Covid-19 Live Updates: As Britain Begins Vaccinations, Focus Turns to Questions on Distribution

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‘Go for It’: U.K.’s First Vaccine Patient Encourages Others

Margaret Keenan, the first patient in Britain to receive the coronavirus vaccine, hopes to set an example for people hesitant to get vaccinated.

It was fine, it was fine. I wasn’t nervous at all. It was really good. “And what do you say to those who might be having second thoughts about this?” Well, I would say go for it. Go for it, because it’s free and it’s the best thing that’s ever happened, at the moment. So, do please go for it. That’s all I’ll say, you know. If I can do it, well, so can you.

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.

Across the nation, vaccine centers are beginning the careful process of delivering vaccinations on a tight schedule, as the vaccine must be used or discarded within five days of being defrosted. “We’re doing it with military precision, and in fact, we have had the military helping with our planning too,” said Fiona Kinghorn, who oversaw the vaccine rollout at one site in Cardiff, Wales.

The effort marks a turning point in the remarkable race to produce a vaccine and the global effort to end a pandemic that has killed 1.5 million people worldwide. At one Welsh vaccination center, a retired nurse on the facility staff described the response by her most recent patient, another nurse. “She just cried and said this was such an emotional day,” she said, adding: “I think partly because she worked on a Covid ward, so she has seen the consequences and probably the outcomes. I presume she has seen a lot.”

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 hope and resilience.

“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. Twitter took the news of his vaccination as an opportunity for delighted wordplay, cracking jokes about the Taming of the Flu and the Gentlemen of Corona.

“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.”

Jenna Ellis, a senior legal adviser to President Trump, has tested positive for the coronavirus, according to a White House official familiar with the situation. She is the latest in a string of officials connected to Mr. Trump who have tested positive.

Ms. Ellis has appeared in recent weeks alongside Rudolph W. Giuliani and other Trump lawyers — a group Ms. Ellis has described as an “elite strike-force team” — at public hearings where she amplified the president’s false claims of widespread voter fraud.

Mr. Giuliani, the lead lawyer for the president’s efforts to overthrow the results of the election, confirmed over the weekend that he had tested positive for the virus, and a person who was aware of his condition but not authorized to speak publicly said then that he had been hospitalized at Georgetown University Medical. At age 76, Mr. Giuliani is in a high-risk category. Mr. Trump said on Monday that he had spoken to Mr. Giuliani and he was doing “very well.”

Ms. Ellis was photographed last week, on Wednesday, sitting next to Mr. Giuliani during a hearing before the Michigan House Oversight Committee. It was not immediately clear whether she had any symptoms, or what kind of test she had taken. Ms. Ellis continued to post to Twitter throughout the day on Tuesday, including sharing a statement attributed to her and Mr. Giuliani about their legal efforts. She did not respond to a message seeking comment.

Ms. Ellis has been a frequent guest on cable news, where she aggressively defended Mr. Trump as he faced investigation and impeachment. She presents herself as a constitutional law attorney, but has never appeared in federal district or circuit court, where most constitutional matters are considered, according to national databases of federal cases. She does not appear to have played a major role in any cases beyond criminal and civil work in Colorado.

Ms. Ellis’s most recent work appears to have been largely in a public-relations capacity. The Trump campaign and its supporters have so far filed about 50 election-related lawsuits. She has not signed her name or appeared in court to argue a single one.

At least 40 members of Mr. Trump’s administration, campaign and inner circle have contracted the virus since late September. In early October, Mr. Trump was hospitalized for a few days after testing positive and developing symptoms of Covid-19.

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.

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William Shakespeare Receives Coronavirus Vaccine in Britain

In Coventry, England, on Tuesday, a man named William Shakespeare, 81, joined Margaret Keenan, 90, as a recipient of the new coronavirus vaccine.

“I hear your having an an injection then, OK?” “OK.” “I’ll speak to you soon. Do you want me to look after these?” “Yes.” “OK.”

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 outside a clinical trial

“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 the man for whom he was named was born in 1564.

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 mounting 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 Two 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 two patients to receive the vaccine.

Even Britain’s theaters weighed in.

Mr. Shakespeare, who has been hospitalized in Coventry for several weeks after a stroke, received the shot in his left arm on Tuesday morning, wearing a hospital gown and bright red socks. He felt a little frail and took a nap in the afternoon, according to his niece, Emily Shakespeare.

“He’s delighted with it,” Ms. Shakespeare said in a telephone interview about her uncle’s first injection. “He’s dying to come home.”

Countless families around the world have been unable to visit relatives in nursing homes or hospitals during the pandemic, leaving many patients to suffer loneliness, atrophy and depression. Others died alone, and families never got to say goodbye.

