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White House staff members who work in close quarters with President Trump have been told they are scheduled to receive injections of the coronavirus vaccine soon, at a time when the first doses of the vaccine are being distributed only to high-risk health care workers, according to two sources familiar with the distribution plans.
The goal of distributing the vaccine inside the West Wing is to prevent additional government officials from falling ill in the final weeks of the Trump administration. The hope is to eventually distribute the vaccine to everyone who works in the White House, but will begin with some of the most senior people who work around the president, one of the people said.
It is not clear how many doses are being allocated to the White House or how many are needed, since many staff members have already tested positive for the virus and recovered. While many Trump officials said they were eager to receive the vaccine and would take it if it were offered, others said they were concerned it would send the wrong message by making it appear as if Trump staff members were hopping the line to protect a president who has already recovered from the virus and bragged that he is now “immune.”
The first doses of the Pfizer-BioNTech vaccine left a facility in Michigan early Sunday, with UPS and FedEx teaming up to ship them to all 50 states for distribution. A White House spokesman did not respond to a request for comment.
The White House has seen multiple waves of coronavirus cases. Mr. Trump, the first lady and a half-dozen advisers tested positive at the end of September and early October. A few weeks later, Vice President Mike Pence’s chief of staff, Marc Short, and a handful of other Pence staff members and advisers got sick.
And a third wave hit the West Wing after the president’s election night party at the White House. The White House chief of staff, Mark Meadows, got sick around that time, as did a number of other Trump advisers.
Since then, some senior Trump advisers have left the White House, like the senior communications adviser, Alyssa Farah. But the president’s core circle of top staff remains.
John Ullyot, a spokesman for the National Security Council, would not say whether White House officials who had already recovered would still receive the vaccine, or whether Mr. Trump himself would get one.
Trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine fanned out across the country on Sunday as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour.
The inoculation effort, set in motion after the Food and Drug Administration’s emergency authorization of the vaccine on Friday night, comes as the U.S. coronavirus death toll approaches 300,000. Rollout of the Pfizer-BioNTech vaccine is less centralized in the United States than in other countries that are racing to distribute it. (In Britain, the process is very centralized, and in Canada it is somewhere in between.)
Gen. Gustave F. Perna, the chief operating officer of Operation Warp Speed, the federal effort to develop a vaccine, said that 145 sites would receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.
A majority of the first injections are expected to be given on Monday 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 different departments.
Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin getting vaccinations next week. A vast majority of Americans will not be eligible for vaccinations until the spring or later.
On the snowy plains of Fargo, N.D., Jesse Breidenbach, the senior executive director of pharmacy for Sanford Health, which operates hospitals and clinics across the Upper Midwest, refreshed his email again and again on Sunday, waiting to receive a FedEx tracking number that would confirm that some 3,400 doses were en route.
The Sanford hospital in Fargo was converting its Veterans Club into a vaccination site, and officials said they would start inoculating a first group of emergency and critical-care doctors and nurses within hours after the vaccine arrived. But when would that be?
The answer came on Sunday afternoon: Expected vaccine delivery, 10:30 a.m. Monday, with vaccinations starting early in the afternoon.
transcript
transcript
First U.S. Coronavirus Vaccines Leave Michigan Plant
Workers at a Pfizer plant in Kalamazoo, Mich., packed boxes of the Pfizer-BioNTech vaccine on Sunday morning and loaded them onto trucks. Nearly 3 million doses are expected to reach all 50 states this week.
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[Applause]
The first of nearly three million doses of the first Covid-19 vaccine were packed in dry ice and put on trucks at a Pfizer plant in Kalamazoo, Mich., on Sunday morning, destined for hundreds of distribution centers in all 50 states, the most ambitious vaccination campaign in American history.
Workers applauded as the first truck left the plant carrying a load of the vaccine.
The inoculation effort, set in motion after the Food and Drug Administration’s emergency authorization on Friday night of the vaccine developed by Pfizer and BioNTech, comes as the U.S. coronavirus death toll approaches 300,000. And it is happening amid fears that Americans will continue to crowd together indoors over the holiday season and accelerate surges in cases, hospitalizations and deaths.
Officials reported more than 207,000 new cases and more than 2,200 deaths on Saturday. That brought the total number of U.S. cases to more than 16 million, by far the most in the world, less than a week after the country surpassed 15 million. More than 3,000 deaths were reported for the first time on Wednesday.
The first injections are expected to be given by Monday to high-risk health care workers, the initial step toward the goal of inoculating enough people by spring to finally halt the spread of a virus that has sickened millions and upended the country’s economy, education system and daily life.
