Covid-19 Live Updates: Britain Begins Vaccinating Citizens

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Britain’s National Health Service delivered its first shots of the Pfizer-BioNTech Covid-19 vaccine on Tuesday, opening a mass vaccination campaign with little precedent in modern medicine and making Britons the first people in the world to receive a clinically authorized, fully tested vaccine.

At 6:31 a.m. Tuesday, Margaret Keenan, 90, a former jewelry shop assistant, rolled up the sleeve of her “Merry Christmas” T-shirt to receive the first shot, and her image quickly became an emblem of the remarkable race to produce a vaccine and the global effort to end a pandemic that has killed 1.5 million people worldwide.

“I feel so privileged to be the first person vaccinated against Covid-19,” said Ms. Keenan, who lives in Coventry, in central England. “It means I can finally look forward to spending time with my family and friends in the new year after being on my own for most of the year.”

British regulators leapt ahead of their American counterparts last week to authorize a coronavirus vaccine, upsetting the White House and setting off a spirited debate about whether Britain had moved too hastily, or if the United States was wasting valuable time as the virus was killing about 2,200 Americans a day over the last week, as of Monday.

President Trump planned on Tuesday to issue an executive order proclaiming that other nations will not get U.S. supplies of its vaccine until Americans have been inoculated, a directive that appeared to have no real teeth but nevertheless was indicative of the heated race to secure shipments of doses.

For the people receiving vaccinations in Britain, among them doctors and nurses who have fortified the country’s National Health Service this year, the shots were an early glimpse at post-pandemic life. Besides Ms. Keenan, none attracted as much attention as William Shakespeare, who was second in line for a shot in Coventry and who, the National Health Service confirmed, really is named William Shakespeare.

“Today is a great day for medical science, and the future,” Chris Whitty, the chief medical officer for England, said on Tuesday. (An earlier version of this item mistakenly said he was the chief medical officer for all of Britain.)

The first 800,000 doses of the Pfizer-BioNTech vaccine for Britain were 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. The vaccine must be transported at South Pole-like temperatures before it can be stored for five days in a normal refrigerator, Pfizer has said. First to receive the vaccine will be doctors and nurses, certain people aged 80 and over, 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 aged 80 and over 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.

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.

Hundreds of people are still dying in Britain each day from the virus, and the country has made allowances for travel over the Christmas period that scientists fear will seed another uptick in infections.

“It is amazing to see the vaccine, but we can’t afford to relax now,” Prime Minister Boris Johnson of Britain said on Tuesday morning as he visited a London hospital. Trying to calm a recipient’s nerves about needles, he suggested, “I always try to think of something else — recite some poetry.”

Ms. Keenan, the first vaccine recipient, showed no such nerves. Nicola Sturgeon, Scotland’s first minister, said on Twitter that watching Ms. Keenan receive the shot gave her “a bit of a lump in the throat.”

“Feels like such a milestone moment after a tough year for everyone,” Ms. Sturgeon added.

Administering Ms. Keenan’s shot was May Parsons, a nurse who is originally from the Philippines and has worked for the National Health Service for 24 years.

“The last few months have been tough for all of us working in the N.H.S.,” she said, “but now it feels like there is light at the end of the tunnel.”

The University of Oxford published a much-anticipated paper on Tuesday detailing the findings of its coronavirus vaccine trials, echoing results first announced two weeks ago that showed the vaccine had 70 percent efficacy on average across two different dosing regimens.

But while it was the first peer-reviewed publication outlining late-stage results of a leading coronavirus vaccine, it did little to answer the most pressing questions facing the university and AstraZeneca, the drug maker, since they offered a glimpse at the same promising, if somewhat puzzling, results two weeks ago.

Among nearly 8,900 participants who received two full doses of the vaccine, it had 62 percent efficacy. But after a discrepancy over methods for measuring the concentration of viral particles in the vaccine created uncertainty over the dosage during an early stage of manufacturing, 2,741 participants were given a half dose of the vaccine followed a month later by a full dose. In that smaller group of participants, the vaccine had 90 percent efficacy.

The Oxford scientists said in the paper, published in the Lancet, a British medical journal, that “further work is needed to determine the mechanism of the increased efficacy.”

Both dosing regimens appeared to protect participants in the trials from hospitalization or severe disease.

The results combined data from a trial in Brazil with a trial in Britain. In the British trial, the researchers asked participants to swab their noses and throats weekly to test for asymptomatic infections, a way of determining whether the vaccine could protect not only against disease but also transmission.

