By LAURAN NEERGAARD

AP NEWS – The biggest vaccination campaign in U.S. history kicked off Monday as health workers rolled up their sleeves for shots to protect them from COVID-19 and start beating back the pandemic — a day of optimism even as the nation’s death toll closed in on 300,000.

“I feel hopeful today. Relieved,” critical care nurse Sandra Lindsay said after getting a shot in the arm at Long Island Jewish Medical Center in New York.

With a countdown of “three, two, one,” workers at Ohio State University’s Wexner Medical Center gave the first injections to applause.

And in New Orleans, Steven Lee, an intensive care unit pharmacist at Ochsner Medical Center, summed up the moment as he got his own vaccination: “We can finally prevent the disease as opposed to treating it.”

Other hospitals around the country, from Rhode Island to Texas, unloaded precious frozen vials of vaccine made by Pfizer Inc. and its German partner BioNTech, with staggered deliveries set throughout Monday and Tuesday. Several other countries also have authorized the vaccine, including Britain, which started vaccinating people last week.

For health care workers, who along with nursing home residents will be first in line for vaccination, hope is tempered by grief and the sheer exhaustion of months spent battling a coronavirus that still is surging in the U.S. and around the world.

“This is mile 24 of a marathon. People are fatigued. But we also recognize that this end is in sight,” said Dr. Chris Dale of Swedish Health Services in Seattle.

Packed in dry ice to stay at ultra-frozen temperatures, the first of nearly 3 million doses being shipped are a down payment on the amount needed. More of the Pfizer-BioNTech vaccine will arrive each week. And later this week, the FDA will decide whether to green-light the world’s second rigorously studied COVID-19 vaccine, made by Moderna Inc.

While the U.S. hopes for enough of both vaccines together to vaccinate 20 million people by the end of the month, there won’t be enough for the average person to get a shot until spring.

“This is the light at the end of the tunnel. But it’s a long tunnel,” New York Gov. Andrew Cuomo said.

Now the hurdle is to rapidly get vaccine into the arms of millions, not just doctors and nurses but other at-risk health workers such as janitors and food handlers — and then deliver a second dose three weeks later.

“We’re also in the middle of a surge, and it’s the holidays, and our health care workers have been working at an extraordinary pace,” said Sue Mashni, chief pharmacy officer at Mount Sinai Health System in New York City.

Plus, the shots can cause temporary fever, fatigue and aches as they rev up people’s immune systems, forcing hospitals to stagger employee vaccinations.

A wary public will be watching closely to see whether health workers embrace vaccinations. Just half of Americans say they want to get vaccinated, while about a quarter don’t and the rest are unsure, according to a recent poll by The Associated Press-NORC Center for Public Health Research.

The FDA, considered the world’s strictest medical regulator, said the Pfizer-BioNTech vaccine, which was developed at breakneck speed less than a year after the virus was identified, appears safe and strongly protective, and it laid out the data in a daylong public meeting last week for scientists and consumers alike to see.

“Please, people, when you look back in a year and you say to yourself, ‘Did I do the right thing?’ I hope you’ll be able to say, ‘Yes, because I looked at the evidence,’” Dr. Francis Collins, director of the National Institutes of Health, said Sunday on NBC’s “Meet the Press.” “People are dying right now. How could you possibly say, ‘Let’s wait and see’?”

Still, in winning approval for widespread emergency use, the vaccine was cleared before a final study in nearly 44,000 people is complete. That research is continuing to try to answer additional questions.

For example, while the vaccine is effective at preventing COVID-19 illness, it is not yet clear if it will stop the symptomless spread that accounts for half of all cases.

The shots still must be studied in children and during pregnancy. But the American College of Obstetricians and Gynecologists said Sunday that vaccination should not be withheld from pregnant women who otherwise would qualify.

Also, regulators in Britain are investigating a few severe allergic reactions. The FDA’s instructions tell providers not to give it to those with a known history of severe allergic reactions to any of its ingredients.

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AP journalists Marion Renault, Andrew Welsh-Huggins, Tamara Lush and Kathy Young contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

By LAURAN NEERGAARD and MATTHEW PERRONE

WASHINGTON (AP) — A U.S. government advisory panel endorsed widespread use of Pfizer’s coronavirus vaccine Thursday, putting the country just one step away from launching an epic vaccination campaign against the outbreak that has killed close to 300,000 Americans.

Shots could begin within days, depending on how quickly the Food and Drug Administration signs off, as expected, on the expert committee’s recommendation.

“This is a light at the end of the long tunnel of this pandemic,” declared Dr. Sally Goza, president of the American Academy of Pediatrics.