UPS and FedEx said plans to ship the vaccine were already underway on Saturday, with vials of vaccines packed at Pfizer facilities and prepared for shipping. Employees from the Centers for Disease Control and Prevention were on hand to make sure there were no mishaps, according to a senior C.D.C. official.
About 2.9 million doses of the vaccine are to travel by plane and guarded truck from Pfizer facilities in Michigan and Wisconsin to designated distribution locations, mostly hospitals. Gen. Gustave F. Perna, the chief operating officer of Operation Warp Speed, the federal effort to bring a vaccine to market, said that 145 sites would receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday. He likened the operation to the Allied invasion of Europe in World War II.
“D-Day was the beginning of the end, and that’s where we are today,” he said, cautioning it would still take months “to eventually achieve victory.”
States are largely planning to follow C.D.C. recommendations about who gets vaccinated first: health care workers at high risk of exposure and residents of nursing homes and other long-term care facilities, a population that has died from the virus at disproportionately high rates.
FedEx and UPS will transport the vaccine throughout most of the country, and each delivery will be followed by shipments of extra dry ice a day later. Pfizer designed special containers, with trackers and enough dry ice to keep the doses sufficiently cold for up to 10 days. Every truck carrying the containers will have a device that tracks its location, temperature, light exposure and motion.
The rapid development of the vaccine, and its authorization based on data showing it to be 95 percent effective, has been a triumph of medical science, but much in this complicated next stage could go wrong.
The Pfizer vaccine needs to be kept at minus 94 degrees Fahrenheit, and the special boxes it is being shipped in can be opened no more than twice a day, to maintain the deep freeze. Side effects, like achiness or headache, could cause some of the nurses, doctors and others who are first in line for the vaccine to miss a day or two of work, challenging overburdened hospitals.
Rollout of the Pfizer vaccine is also less centralized in the United States than in other countries that are racing to distribute it. (In Britain, the process is very centralized, and in Canada, it is somewhere in between.)
States say they have only a fraction of the funding they need from the federal government for staffing to administer the shot, for tracking who has received both doses of the vaccine — a booster is needed three weeks after the initial injection — and for other crucial pieces of the effort.
Additional vaccines are in the pipeline. Moderna recently applied for emergency authorization for its vaccine and said it was “on track” to produce 20 million doses by the end of this month and between 500 million and a billion through 2021.
Reporting was contributed by Roni Caryn Rabin, Julie Bosman, Reed Abelson and Richard Pérez-Peña.
The U.S. Food and Drug Administration commissioner disagreed on Sunday with President Trump’s claims that the Pfizer-BioNTech vaccine could have been released a week ago.
The commissioner, Dr. Stephen Hahn, said the F.D.A.’s decision on Friday to authorize the vaccine for emergency use was made as quickly as possible while still ensuring that the vaccine was safe and effective.
“We do not feel that this could have been out a week earlier,” Dr. Hahn said on the ABC News program “This Week.” “We went through our process. We promised the American people that we would do a thorough review of the application and that’s what we did.”
Pfizer and BioNTech’s vaccine has been developed and has cleared those regulatory hurdles faster than any other vaccine the F.D.A. has evaluated. Work on it began shortly after the coronavirus was identified in Wuhan, China, less than a year ago.
The first of roughly three million doses of Pfizer’s vaccine began their journeys on Sunday morning to sites across the country, where they will be administered to health workers and nursing home residents and employees starting this week.
Dr. Hahn has faced mounting public rebukes and pressure from Mr. Trump, including insulting tweets, and from White House officials to speedily approve treatments and vaccines that are under development, including Pfizer’s and Moderna’s. Pressed in the television interview about whether Mark Meadows, the White House chief of staff, had threatened his job, Dr. Hahn said he didn’t want to get into individual discussions.
In a separate interview on Fox News Sunday, Moncef Slaoui, the scientific head of the administration’s vaccine effort, known as Operation Warp Speed, was asked if political interference had caused problems with vaccine development.
Dr. Slaoui described reports of political pressure as “not helpful” and “not needed,” adding that they could cloud discussions on the vaccine’s safety and efficacy. He noted that the past week had been filled with experts being “remarkably transparent” about the scientific data supporting the vaccine’s performance.
“If that phone call happened,” he said, referring to reports that Mr. Meadows contacted Dr. Hahn, “I think it was useless and unfortunate, and so are some of the tweets.”