The vaccine appeared to be more effective in protecting against asymptomatic infections in the low-dose, high-dose regimen, but the numbers were so small that it was difficult to be sure. The researchers wrote in the paper that the results “provide some hope that Covid-19 vaccines might be able to interrupt some asymptomatic transmission,” though they said “more data are needed to confirm.”

The complicated logistics at one vaccination center offer insights into the challenges ahead for a mass rollout of the new inoculation program across Britain. While the country has been getting ready for a vaccine for some time, only now are the difficulties involved in a program of this scale being fully understood.

Fiona Kinghorn, executive director of public health for the Cardiff and Vale University Health Board, who oversaw the vaccine rollout at one site in Cardiff, the capital of Wales, said setting up the center and delivering the first shots on Tuesday was a major undertaking.

“It’s not just this week, it’s been six months of work,” she said.

Work on a mass vaccination program began in earnest in June, long before it was clear which vaccine might be approved by the government and when. On Monday, the center received one batch of vaccine — a tray of vials containing 975 doses, five to each vial — that must be used within five days after being defrosted.

“We’ve had to prioritize and phase how we might bring people in,” she said. The center began with health care workers and social care staff.

Unlike flu vaccines, which come prepacked in syringes for easy use, the coronavirus vaccines must be prepared on site after they are defrosted, and then the prepared vials must be used within hours. The center was scheduled to provide 225 vaccinations on Tuesday and continue daily until they finish the tray. Any doses they failed to use in time would have to be discarded, creating a sense of urgency.

“We’re doing it with military precision, and in fact, we have had the military helping with our planning too,” Ms. Kinghorn said.

The center will receive its next tray of vaccine on Friday, and then will decide on the right time to defrost and begin using those.

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

Here is a guide to some of the basics.

Should I be concerned about the safety of the vaccine in Britain?

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.”

Who in Britain will get the vaccine first?

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

When can I return to normal life after being vaccinated?

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.

If I’ve been vaccinated, do I still need to wear a mask?

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.

Will it hurt? What are the side effects?

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.

Does the vaccine affect fertility?

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 coronavirus vaccine made by Pfizer and BioNTech provides strong protection against Covid-19 within about 10 days of the first dose, according to documents published on Tuesday by the Food and Drug Administration before a meeting of its vaccine advisory group.

The finding is one of several significant new results featured in the briefing materials, which span 53 pages of data analyses from the agency. Last month, Pfizer and BioNTech announced that their two-dose vaccine had an efficacy rate of 95 percent after two doses administered three weeks apart. The new analyses show that the protection starts kicking in far earlier.

What’s more, the vaccine worked well regardless of a volunteer’s race, weight or age. While the trial did not find any serious adverse events caused by the vaccine, many participants did experience aches, fevers and other side effects.

On Thursday, the F.D.A.’s vaccine advisory panel will discuss these materials in advance of a vote on whether to recommend authorization of Pfizer and BioNTech’s vaccine.

Despite the early protection afforded by the first dose, it’s unclear how long that protection would last on its own, underscoring the importance of the second dose. Previous studies have found that the second dose of the Pfizer-BioNTech vaccine gives the immune system a major, long-term boost, an effect seen in many other vaccines.

Many experts have expressed concern that the coronavirus vaccines might protect some people better than others. But the results in the briefing materials indicate no such problem. The vaccine has a high efficacy rate in both men and women, as well as similar rates in white, Black and Latino people. It also worked well in obese people, who carry a greater risk of getting sick with Covid-19.

The Trump administration is requiring states to submit personal information of people vaccinated against Covid-19 — including names, birth dates, ethnicities and addresses — raising alarms among state officials who fear that a federal vaccine registry could be misused.

The Centers for Disease Control and Prevention is instructing states to sign so-called data use agreements that commit them for the first time to sharing personal information in existing registries with the federal government. Some states, such as New York, are pushing back, either refusing to sign or signing while refusing to share the information.

Gov. Andrew M. Cuomo of New York warned that the collection of personal data could dissuade undocumented people from participating in the vaccination program. He called it “another example of them trying to extort the State of New York to get information that they can use at the Department of Homeland Security and ICE that they’ll use to deport people.”