So Mr. Shakespeare’s vaccination brought a bit of heartwarming news for people in Britain, and for his family. Within a few hours on Tuesday, he and Ms. Keenan had become the face of the country’s resilience against a virus that has killed more people in Britain than anywhere else in Europe.

“He is fed up being in the hospital,” Ms. Shakespeare said of her uncle, “but today I just want to say that I’m proud that he’s leading the way.”

She said it was “highly likely” that her uncle was related to “the” William Shakespeare, who died in 1616; she has traced his lineage back to the early 1700s, she said, but had more research still to do.

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, which surely made Mr. Shakespeare raise an eyebrow, his niece said. “He’s left-leaning, so I’m not entirely sure how he feels about it,” Ms. Shakespeare added about the reaction from Mr. Hancock, a conservative.

May Parsons, the nurse who vaccinated 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.

Unsurprisingly, Mr. Shakespeare’s name has brought him little moments of fame before, like the time in the 1960s when he was pulled over for speeding in Stratford-upon-Avon and the police officer did not believe it was his real name, Ms. Shakespeare said. “But this one goes beyond what he’s seen in the past,” she said.

It is also likely that another William Shakespeare will be vaccinated next year: Mr. Shakespeare’s 41-year-old son is also called William.

Ms. Shakespeare said the family wanted to remind everyone that there was much more at stake than the ephemeral fame of “their” William Shakespeare.

“He wants to to see his wife, his children and his grandchildren, who can’t visit him at the moment,” she said. “But the outpouring of attention will surely give him a boost.”

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.

In other developments around the world

• Hong Kong said it would once again ban restaurant dining after 6 p.m., and close all gyms and beauty salons, to help curb a rise in virus cases, Reuters reported. Health authorities said on Tuesday that people arriving in Hong Kong, who already must be tested on arrival and toward the end of the mandatory two-week quarantine, would also be required to be tested a third time three weeks after arrival. Hong Kong recorded 78 new cases on Monday, raising its total for the pandemic to 6,976 — tiny figures compared with most large Western countries, but a sign that even places that have been able to keep a tight lid on the virus are facing problems now.

• Australia, where coronavirus cases are low, extended for another three months its ban on residents leaving the country, official said Tuesday. The country, which has some of the tightest restrictions anywhere, also extended its ban on cruise ships until March.

• Chile announced new measures for Santiago, the capital, this week that are meant to avoid a total lockdown, the authorities said. The new restrictions include a full lockdown on weekends and lesser limitations during the week. The capital region reported an 18 percent increase in new cases last week, which “is shocking and worries us a lot,” said Enrique Paris, the health minister.

• Four lions at the Barcelona Zoo have tested positive for the coronavirus, officials in Barcelona said Tuesday. The lions — three females and a male — were tested after showing symptoms, and were treated with anti-inflammatory drugs. Two employees also tested positive, officials said. It is the second known instance involving large felines: several lions and tigers at the Bronx Zoo in New York tested positive in April.

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

Hilary Nelson, 45, an intensive care unit 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.

“I’ve asked my questions, and I’m satisfied that it is safe.”

John Pollard, 90, was surprised to find out he was among the first patients in Britain to be offered the vaccine.

“Over the years, I’ve had all sorts of vaccinations,” he said. “I’ve never given it any thought really, all I thought was that I would like to not get Covid.” He lives on his own, so his daughter will be bringing him in for the vaccine at a hospital near his home in Brighton.

He plans to spend this Christmas at his daughter’s house, with his family around him and has high hopes for the new year: “If and when I feel if I feel fit enough, I might make a trip to Australia.”

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.”

At a newly created vaccine center on the outskirts of Cardiff, the capital of Wales, there was a small but steady flow of people coming in on Tuesday morning. Most were health care workers who entered the Cardiff and Vale Therapy Center — a former gymnasium used for rehabilitation therapy — wearing masks.

Betty Spear, a retired pediatric nurse, pulled back the blue curtain from the small cubicle she was working in after having administered the vaccine to a fellow nurse.

“She just cried and said this was such an emotional day,” Ms. Spear said of her most recent patient. “Generally, I think people are extremely happy that the day is coming, that the day has come that they are getting this vaccination.”

She added: “That last lady was very emotional, I think partly because she worked on a Covid ward, so she has seen the consequences and probably the outcomes. I presume she has seen a lot.”

Ms. Spear said she herself was “slightly anxious because it’s a different area but we’ve had a lot of training over the last few days.”

Nearly all of the people vaccinated here were health care workers, and many have experienced the virus’s horrors first hand. They expressed excitement and relief that there was some hope on the horizon for an end to pandemic.

Dr. Chris Hingston, 45, who is an I.C.U. consultant at the University Hospital of Wales, said he initially felt almost guilty for being among the first to receive the shot, pointing to the nurses in Covid wards as among the most in need. But after speaking with colleagues, he decided it was important to be inoculated as soon as possible to provide wider protection for his colleagues and patients.