Dr. Slaoui predicted that 100 million people in the U.S. would be vaccinated by the end of the first quarter of 2021. He noted that Pfizer’s product was highly unlikely to be the only vaccine to be ready for use soon, and pointed to the similar vaccine developed by Moderna. An independent panel of F.D.A. experts is scheduled to review that vaccine on Thursday, and Dr. Slaoui predicted that it would receive authorization for use as early as Friday.
Some 75 or 80 percent of Americans will need to be immunized before enough people are resistant to the virus to substantially slow its spread, a phenomenon called herd immunity, Dr. Slaoui said.
That benchmark could perhaps be met by the start of next summer. But Dr. Slaoui expressed concern about the degree of vaccine hesitancy that still pervades the country — a sense of skepticism that has not been helped, he noted, by rampant politicization of vaccination efforts or by rumors that powerful political figures had pressed government agencies to rush the timeline of vaccine clearance.
Last week, the F.D.A. released a review of Pfizer’s data from its clinical trials, which indicated that its vaccine can effectively prevent symptomatic cases of Covid-19. Few serious side effects were reported. Researchers will continue to monitor people who receive the vaccine to ensure its safety, but its promising performance in clinical trials has many experts hopeful.
“We hope that, now that all the data is out and available to be discussed in detail, that people will keep their mind open,” Dr. Slaoui said. “This a very effective and safe vaccine.”
Dr. Megan Ranney, an emergency physician in Rhode Island, echoed Dr. Slaoui’s concerns. “The vaccine is great, but only if it gets in people’s arms,” she said.
Dr. Ranney was eagerly anticipating getting her own shot. “Vaccines are one of the greatest miracles of modern medicine,” she said. “I cannot wait to get vaccinated myself and see my community vaccinated.”
Four more states that hesitated to take the Trump administration’s word on a new vaccine have completed their review of the Pfizer-BioNTech vaccine and recommended it as safe for use, according to a statement on Sunday from Gov. Gavin Newsom of California, one of the four states. The others are Washington, Oregon and Nevada.
“With shipments of the vaccine soon on their way to California, we are working hand-in-hand with local public health officials to get the vaccine out to the first phase of recipients,” the statement said. “Their work will continue as data becomes available on other potential vaccines.”
In October, the four states formed the Western States Scientific Safety Review Workgroup, made up of medical experts and officials, to analyze data supplied by the federal government and to review the processes of the federal advisory committees and agencies that were assessing the safety and efficacy of Covid vaccines.
New York State, which also set up an independent review panel, approved the state’s use of the Pfizer-BioNTech vaccine on Friday, hours before the Food and Drug Administration issued its emergency use authorization for the vaccine.
Special committees in about a half-dozen states, mostly Democratic-led, and the District of Columbia were created to add an extra layer of scrutiny and to vet any vaccine authorized by the F.D.A., in part because of concerns that the Trump administration might try to rush vaccine approvals for political reasons.
“The people of this country don’t trust this federal government with this vaccine process,” Gov, Andrew M. Cuomo of New York said in September when announcing his state’s vaccine committee, led by a Nobel-winning virologist.
Prime Minister Ambrose M. Dlamini of Eswatini died of Covid-19 on Sunday, according to a statement from the government. He was 52.
The deputy prime minister, Themba Masuku, notified the country, formerly known as Swaziland, of the leader’s “sad and untimely passing” in a statement on Twitter late Sunday. “His excellency passed on this afternoon while under medical care in a hospital in South Africa,” the statement read. Mr. Masuku added, “May his soul rest in peace.”
Twitter users responded with shock and sadness, sending broken-heart emoji and writing variations of “What a year.” Mr. Dlamini had been moved to a hospital in South Africa two weeks ago for treatment, Reuters reported, after contracting the virus in November. He had served as prime minister for two years in Africa’s last absolute monarchy.
The government did not immediately respond to requests for comment late Sunday. The nation of 1.2 million reported more than 6,714 cases as of Saturday, according to a New York Times database. The country’s health minister, Lizzie Nkosi, released a statement on Friday urging caution ahead of the festive season: “All signs show that we have now begun the second wave,” she wrote, saying the kingdom had recorded more than 120 deaths so far.
Mr. Dlamini is one of several world leaders who contracted the coronavirus — including President Trump, President Jair Bolsonaro of Brazil, Prime Minister Andrej Plenkovic of Croatia and Prime Minister Boris Johnson of Britain — but among very few who have died of Covid-19.
When Mr. Johnson tested positive for the virus, Mr. Dlamini shared his wishes for a speedy recovery on Twitter, writing: “Our thoughts are with the people of Britain and his loved ones. We believe that God will save the world from this scourge that has gripped our planet.”