Administration officials say that the information will not be shared with other federal agencies and that it is needed for several reasons: to ensure that people who move across state lines receive their follow-up doses; to track adverse reactions and address safety issues; and to assess the effectiveness of the vaccine among different demographic groups.

At a briefing with a small group of reporters on Monday, officials from Operation Warp Speed, the government’s vaccine initiative, defended the plan. They said all but a handful of states had signed data agreements, and the rest would sign by the end of the week, though it is not clear how many states will submit personal information.

“There is no social security number being asked for, there is no driver’s license number,” said Deacon Maddox, who runs the operation’s data and analysis system. “The only number I would say that is asked is the date of birth.”

The hurried effort at data gathering, with delivery of vaccine doses expected to begin next week, is making many immunization experts deeply uneasy. At issue is the delicate balance between a patient’s right to privacy and the government’s right to invoke its expansive authority in the name of ending the deadliest pandemic in more than a century.

The world may be a stage, but William Shakespeare from Warwickshire didn’t flinch or shy away from his task: As Britain started to roll out the coronavirus vaccine on Tuesday, Mr. Shakespeare became the second person in the country to receive the vaccine.

“It could make a difference to our lives from now on, couldn’t it?,” Mr. Shakespeare, 81, said with a smile shortly after being vaccinated at University Hospital Coventry, in central England, just 20 miles north of where his namesake, the slightly older and more well-known poet and playwright, was born.

That one of the first recipients of the vaccine bore such a famous name — a fact that was confirmed by the National Health Service — brought surprise and lighthearted jokes at a time when Britain faces the daunting task of implementing the largest vaccination campaign in its history.

“Shakespeare gets Covid vaccine,” the BBC wrote as a headline. Shakespeare’s comedy “The Taming of the Shrew” became The Taming of the Flu. And “The Gentlemen of Verona” quickly turned into The Gentlemen of Corona.

In a reference to Hamlet, one user wrote on Twitter, “If Margaret Keenan is patient 1A for the vaccine, would William Shakespeare be 2B, or not 2B …,” about the first patient to receive the vaccine, and Mr. Shakespeare, who was next in line.

Even Britain’s theaters weighed in.

Casting director: So what would you bring to the role of second patient? We want a sense of real drama and patriotism here.

Auditionee: I’m literally called William Shakespeare.

Casting director: Fair enough, the part’s yours. https://t.co/phnYvq0SSh

— Is it the National Theatre? Oh yes it is (@NationalTheatre) December 8, 2020

Mr. Shakespeare received the shot in his left arm and wore a hospital gown and bright red socks.

Britain’s health secretary, Matt Hancock, appeared to shed some tears on ITV as he heard the name of the first man in the country to receive the vaccine.

May Parsons, a nurse at the hospital who administered the dose to Mr. Shakespeare and Ms. Keenan, said the injections were a first step in giving more people a sense of normality. “This is really important for me knowing that they’re going to be safe, that they’re going to be protected,” Ms. Parsons told Sky News about the first recipients of the vaccine.

For the countless jokes made, though, Mr. Shakespeare’s relatives reminded everyone that much more was a stake than the ephemeral fame of “their” William Shakespeare.

“At some point he’d like to see his wife, children and grandchildren who can’t visit him at the moment,” Emily Shakespeare said on Twitter about her uncle.

“Bill is much loved,” she added in a reply to a well-wisher.

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.

Global Roundup

Pope Francis canceled the traditional Dec. 8 papal visit to a Rome landmark because of social distancing concerns, he said on Tuesday. The afternoon event, observing the feast of the Immaculate Conception of the Virgin Mary, normally draws thousands of people.

“The traditional homage” did not take place, “to avoid the risk of crowds, as ordered by civil authorities, who we must obey,” Francis told the faithful who gathered in St. Peter’s Square for the Angelus prayer. Instead, the pope went to the site unannounced at 7 a.m., and left a bouquet of roses at the base of a column near the Spanish Steps that is topped by a statue of the Virgin Mary.

Other than in September and October, when new coronavirus cases in Italy appeared to have dropped significantly, Pope Francis has canceled most of his regular public appearances during the pandemic, so that crowds would not gather to see him. In their place, he has been streaming events online from the Apostolic Library in the Vatican. But he still appears every week at a window overlooking St. Peter’s Square to pray with and bless socially distanced worshipers below in the square.

Late last month, though, the pope did meet with a delegation of five N.B.A. players and officials from the players’ association privately at the Vatican to discuss their efforts to address social justice and economic inequality.