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In the United Kingdom, people are getting Pfizer’s Covid vaccine. The idea that we’ve officially entered the vaccine stage of this thing in the Western Hemisphere actually made me do a fist pump this morning. This is huge.

The process looks very organized in the UK, where they’re converting sports stadiums to vaccine delivery locations for the masses. That is in part because in the UK they have the National Health Service, which means structure for everyone, ultimately, to get stuck. (Prime Minister Boris Johnson is waiting for his place in line, he said today.)

Here in the US, there is second-guessing of a Trump administration decision not to buy more vaccine from Pfizer, which is first out of the gate in the UK. It’s also likely to be first in the US, but did not take part in all of Operation Warp Speed, the US vaccine effort. (Note: A former board member for Moderna, a Pfizer competitor, leads Operation Warp Speed.)

And there is no clear idea who will get the vaccine when in the US, although an executive order should be coming from President Donald Trump on that.

Here, there’s a profit motive to health care and it’s not clear to me that everyone will get a dose for free. It’s also not clear who will want to take it. An administration official said Monday that by the end of March, 100 million Americans could have a vaccination – everyone who wants it. There are more than 300 million people in this country.

USA Today surveyed health care providers in all 50 states and reported that while every state has a broad plan to disseminate vaccine, there’s a broad variation in how that will happen – from calling out the National Guard to almost-secret plans.

President-elect Joe Biden has complained there is no detailed national plan he’s seen for distribution.

Why didn’t the US place a hold on Pfizer’s product? Pfizer sold much of its lot to other countries because the US didn’t buy in over the summer, apparently. “I think they’re betting that more than one vaccine is going to get authorized and there will be more vaccines on the market, and that perhaps could be why they didn’t take up that additional 100 million option agreement,” former FDA commissioner and Pfizer board member Scott Gottlieb said Tuesday on CNBC.

America first, but how?

Trump is trying too late to counter the impression that other countries will get vaccines sooner than the US with an executive order that would, although it’s not clear how, prioritize the sale of vaccine to Americans.

Everyone is waiting for the FDA to say these things are safe. Everyone. But officials have promised to have vaccine for Americans this year and early next year.

Trump’s Health and Human Services secretary, Alex Azar, promised Tuesday that tens of millions of Americans would have the vaccine before Trump leaves office.

Cases and hospitalizations continue to surge in the US, but as CNN’s Stephen Collinson writes, the President can’t be bothered to deal with it and the President-elect is not yet in office: Trump, in his last weeks in office, has the power and presidential megaphone that could go a long way toward convincing Americans to take precautions, but has no inclination to do so. Biden has the plans and a fresh team of experts who could make a difference, but he has no real power to shift American behavior and policies until he is inaugurated next month.

Trump was in Washington at a vaccine summit on Tuesday, claiming some credit for the vaccines that are to come. Biden was in Delaware, introducing his health team, including Xavier Becerra, his nominee to be HHS secretary.

Biden’s three priorities

He laid out his 100-day Covid plan as he announced his team. (Note: 100 days from January 20 is April 30.)

  • Masks - First, he will ask every American to wear a mask for 100 days, and require it where he can legally do so.
  • Vaccines - Get “at least 100 million Covid vaccine shots into the arms of the American people in the first 100 days.”
  • Schools - Get most kids back into schools if Congress provides the necessary funding and states and cities put strong health measures in place.

Interestingly, these are all things screaming out for a national plan. They’re also all things that, normally, are handled at the local level.

Bill Shakespeare, stuck in the arm with a bare bodkin

From CNN’s report on the UK distribution: William Shakespeare, 81, known to friends as Bill, was the second person to get a Covid-19 vaccine at the Coventry hospital on Tuesday. Shakespeare, a patient on the hospital’s frailty ward, sat with his grandchildren’s artwork nearby as he received the jab.

These stories about the individuals who got the vaccine are worth reading. I can’t wait for these to be stories about Americans:

Husband died of Covid. Now she’s got the vaccine. Gill Rogers, whose husband died with the virus in residential care in April, was among the first to receive the vaccine in Sussex, in southeast England, on Tuesday.

The 86-year-old, who lives near Brighton, told the BBC it had been “quite hard” dealing with grief as well as isolation and that being given the shot meant she would not need to be so careful.

“I’m a bit pleased,” she said. “I shan’t be so careful, no, I shan’t be so worried, I will go in shops more and with luck I might get on to public transport.”

“I wasn’t doing much before, because while my husband was alive I was spending a lot of time going to the care home, so I’ve been pretty limited for a long time now,” she said.

This won’t happen overnight. The logistical challenges of manufacturing and distributing tens of millions of vaccines mean the rollout will be gradual, with the most vulnerable people and health care workers first in line.

The stockpile. The UK has ordered 40 million doses of the vaccine, but only 800,000 shots will be available as part of the first wave that began on Tuesday.

Related: Canada did much better than the US early during Covid. But it’s gotten complacent too.

Denialism. Fauci to the Wall Street Journal: “Trouble is, you go to different parts of the country, and even when the outbreak is clear and hospitals are on the verge of being overrun, there are a substantial proportion of the people who still think that this is not real, that it’s fake news or that it’s a hoax.”

Guns drawn on former Florida data official. Armed agents stormed into the house of a whistleblower Florida data scientist. She’s suspected of misusing a state messaging system.