Peru has suspended clinical trials for an experimental coronavirus vaccine manufactured by the Chinese company Sinopharm, citing concerns about safety, after a report of a “serious adverse event” in a study volunteer.
Pilar Mazzetti, Peru’s minister of health, stressed in a statement on Saturday that the pause in the trials was intended to ensure the vaccine’s safety, and noted the importance of continuing to wear masks and maintain physical distance even in the wake of widespread vaccination.
Sinopharm, a state-owned company, has been testing two vaccines in Peru, and was on the verge of completing its trials in the country. It’s unclear which of the two vaccines the volunteer who became ill was helping to test.
The volunteer’s illness involved feeling weakness in the legs, a medical researcher told a radio station in Lima. A temporary halt to the trial will allow experts to investigate the issue and determine whether it was linked to the vaccine.
Sinopharm’s vaccines contain modified, inactivated versions of the coronavirus, which do not pose an infectious threat. When injected into people, they can teach the immune system to recognize the virus’s “corpse,” preparing it to fight an active version of the virus should the recipient be exposed.
The United Arab Emirates gave full approval last week to one of Sinopharm’s vaccines, developed by the Beijing Institute of Biological Products, and said that the vaccine had an efficacy rate of 86 percent. On Sunday, the neighboring country of Bahrain followed suit.
Sinopharm did not respond immediately to a request for comment on the suspension in Peru, which has reported more than 36,500 deaths from the coronavirus.
BERLIN — Germans will be forced into a strict lockdown over Christmas after weeks of milder restrictions failed to prevent the coronavirus from spreading through the country, leading to record numbers of new infections and deaths.
Starting on Wednesday, most stores, schools and hairdressers will be required to close, and gatherings over the holidays will be restricted, Chancellor Angela Merkel said on Sunday. The measures, which Ms. Merkel announced after consultation with the governors of Germany’s 16 states, will apply through at least Jan. 10. Restaurants will still be allowed to sell takeaway food, but consumption of both food and alcohol in public will be banned.
“The ‘lockdown light’ had an effect, but it was not enough,” Markus Söder, governor of Bavaria, said, referring to the partial restrictions on social contacts that have been in place since early November. “If we are not careful, Germany will become the problem child of Europe,” he added.
Under the new restrictions, private meetings between people from two separate households will be limited to no more than five people over the age of 14, in addition to children. The restrictions will be expanded for Christmas, when people from up to four different households, plus children, will be allowed to meet, but only from Dec. 24 to 26.
No exception will be made over New Year’s, when gatherings will be banned, as will the fireworks that normally accompany the holiday in Germany.
Germany recorded 20,200 new infections on Sunday, over 2,000 more than what was recorded on the same day last week. The country has lost 21,787 people to the virus and the number of people being treated in intensive care is increasing.
Despite the horrifying surge of Covid-19 cases and deaths in the United States right now, one bit of good epidemiology news is emerging this winter: It now looks unlikely that the country will endure a “twindemic” of flu and the coronavirus hitting at the same time.
That comes as a profound relief to public health officials who predicted as far back as April that thousands of flu victims with pneumonia could pour into hospitals this winter, competing with equally desperate Covid-19 pneumonia victims for scarce ventilators.
“Overall flu activity is low, and lower than we usually see at this time of year,” said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. “I don’t think we can definitively say there will be no twindemic; I’ve been working with flu for a long time, and I’ve been burned. But flu is atypically low.”
Since September, the C.D.C. “FluView” — its weekly report on influenza surveillance — has shown all 50 states in shades of green and chartreuse, indicating “minimal” or “low” flu activity. Normally by December, at least a few states are painted in oranges and reds for “moderate” and “high.”
A combination of factors has made the flu season remarkably quiet, experts said.
In the Southern Hemisphere, where winter stretches from June through August, widespread mask-wearing, rigorous lockdowns and other precautions against Covid-19 transmission also drove the incidence of flu down to record lows. In the United States, the cancellation of large indoor gatherings, closings of schools and use of masks have been mitigating all respiratory diseases, including influenza.
That has buoyed the spirits of flu experts.
Dr. William Schaffner, medical director at the National Foundation for Infectious Diseases, which promotes flu shots, said he was recently on a telephone discussion with other preventive medicine specialists. “Everybody was in quiet awe about how low flu is,” he said. “Somebody said: ‘Shh, don’t talk about it. The virus will hear us.’”
