Health care workers around the country rolled up their sleeves for the first covid-19 shots Monday as hope that an all-out vaccination effort can defeat the coronavirus smacked up against the reality of 300,000 U.S. deaths.
"Relieved," critical care nurse Sandra Lindsay said of her feelings after getting inoculated at Long Island Jewish Medical Center in New York. "I feel like healing is coming."
State officials said the shot was the first to be given outside a vaccine trial in the United States.
"I believe this is the weapon that will end the war," Gov. Andrew Cuomo said.
New York City Mayor Bill de Blasio said, "We were watching an incredibly historic moment and the beginning of something much better for this city and this country."
Lindsay, who is also director of patient services in the intensive care unit at her hospital, has treated patients throughout the pandemic. She said 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.
President Donald Trump posted on Twitter: "First Vaccine Administered. Congratulations USA! Congratulations WORLD!"
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People across the nation began receiving the vaccine.
With a countdown of "3-2-1," workers at Ohio State University's Wexner Medical Center gave initial injections to applause.
"Today is the first day on the long road to go back to normal," Mona Moghareh, a pharmacist, said after administering the first dose at a hospital in New Orleans.
And in Colorado, Gov. Jared Polis personally opened a delivery door to the FedEx driver and signed for a package holding 975 frozen doses of vaccine made by Pfizer Inc. and German partner BioNTech.
The shots kicked off what will become the largest vaccination effort in U.S. history, one that could finally conquer the outbreak.
Dr. Valerie Briones-Pryor, who has worked in a covid-19 unit at University of Louisville Hospital since March and recently lost her 27th patient to the disease caused by the coronavirus, was among the first recipients.
"I want to get back to seeing my family," she said. "I want families to be able to get back to seeing their loved ones."
Some 145 sites around the country, from Rhode Island to Alaska, received shipments, with more deliveries set for the coming days. High-risk health care workers were first in line.
"This is 20,000 doses of hope," John Couris, president and chief executive of Tampa General Hospital in Florida, said of the first delivery.
Nursing home residents also get priority, and a Veterans Affairs Medical Center in Bedford, Mass., announced via Twitter that its first dose went to a 96-year-old World War II veteran, Margaret Klessens. Other nursing homes around the U.S. expect inoculations soon.
'NUMBERS ARE STAGGERING'
The campaign began the same day the U.S. death toll from the surging outbreak crossed the 300,000 threshold, according to the count kept by Johns Hopkins University using data supplied by health authorities across the country.
The number of dead is more than five times the number of Americans killed in the Vietnam War.
Globally, the virus is blamed for more than 1.6 million deaths.
"To think, now we can just absorb in our country 3,000 deaths a day as though it were just business as usual. It just represents a moral failing," said Jennifer Nuzzo, a public health researcher at Johns Hopkins.
"The numbers are staggering -- the most impactful respiratory pandemic that we have experienced in over 102 years, since the iconic 1918 Spanish flu," Dr. Anthony Fauci, the government's top infectious-disease expert, said days before the milestone.
Experts say it could take well into spring for the shots and other measures to bring cases and deaths under control in the U.S.
With cold weather driving people inside, where the virus spreads more easily, and many Americans disdainful of masks and other precautions, some public health authorities project 100,000 more Americans could die before the end of January.
In an interview with MSNBC on Monday, Fauci laid out a timeline that stretched well into 2021.
He predicted that the average person with no underlying conditions would get the vaccine by March or April. If the campaign is efficient and effective in persuading people to get the shots, then 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: "It's not a substitute. It complements it. 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."
COMBATING SKEPTICISM
Health experts know a wary public is watching the vaccination campaign, especially communities of color that have been hit hard by the pandemic but, because of the nation's legacy of racial health disparities and research abuses against Black people, have doubts.
Getting vaccinated is "a privilege," said Dr. Leonardo Seoane, chief academic officer at Ochsner Health in suburban New Orleans, after getting his dose. Seoane, who is Cuban American, urged "all of my Hispanic brothers and sisters to do it. It's OK."
Lindsay, the New York nurse, 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.
"I want people who look like me and are associated with me to know it's safe," Lindsay said. "Use me as an example. I would not steer the public wrong."
The nearly 3 million doses being shipped are just a down payment on the amount needed. More of the Pfizer-BioNTech vaccine will arrive each week. And later this week, the Food and Drug Administration is to decide whether to green-light the world's second rigorously studied vaccine, made by Moderna Inc.