In a 17-4 vote with one abstention, the government advisers concluded that the vaccine from Pfizer and its German partner BioNTech appears safe and effective for emergency use in adults and teenagers 16 and over.

That endorsement came despite questions about allergic reactions in two people who received the vaccine earlier this week when Britain became the first country to begin dispensing the Pfizer-BioNTech shot.

While there are a number of remaining unknowns about the vaccine, in an emergency, “the question is whether you know enough” to press ahead, said panel member Dr. Paul Offit of Children’s Hospital of Philadelphia. He concluded that the potential benefits outweigh the risks.

The decision came as COVID-19 cases surge to ever-higher levels across the U.S., with deaths setting an all-time, one-day record of more than 3,100 on Wednesday.

Pfizer has said it will have about 25 million doses of the two-shot vaccine for the U.S. by the end of December. But the initial supplies will be reserved primarily for health care workers and nursing home residents, with other vulnerable groups next in line until ramped-up production enables shots to become widely available on demand — something that will probably not happen until the spring.

Next week, the FDA will review a second vaccine, from Moderna and the National Institutes of Health, that appears about as protective as Pfizer-BioNTech’s shot. A third candidate, from Johnson & Johnson, which would require just one dose, is working its way through the pipeline. Behind that is a candidate from AstraZeneca and Oxford University.

U.S. health experts are hoping a combination of vaccines will ultimately enable the U.S. to conquer the outbreak.

Still, experts estimate at least 70% of the U.S. population will have to be vaccinated to achieve herd immunity, the point at which the virus can be held in check. That means it could be several months before things start to get back to normal and Americans can put away their masks.

All eyes now turn to the FDA staff scientists who will make the final decision of whether to press ahead with large-scale immunizations with Pfizer-BioNTech’s vaccine. The FDA’s vaccine director, Dr. Peter Marks, said a decision would come within “days to a week.”

Dr. William Moss of Johns Hopkins University, who was not involved in the expert panel’s review, welcomed the outcome, saying, “Given how bad the pandemic is now, we need to move.”

The independent review by non-government experts in vaccine development, infectious diseases and medical statistics was considered critical to boosting Americans’ confidence in the safety of the shot, which was developed at breakneck speed less than a year after the virus was identified.

Regulators in both Britain and Canada have already approved the vaccine for use in their countries, and President Donald Trump and White House officials have complained for weeks that the FDA was moving too slowly.

“Americans want us to do a scientific review, but I think they also want us to make sure we’re not wasting time on paperwork as opposed to going forward with the decision,” FDA Commissioner Stephen Hahn said before the meeting.

FDA scientists issued a glowing review of the vaccine earlier in the week. Agency staffers said data from Pfizer’s ongoing study of 44,000 people showed strong protection across different age groups, races and health conditions with no major, unexpected safety problems.

The Pfizer-BioNTech shot remains experimental because that final-stage study isn’t complete. As a result, the expert panel wrestled with a list of questions that have yet to be answered.

For example, while the vaccine is more than 90% effective in blocking the symptoms of COVID-19, the FDA’s advisers stressed it is not yet clear whether it can stop the silent, symptomless spread that accounts for roughly half of all cases.

“Even though the individual efficacy of this vaccine is very, very, very high, you really as of right now do not have any evidence” that it will lower transmission, said Dr. Patrick Moore of the University of Pittsburgh. He urged Pfizer to take additional steps to answer that question.

Several of the dissenting panel members objected to authorizing the shot for 16- and 17-year-olds, given their small numbers in the study and the low risk they face from COVID-19.

Members worried, too, that Pfizer will lose its opportunity to answer critical questions once it begins offering the real vaccine to study participants who had been getting dummy shots up to now.

The company proposed gradually moving those patients to the vaccine group, with priority based on age, health conditions and other factors. Under that plan, 70-year-old participants would cross over before healthy 30-year-olds.

Pfizer must still show whether the vaccine works in children younger than 16 and in pregnant women.

On the safety front, as widespread vaccinations begin, the first recipients will be closely tracked by government health authorities, since studies in tens of thousands of people can’t detect side effects that strike 1 in a million. Hanging over the meeting were the British allergic reactions and a warning from authorities there that people with a history of serious reactions shouldn’t get the vaccine for now.

Pfizer representatives said they have seen no signs of allergic reactions in their trial. But some of the FDA advisers fear the British warning will deter millions of Americans with allergies who might benefit from the COVID-19 vaccine from giving it a try and urged additional studies to try to settle the issue.

“This issue is not going to die until we have better data,” Offit said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.