The Food and Drug Administration’s emergency authorization on Friday night of the vaccine developed by Pfizer and BioNTech cleared the way for a complex effort led by the giant pharmacy chains CVS and Walgreens to give the vaccine to nursing home residents and workers, who have died from the virus at disproportionate rates.
Both companies have contracts with the federal government to send teams of pharmacists and support staff into thousands of long-term care facilities in the coming weeks to vaccinate all willing residents and staff members. CVS and Walgreens are both planning to administer their first vaccinations on Dec. 21.
More than 40,000 facilities have chosen to work with CVS. Nearly 35,000 picked Walgreens. Each U.S. state has already picked, or will soon pick, either the Pfizer or the Moderna vaccine for all of its long-term care facilities that will be working with CVS and Walgreens.
CVS has designated about 1,000 of its store pharmacies to serve as hubs for receiving the Pfizer vaccine. The shipments will come via FedEx and UPS.
“Those folks know that they are to bring that product right back to our pharmacy,” said Chris Cox, a CVS executive leading the company’s planning of the effort. “So no dropping it off at the back door, no dropping it off with our front store colleagues — it is to go straight to the pharmacy counter, so that the pharmacists themselves can receive it.”
On the morning the Pfizer doses are ready to go out to a nursing home, pharmacists will load them into small, hand-held coolers intended to keep the doses refrigerated for up to 24 hours. The pharmacists will drive with the doses in their own cars — traveling separately from several support staff members in an effort to maintain social distancing restrictions. The farthest long-term care facility will be about 75 miles by car, though most drives will be much shorter.
Once the CVS teams arrive at a nursing home, they’ll go room by room to administer shots to residents, while facility workers will generally be vaccinated in a common area. The visit will last two to four hours on average, Mr. Cox said. The CVS teams will generally make three visits to each home. For the Pfizer vaccine, each visit will be separated by about three weeks, the amount of time between the first shot and the booster.
“There’s a healthy level of anxiety here because the stakes are so high and the purpose is so great,” Mr. Cox said. “But I’d also say that we’ve been planning this for months — and we’ve been planning for the hardest and most potentially complex scenarios that could face us — so I feel confident that we’re ready to go.”
Although states are largely planning to follow C.D.C. recommendations about who to vaccinate first, there is some variation among their plans.
Gov. Ron DeSantis of Florida said that “tip-of-the-spear, high-contact workers” in hospitals would receive the very first shots and that he hoped to reach “as many elderly people as we can” by the end of December. Ohio has prioritized getting initial doses of the vaccine to people in nursing homes and assisted living centers. And in Mississippi, Dr. Thomas Dobbs, the state health officer, said frontline hospital workers would get the shots ahead of nursing home residents, in part to ease any anxiety those residents might have about the vaccine.
“They’re still a little bit hesitant,” he told reporters on Tuesday. “If we don’t put ourselves out there first, take the first doses of vaccine and show that we believe in it and trust it, I don’t think the long-term care folks are going to have the uptake they need.”
In most states, the concerted effort to vaccinate nursing home residents will begin a week later.
CVS, Walgreens and other pharmacies are also set to play a key role in vaccinating the general public once vaccines are more widely available, but that process will involve people going into their local pharmacies and could be weeks or months away.
Abby Goodnough contributed reporting.
Italy on Sunday unveiled a floral logo and a slogan for its coronavirus vaccination campaign: “With a flower, Italy comes back to life.”
A Milanese architect, Stefano Boeri, and a team of consultants came up with the flower design, which will be used on the temporary pavilions where the vaccine will be dispensed.
“This idea of a spring flower helping us emerge from a dark and cold winter is the message we want to give,” Mr. Boeri said in a streamed news conference on Sunday morning.
About 1.8 million Italians — health workers and nursing home residents — are expected to start receiving the Pfizer vaccine in mid-January, said Domenico Arcuri, the official in charge of the coronavirus response, at the news conference. Vaccines in Europe are awaiting approval from the European Medicines Agency.
About 1,500 pavilions will be set up in the main squares of Italian cities, Mr. Arcuri said, along with information booths also bearing the flower design.
Mr. Arcuri said that logistical questions, such as acquiring needles and syringes, were under control and that Italy had issued “a call to arms for 3,000 doctors and 12,000 nurses” to operate the pavilions.
Italy was the first European country to impose a nationwide lockdown in March, when the coronavirus swelled its hospitals, and a resurgence of the virus in the fall led to restrictions being reimposed. The country has registered a total of more than 64,000 virus deaths.
Mr. Arcuri said he hoped the “campaign of information and communication” would persuade Italians skeptical of the vaccine that the shots were safe.
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