“From my point of view, well, I’ve no fear of it. But you know, a lot of people out there, I think, are quite worried,” he said. “I don’t feel it’s for myself necessarily, having the vaccine. It’s really for others in many ways.”

When he received his vaccine on Tuesday morning, he likened it to having the flu shot.

“I didn’t even feel it,” he said as he chatted casually with Lynne Cronin, 60, the acting lead nurse at the center who delivered the vaccine.

“You’re exactly the people we need to come through,” she said, after learning that he is an I.C.U. doctor. Ms. Cronin said it had been a huge undertaking to get the site up and running for Tuesday, just days after the vaccine received emergency approval from the British government, but she lauded the local health authorities for their work.

“It’s been a huge ask to get everybody ready to vaccinate,” she said. “We’re still trying to train people up. We needed today and the next few days to sort any teething problems.”

She said other than a few early technical hiccups in the system being used to document the vaccinations, the roll out had been smooth.

“We just need to make sure it’s safe for people, and for my staff to make sure they are comfortable,” she said.

President-elect Joseph R. Biden Jr. appeared on Tuesday to formally name members of his health team, and vowed to change the course of the Covid-19 pandemic during his first 100 days in office.

The senior officials Mr. Biden will appoint — including Xavier Becerra, a former congressman who is now the California attorney general, as his nominee for secretary of health and human services — will face the immediate challenge of slowing the spread of the coronavirus, which has already killed more than 283,000 people in the United States and has taken a particularly devastating toll on people of color.

In making his announcement, Mr. Biden asked Americans to wear masks for the first 100 days of his presidency, and pledged to run “the most efficient mass vaccination plan in U.S. history” — including getting 100 million “vaccine shots into the arms of the American people” in his first 100 days. He also said he would set a “national priority” to get children back in school during that time period.

“My first 100 days won’t end the Covid-19 virus — I can’t promise that,” Mr. Biden said. But he added, “I’m absolutely convinced we can change course.”

Mr. Biden’s announcement, in Wilmington, Del., — where he appeared without wearing a boot on the ankle he twisted last month — started around the same time that a “virus summit” hosted by President Trump began at the White House.

In introducing Mr. Becerra, Mr. Biden stumbled a bit, mispronouncing the California attorney general’s last name. Mr. Becerra, 62, a Democrat who had carved out a profile more on the issues of criminal justice, immigration and tax policy, was long thought to be a candidate for attorney general, and he emerged as Mr. Biden’s clear choice for health and human services secretary only over the past few days, according to people familiar with the transition’s deliberations. It was a surprise ending to a politically delicate search that brought complaints from the Congressional Hispanic Caucus about a lack of Latinos in the incoming cabinet.

Other health officials included in the event today:

• Dr. Rochelle Walensky, the chief of infectious diseases at Massachusetts General Hospital, to lead the Centers for Disease Control and Prevention, replacing Dr. Robert R. Redfield

• Dr. Vivek Murthy as the surgeon general

• Dr. Marcella Nunez-Smith to lead the Covid-19 equity task force

• Jeff Zients as coordinator of the Covid-19 response.

• Dr. Anthony S. Fauci, whom Mr. Biden has recruited to be his chief medical adviser in addition to continuing in his role as the director of the National Institute of Allergy and Infectious Diseases, is not expected to appear in-person at the event, but he is expected to make a video appearance.

The new Covid-19 vaccines from Pfizer and Moderna seem to be remarkably good at preventing serious illness. But it’s unclear how well they will curb the spread of the coronavirus.

That’s because the Pfizer and Moderna trials tracked only how many vaccinated people became sick with Covid-19. That leaves open the possibility that some vaccinated people could get infected without developing symptoms, and could then silently transmit the virus.

If vaccinated people are silent spreaders of the virus, they may keep it circulating in their communities.

“A lot of people are thinking that once they get vaccinated, they’re not going to have to wear masks anymore,” said Michal Tal, an immunologist at Stanford University. “It’s really going to be critical for them to know if they have to keep wearing masks, because they could still be contagious.”

In most respiratory infections, including the new coronavirus, the nose is the main port of entry. The virus rapidly multiplies there, jolting the immune system to produce a type of antibodies that are specific to mucosa, the moist tissue lining the nose, mouth, lungs and stomach. If the same person is exposed to the virus a second time, those antibodies, as well as immune cells that remember the virus, rapidly shut down the virus in the nose before it gets a chance to take hold elsewhere in the body.

The coronavirus vaccines, in contrast, are injected deep into the muscles and are quickly absorbed into the blood, where they stimulate the immune system to produce antibodies.

Some of those antibodies will circulate to the nasal mucosa and stand guard there, but it’s not clear how much of the antibody pool can be mobilized, or how quickly. If the answer is not much, then viruses could bloom in the nose — and be sneezed or breathed out to infect others.

