Credit…Oliver Contreras for The New York Times

President Trump said on Sunday night that he would delay a plan for senior White House staff members to receive the coronavirus vaccine in the coming days.

The shift came just hours after The New York Times reported that the administration was rapidly planning to distribute the vaccine to its staff at a time when the first doses are generally being reserved for high-risk health care workers.

Mr. Trump, who tested positive for the coronavirus in October and recovered after being hospitalized, also implied that he would get the vaccine himself at some point in the future, but said he had no immediate plans to do so.

“People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary,” Mr. Trump tweeted, hours after a National Security Council spokesman had defended the plan. “I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!”

It was not immediately clear why Mr. Trump decided to change the policy, or whether he had even been aware of it ahead of time. But White House staff members who work in close quarters with him had been told that they were scheduled to receive injections of the coronavirus vaccine soon, two sources familiar with the distribution plans said.

The goal of distributing the vaccine in the West Wing was to prevent additional government officials from falling ill in the final weeks of the Trump administration. The hope was to eventually distribute the vaccine to everyone who works in the White House, one of the people said.

It was not clear how many doses were being allocated to the White House or how many were needed, since many staff members had 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.”

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.
Credit…Tim Gruber for The New York Times

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.

Across the country, according to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites are set to 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 workers.

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.

Five of the first vaccinations will take place at what the Department of Health and Human Services is calling a national ceremonial “kickoff event,” scheduled for Monday afternoon at George Washington University Hospital.

The five people were selected with an algorithm the hospital is using to assign the first doses, the result of a survey hospital employees filled out that asked about age, underlying medical conditions and the risk they carry in their jobs, according to a federal health official familiar with the planning who was not authorized to speak publicly. The event is intended to demonstrate the way many health workers will be vaccinated this week, the official said.

The kickoff is part of what the official said will be a series of vaccination events featuring top health officials.

In Canada, the first shipments of the Pfizer-BioNTech vaccine arrived on Sunday, Prime Minister Justin Trudeau announced on Twitter. He called it an “important step in our fight against the virus.”

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.

Dr. Stephen Hahn, right, the U.S. Food and Drug Administration commissioner, and President Trump, at a press briefing at the White House in August.
Credit…Oliver Contreras for The New York Times

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.”

The four states had formed a group of medical experts and officials to assess the safety and effectiveness of Covid-19 vaccines.
Credit…Pool photo by Marcio Jose Sanchez

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 Mandvulo Dlamini of Eswatini speaks at the U.N. Climate Change Conference in Katowice, Poland, in 2018. Mr. Dlamini died on Sunday.
Credit…Kacper Pempel/Reuters

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.”

A health worker in Lima, Peru,  preparing to inoculate a volunteer with a Covid-19 vaccine produced by the Chinese company Sinopharm.
Credit…Ernesto Benavides/Agence France-Presse — Getty Images

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.

Kate McKinnon as Dr. Anthony Fauci and Heidi Gardner as Dr. Deborah Birx on Saturday Night Live.
Credit…Will Heath/NBC

While the pandemic has made Dr. Anthony Fauci, the U.S. government’s top expert on infectious diseases, a highly visible figure in American life, “Saturday Night Live” has been circumspect about satirizing him in comedy sketches.

But this weekend, the “S.N.L.” cast member Kate McKinnon played Fauci in the show’s opening sketch. She was joined by Heidi Gardner, playing Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, as they explained how Pfizer’s Covid-19 vaccine, newly approved for emergency use, would be distributed to the American public.

Following some applause from the audience, McKinnon said, “Let’s try to keep the woos to a minimum, please. As you all know, woos spread droplets.”

McKinnon proudly announced that “the vaccine is approved and I am officially joining the Biden administration to continue the fight against Covid.”

With some hesitation, Gardner added, “And I think I’ll be joining as well, right? Remember when Trump said to inject bleach and I did a stanky little face? And I almost whispered, ‘No’? Remember?”

McKinnon said that “we’re doing this vaccine World War II-style,” and further explained: “We made England go in first, see what’s what. And then we swoop in at the end and steal the spotlight. Tom Hanks will make 10 movies about it and when it’s all over you can kiss any nurse you want.”

On Trump’s performance during the pandemic, McKinnon said, “This president has done about as good a job with this rollout as I did throwing out that first pitch at the Nationals game.” “S.N.L.” played video of Fauci’s pitch from July, which markedly missed home plate.

The virus was a focus in other skits, as Timothée Chalamet, the week’s host, played a rebellious teenage son in a family of coronavirus cells. “I’m sorry,” he said. “Are my proteins not perfect like my little sis, back from her first semester at the University of Phoenix in person?”

A passenger hugs a family member upon arrival from New Zealand at Sydney International Airport in October. The current one-way travel agreement between Australia and New Zealand is being expanded to include traveling to and from both countries.
Credit…David Gray/Agence France-Presse — Getty Images

The New Zealand government intends to establish a travel bubble with Australia in the first quarter of next year, Prime Minister Jacinda Ardern announced on Monday.

The arrangement would allow people to travel freely between Australia and New Zealand without needing to quarantine for two weeks on arrival. Passengers arriving from New Zealand to Australia are already exempt from quarantine requirements.

The travel bubble was “pending confirmation” from Australian officials, Ms. Ardern said during a live-streamed news conference, and would be contingent on “no significant changes in the circumstances of either country.”

New Zealand has been among the countries least affected by the pandemic, with 2,096 cases and 25 lives lost, according to a New York Times database. In Australia, 28,031 people have tested positive for the coronavirus, while 908 have died.

In May, the governments of New Zealand and Australia first announced that they had reached a formal agreement to form a travel bubble as soon as it was safe to do so. But surges in the number of cases, most notably in Victoria, Australia, led to the plans being temporarily scrapped.

Ms. Ardern said she would not give a more detailed timeline for when the bubble might be established. Further details still needed to be fine tuned, she said, including how airlines would handle the travel corridor and the two countries’ contingency plans in the event of another outbreak.

New Zealand is expected to establish quarantine-free travel with the Cook Islands before it opens its borders to Australia.

Festive stands in Ansbach, Germany, last week.
Credit…Laetitia Vancon for The New York Times

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.

Both CVS and Walgreens will 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.
Credit…Shannon Stapleton/Reuters

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.

A Milanese architect and a team of consultants came up with the design, which will be used on the temporary pavilions where the vaccine will be available.
Credit…Stefano Boeri Architetti

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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