While the U.S. hopes for enough of both vaccines together to vaccinate 20 million people by the end of the month and 30 million more in January, there won't be enough for the average person to get a shot just yet.
For now the hurdle is to rapidly get vaccine into the arms of millions, not just doctors and nurses but other at-risk health workers such as janitors and food handlers -- and then deliver a second dose three weeks later.
"We're also in the middle of a surge, and it's the holidays, and our health care workers have been working at an extraordinary pace," said Sue Mashni, chief pharmacy officer at the Mount Sinai Health System in New York City.
Plus, the shots can cause temporary fever, fatigue and aches as they rev up people's immune systems, forcing hospitals to stagger employee vaccinations.
Just half of Americans say they want to get vaccinated, while about a quarter don't and the rest are unsure, according to a recent poll by The Associated Press-NORC Center for Public Health Research.
"I know it's going to be a big hurdle to convince people because it's new, it's uncertain," said intensive care nurse Helen Cordova, who got a shot at Kaiser Permanente Los Angeles Medical Center. "This can be encouraging for others."
The FDA, considered the world's strictest medical regulator, said the first vaccine, which was developed at breakneck speed less than a year after the virus was identified, appears safe and strongly protective, and the agency laid out the data in a daylong public meeting last week for scientists and the public alike to see.
"We know it works well," said Ochsner infectious-disease expert Dr. Katherine Baumgarten, who got her shot on Day 1. "As soon as you can get it, please do so."
Still, the vaccine was cleared for emergency use before a final study in nearly 44,000 people was complete. That research is continuing to try to answer additional questions.
For example, while the vaccine is effective at preventing covid-19 illness, it is not clear if it will stop the symptomless spread that accounts for half of all cases.
The shots still must be studied in children and during pregnancy. But the American College of Obstetricians and Gynecologists said Sunday that vaccination should not be withheld from pregnant women who otherwise would qualify.
Also, regulators in Britain are investigating a few severe allergic reactions. The FDA instructed providers not to give the vaccine to those with a known history of severe allergic reactions to any of its ingredients.
VACCINATING OFFICIALS
Senior federal officials will begin receiving vaccinations this week as part of updated federal continuity-of-government plans that now include terrorism and pandemics as threats to the nation and its leaders.
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Doses are expected to be administered at the White House, Capitol Hill and other facilities, according to senior administration officials.
Also among those expected to receive initial doses are military aides to the president, Situation Room watch officers and Secret Service agents. Quarantines for exposure to the virus have proved particularly challenging to those essential government functions.
The exact number and roles of officials is classified, according to the officials. It is not expected to include Trump and Vice President Mike Pence at this point. Lawmakers on Capitol Hill have yet to be informed how many doses they will receive and have yet to develop a vaccination plan, an official said. The Supreme Court did not comment on whether justices or other key staff members would be vaccinated.
Aides to President-elect Joe Biden have been discussing when and how he should receive the vaccine and have been working to establish plans to boost virus safeguards in the West Wing to keep the 78-year-old Democrat healthy after he takes office.
NYC RESTRICTIONS
While New York welcomed the vaccine, the city was told it should be prepared for another full shutdown. Indoor dining was closed again Monday.
"The governor said we should prepare for the possibility for a full shutdown, I agree with that," de Blasio said. "We need to recognize that that may be coming, and we need to get ready for that now."
"At the current rate we're going, you have to be ready now for a full shutdown, a pause like we had back at the end of the spring. That's increasingly necessary to break the back of the second wave, to stop it from growing, taking lives, threatening our hospitals," de Blasio said.
He urged city residents not to get complacent just because a vaccine has arrived. And de Blasio urged people who don't need to be going into a workplace to work remotely "as much as they could."
"The likelihood of more restrictions soon is high, so folks should begin making adjustments soon and work remotely if they can," he said. He couched a potential shutdown as shorter than the one New York experienced in the spring. "We're hopefully talking about weeks, but we're preparing mentally and practically for that possibility," he said.
Information for this article was contributed by Lauran Neergaard, Marion Renault, Andrew Welsh-Huggins, Rebecca Santana, Dylan Lovan, Tamara Lush, Jeff Turner, Kathy Young, Adam Geller, Heather Hollingsworth, Zeke Miller, Lisa Mascaro and Aamer Madhani of The Associated Press; by Jack Healy, Amy Harmon, Simon Romero, Noah Weiland, Michael Gold, Roni Caryn Rabin and Karen Zraick of The New York Times; and by Shelly Banjo of Bloomberg News.