This is why mucosal vaccines are better than intramuscular injections at fending off respiratory viruses, experts said.

The next generation of coronavirus vaccines may elicit immunity in the nose and the rest of the respiratory tract, where it’s most needed. Or people could get an intramuscular injection followed by a mucosal boost that produces protective antibodies in the nose and throat.

As some New York City school buildings reopen this week, Mayor Bill de Blasio has found himself presiding over a starkly unequal school system in which many white families have flocked back to classrooms while most families of color have chosen to learn from home indefinitely.

That gulf is illustrated in a startling statistic: There are nearly 12,000 more white children returning to public school buildings than Black students — even though there are many more Black students than white children in the system overall.

In New York and across the country, politicians and education officials have found that many nonwhite families are not ready to send their children back to classrooms, despite their struggles with remote learning, in part because of the disproportionately harsh impact the virus has had on their communities.

But the fact that so many students of color have chosen remote over in-person learning is raising alarms that existing disparities in the nation’s largest school system will widen, since remote learning has been far less effective.

New York’s issues with remote instruction begin with a lack of basic infrastructure for students learning from home. Many low-income students, including some living in homeless shelters, cannot even log on for classes because they do not have devices or Wi-Fi.

Educators also said they were scrambling to make lessons more engaging for students without much helpful guidance from the city. So while individual teachers and schools have honed creative strategies to improve online instruction, there is no citywide plan to do the same.

Latino students make up the largest share of students returning to classrooms, at about 43 percent, roughly proportional to their overall representation in the school system. But white children, who are less likely to be low-income than many of their peers, make up a quarter of students back in classrooms, even though they represent just 16 percent of overall enrollment.

Black and Asian-American families are significantly underrepresented in reopened classrooms. Just under 18 percent of Black families have chosen to send their children back to school, though those students make up nearly a quarter of the system. Asian-American children, who represent about 18 percent of the overall school system, make up the smallest share of children in classrooms this week, at just under 12 percent.

One of the biggest rites of college football — the annual Michigan-Ohio State game — is off for this weekend because of the coronavirus pandemic.

Michigan said Tuesday that it would be unable to play at fourth-ranked Ohio State on Saturday because of the number of virus cases inside its football program.

“The number of positive tests has continued to trend in an upward direction over the last seven days,” Warde Manuel, Michigan’s athletic director, said in a statement. “We have not been cleared to participate in practice at this time. Unfortunately, we will not be able to field a team due to Covid-19 positives and the associated quarantining required of close contact individuals.”

The cancellation raised the possibility that Ohio State (5-0) would prove ineligible for the Big Ten championship game on Dec. 19 because it had not played enough games this season. But conference officials have said that the Big Ten policy requiring teams to play at least six games to qualify for the title matchup could be adjusted.

Ohio State struggled with the virus toward the end of November and canceled its Nov. 28 game at Illinois. The Buckeyes had earlier missed out on a game when Maryland canceled because of its own virus troubles.

When Britons receive the Pfizer-BioNTech vaccine shots, they also get a wallet-size vaccination card showing that they have received the first of two required doses.

They are not ID cards; they do not contain any personal information, not even the person’s name. Even so, there are worries that they could be the beginning of a “passport” system that would divide society into two tiers, granting cardholders access to some services and businesses, like boarding a plane or eating at a restaurant, while others are excluded.

British health officials have argued that the cards are merely meant as a reminder of when a patient received the first shot and when they are scheduled to get the second, three weeks later.

The blue-and-white vaccination card, seen in images released by health officials, has spaces to record the vaccine name, dates of the injections and batch numbers. “Don’t forget your Covid-19 vaccination,” it reads. “Make sure you keep this record card in your purse or wallet.”

Britain faces tremendous logistical and security challenges to vaccinate millions of its citizens, and other countries will face them as well when they begin vaccination programs. The authorities have highlighted the need for a reliable record of who has been vaccinated, and have discussed the idea of issuing people documents certifying that they have received the vaccine or recovered from the disease, and thus presumably have some immunity.

But ministers in Prime Minister Boris Johnson’s government have brushed off the idea that the vaccination card will become a so-called immunity passport, and it remains unclear whether such a system will ever exist in Britain. Scientists are skeptical about the idea as well.

Two experts at the University of Birmingham noted in an article published on The Conversation that data on protected people following vaccination had not yet been published. “This is important because if we don’t understand the key ingredients for protection, we can’t monitor immunity effectively,” the experts — KK Cheng, a professor of public health and primary care, and Zania Stamataki, a lecturer in viral immunology, wrote on Monday.

They argued that while the vaccine greatly reduces the chance that the recipient will become severely ill, vaccinated people could still transmit infection to others, limiting an immunity passport’s usefulness.

“Being personally protected following successful vaccination does not absolve us of social responsibility,” they said.