccine, developed with BioNTech, is now authorized in countries including Bahrain, Britain, Canada, Mexico, Saudi Arabia and the United States. Moderna’s is expected soon.

AstraZeneca, which is developing its vaccine with the University of Oxford, is likely to seek approval in Britain, India and several other countries in the next few weeks, armed with data from outside the United States, where it has suffered setbacks with regulators. Valneva has not yet entered clinical trials. Sanofi, which is working with GlaxoSmithKline, recently changed its approval timetable to the end of next year after clinical results showed a poor performance in older people.

But the outlook for most of the developing world is dire. Because of manufacturing limits, it could be as late as 2024 before many low-income countries are able to obtain enough vaccines to fully immunize their populations.

A volunteer on a Covid-19 vaccine trial at the Emilio Ribas Institute in São Paulo, Brazil, on Saturday.
Credit…Victor Moriyama for The New York Times

As countries rushed their preparations to inoculate citizens against the coronavirus, Brazil, with its world-renowned immunization program and a robust pharmaceutical manufacturing capacity, should have been at a significant advantage.

But political infighting, haphazard planning and a nascent anti-vaccine movement have left the nation, which has suffered the pandemic’s second-largest death toll, without a clear vaccination program. Its citizens now have no sense of when they may get relief from a virus that has brought the public health system to its knees and crushed the economy.

“They’re playing with lives,” said Denise Garrett, a Brazilian-American epidemiologist at the Sabin Vaccine Institute, which works to expand access to vaccines. “It’s borderline criminal,” she added.

Experts had held out hope that Brazil’s immunization prowess might allow it to handle the end of the pandemic better than it handled the beginning.

Soon after Covid-19 was first identified in the country in February, Brazil became an epicenter of the global health crisis. President Jair Bolsonaro dismissed scientific evidence, called the virus a “measly” cold that did not warrant shutting down the region’s largest economy, and berated governors who imposed quarantine measures and business closures.

As vaccination efforts get underway in Britain and in the United States, giving their populations a chance to begin to imagine a post-pandemic life, the moment found Brazilian officials once again unprepared and mired in loud disputes over vaccine politics.

The Brazilian Health Ministry last week presented a vaccination plan in response to an order from the Supreme Court. The plan established the order in which vulnerable groups would be vaccinated but lacked a detailed timeline and a clear estimate of how many doses will be available. The ministry had previously said it intended to start the vaccination campaign in March.

Days after the announcement, the Health Ministry was still scrambling to place orders with overextended vaccine suppliers. Officials at the ministry also faced questions over why the country did not have enough syringes and vials on hand to embark on the ambitious vaccination campaign, necessary to cover a country with 210 million residents, where more than 180,000 have succumbed to the virus.

On top of that, Anvisa, Brazil’s health regulatory agency, has yet to approve any coronavirus vaccine for general use.

Students arriving at a public school in Brooklyn last week.
Credit…Victor J. Blue for The New York Times

In Arizona, where several schools have moved online in recent weeks amid a virus surge, Gov. Doug Ducey declared that teachers would be among the very first people inoculated. “Teachers are essential to our state,” he said. Utah’s governor talked about possibly getting shots to educators this month. And Los Angeles officials urged prioritizing teachers alongside firefighters and prison guards.

But in districts where children have spent much of the fall staring at laptop screens, including some of the nation’s largest, it may be too early for parents to get their hopes up that public schools will throw open their doors soon, or that students will be back in classrooms full time before next fall.

Given the limited number of vaccines available to states and the logistical hurdles to distribution, including the fact that two doses are needed several weeks apart, experts said that vaccinating the nation’s three million schoolteachers could be a slow process, lasting well into the spring.

And even once enough educators are inoculated for school officials and teachers’ unions — which hold considerable power in many large districts — to consider it safe to reopen classrooms, schools will likely need to continue requiring masks and distancing students for many months, experts said, until community spread has sharply dropped, possibly by summer.

“I think some people have in their head that we’re going to start rolling out the vaccine and all this other stuff is going to go away,” said Marcus Plescia, the chief medical officer at the Association of State and Territorial Health Officials, which represents public health agencies.

But in schools, as in daily life, he said, there will be no quick fix. “My feeling is that we’re all going to be wearing masks and keeping our distance and trying to be careful around each other for probably most of 2021.”

Teachers, parents and students march through Brooklyn in September to demand a safer teaching environment in New York City schools.
Credit…Spencer Platt/Getty Images

Teachers in Texas, Georgia and other parts of the country plan to call in sick on Tuesday as part of a nationwide protest against standardized testing during the pandemic, along with other policies that educators say are putting them at risk as coronavirus cases rise.

Anger over a Texas policy requiring teachers and students to take a state standardized test, with some districts requiring that students sit for the exam in school buildings, has grown among Houston-area educators since a middle school teacher died of the coronavirus earlier this month.

“They’re prioritizing testing over the safety of students, teachers and communities,” said Naseeb Gill, 32, a fifth-grade teacher in Houston.

Known as the National Day Without Teachers, the planned sickout — organized by a group founded by a Georgia high school teacher — reflects a contentious debate over the safety of in-person instruction that is playing out as the virus surges in many states.

Teachers at about 50 schools in Harris County, Texas, which includes Houston, will participate, according to some who plan to take part. They are motivated by a range of policies, including requirements for teachers to use sick days to quarantine unless their absence is ordered by administrators.

“This is legit just teachers who are just fed up across the nation and are saying this has to stop,” said Alfred Brooks, the founder of Teachers for Good Trouble, which organized the national protests. Teachers in cities from New York to Houston to Los Angeles have signed on, but the exact number planning to participate is unclear, he said. Many teachers in so-called right-to-work states have few labor protections.

Calling in sick has been a common method for teachers to express their concerns during the pandemic. About 100 teachers in Arizona’s third-largest school district staged a sickout on Friday, demanding that schools close after winter break and stay remote until the region’s infection rate declines.

A subway train in Beijing on Monday. Even though China has largely contained the coronavirus, small clusters of cases have continued to surface in the country.
Credit…Andy Wong/Associated Press

The Chinese authorities on Tuesday were investigating a cargo pilot in a province in southwestern China who tested positive for the coronavirus shortly after attending a 300-person wedding, just days after returning to the country from the United States.

His case added to fears about an outbreak in the province, Sichuan, where a few dozen cases — most of them imported — have been registered in recent days. Even though China has largely contained the coronavirus since it emerged in the central city of Wuhan last year, small clusters of cases have continued to surface in the country.

And it marks a stark reversal: Earlier this year, travelers from China were seen as posing a major risk of carrying the virus, but now, with the United States the center of the worst coronavirus outbreak anywhere in the world, the tables have turned.

It is unclear how the pilot, who was identified in Chinese news reports by his surname, Gao, had contracted the virus. Mr. Gao, 26, returned to the city of Chengdu from Los Angeles in late November and spent time in quarantine after testing negative for the virus, according to Chinese news media reports. The authorities have classified his case as an imported infection.

As news of the case spread on Chinese social media sites, many people expressed anger over Mr. Gao’s decision to attend the wedding, which took place in the city of Jiangyou on Saturday, 13 days after his return from the United States. He tested positive on Monday, according to Chinese news reports.

China has some of the strictest virus-control measures in the world, and the government typically mandates two weeks of quarantine for people returning to the mainland. But pilots are allowed exemptions. Some do not need to undergo quarantine if they test negative for the virus upon returning to China.

Here’s what else to know in coronavirus news from around the world:

  • At least 274 journalists around the world were in prison on Dec. 1, including some who had covered the pandemic, according to a report published early Tuesday by the Committee to Protect Journalists, an advocacy group in New York. Notably, at least three journalists in Egypt were arrested after covering their government’s response to the coronavirus, the report said. One of them, Mohamed Monir, contracted the coronavirus in custody and died a few days after his release. In Honduras, the journalist David Romero, who had been serving a 10-year defamation sentence when the pandemic started, died of Covid-19 complications in prison.

  • Moderna, the pharmaceutical company behind a coronavirus vaccine awaiting approval, said that documents related to its candidate were exposed in a cyberattack on the European Medicines Agency. The agency, which vets drugs for the European Union, said that it was targeted in a cyberattack last week. Moderna said in a statement that there was no information that would identify participants in its study in the paperwork stolen.

  • Starting in mid-January, “a limited number of business, official and high economic value” travelers can apply for permission to enter Singapore for stays of up to 14 days, the Ministry of Trade and Industry for the island nation said on Tuesday. Approved travelers will be required to undergo Covid-19 testing before entering, as well as on arrival. They will also be subject to regular testing and must stay in designated facilities.

  • Officials in the Philippines, fearing a surge in coronavirus cases over the holiday season, said on Tuesday that anyone going out in public must wear a face shield on top of a face mask. Face shields had previously been required only on public transit and in enclosed spaces like malls and grocery stores, while masks have been mandatory since April. The Philippines, a country of more than 100 million people, has had a total of more than 450,000 cases, one of the worst outbreaks in Southeast Asia.

Choi Ji-na, right, checking the packages to distribute in Seoul, South Korea.
Credit…Woohae Cho for The New York Times

At a logistics depot in southern Seoul, couriers recently held a ritual at the start of another grueling work day: They stood for a moment of silence to remember 15 fellow couriers who they say died this year from overwork.

“We won’t be surprised here if one of us drops dead, too,” said Choi Ji-na, one of the couriers.

Ms. Choi, 43, and other delivery workers in South Korea say they feel lucky to have jobs amid growing unemployment, and that they are proud to play an essential role in keeping the country’s Covid-19 cases down by delivering record numbers of packages to customers who prefer to stay safe at home.

But they are also paying a price.

The string of deaths among couriers this year has caused a national uproar, drawing attention to worker protections that are unevenly distributed in a place that once had one of the longest workweeks in the world. Packages are expected to arrive with “bullet speed,” but the uninsured workers delivering them say it is becoming impossible to keep up with the demand, and that labor rule changes made by President Moon Jae-in have neglected them.

Couriers are some of the hardest working, least-protected workers in South Korea. Between 2015 and 2019, only one to four couriers died per year. This year, nine couriers died in the first half of the year alone.

When President Moon slashed the maximum workweek to 52 hours from 68 in 2018 to ensure a “work-life balance” and a “right to rest,” couriers were left out of the deal.

Online orders have surged around the world, and demand for delivered goods in South Korea has grown by 30 percent, to 3.6 billion parcels this year, according to some estimates.

Most deliveries in South Korea are handled by large logistics companies. Those firms outsource the labor to couriers, who are independent subcontractors working on commission using their own trucks in assigned areas.

Shopping malls and logistics firms now promise even faster deliveries, offering “within-the-day,” “before-dawn” and “bullet-speed” options. But the fees collected by couriers have dropped. Workers now receive between 60 and 80 cents per parcel and have been slapped with penalties when they fail to meet delivery deadlines.



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