With a more contagious variant of the coronavirus forcing England to impose a strict new national lockdown and European nations extending restrictions in the face of rising cases, political leaders have promised that mass vaccinations will bring an end to the suffering.
But in the race to beat the virus, the virus is still way out in front.
There are shortages of needles in Italy, Greece and other countries. Spain has not trained enough nurses. France has only managed to vaccinate around 7,000 people. Poland’s program was rocked by scandal after it was revealed that celebrities were given preferential treatment. There are calls in Germany to take control over vaccine purchases from European Union authorities. Nearly every country in Europe has complained about burdensome paperwork.
And then there is the Netherlands, which has not even begun its campaign.
Around the world, inoculation efforts are rolling out slower than promised, even as new cases soar and record numbers of virus patients flood hospitals, placing a double burden on health care providers tasked with leading vaccination drives.
In Europe, where most countries have been under varying degrees of lockdown for months, frustration is building as restrictions have been stepped up or extended while national vaccination efforts are stymied by various problems.
The threat posed by the fast-spreading variant is adding extra urgency to an already daunting challenge. And even in places where the rollout has been relatively smooth, it is not nearly fast enough to get ahead of the virus.
Prime Minister Boris Johnson said England would be locked down until inoculations reached the four most vulnerable groups: nursing home residents and those who care for them, everyone over the age of 70, frontline health and social care workers, and extremely vulnerable individuals.
“If we succeed in vaccinating all those groups, we will have removed huge numbers of people from the path of the virus,” he said.
Mr. Johnson said that goal could be achieved by the middle of February, but that the pace of vaccinations would need to increase drastically.
The four groups he cited included 13.9 million people, according to Nadhim Zahawi, the minister overseeing the vaccine effort.
Since the campaign started on Dec. 8, 1.1 million people in England have been vaccinated, Mr. Johnson said Tuesday. Notably, 23 percent of people over 80 have gotten inoculations, and that age group could be fully vaccinated within three weeks, he said.
With the introduction on Monday of the first doses of the vaccine developed by the University of Oxford and AstraZeneca, British officials said the campaign could be ramped up.
To meet the February target, two million doses need to be given every week.
Countries of the European Union, meanwhile, started their campaigns weeks after Britain and the United States because of a slower approval process and have had to rely on a single vaccine, made by Pfizer and BioNTech.
While the bloc’s medical regulatory agency is expected to approve a vaccine from Moderna this week, it has yet to begin consideration of the Oxford-AstraZeneca one, which is easier to distribute as it does not need to be kept at extremely cold temperatures.
For the moment, one of the biggest problems in Europe is distribution.
The situation is similar to that in the United States, where about 4.5 million people have received a dose of a Covid-19 vaccine, according to the Centers for Disease Control and Prevention, using only a fraction of the 15 million doses delivered by manufacturers.
One complicating factor is that some countries have turned to local health authorities to develop their own strategies, leading to problems.
In Spain, it is a shortage of nurses. For instance, in the Catalonia region less than a fifth of the doses on hand have been used and local health authorities acknowledge they do not have enough trained nurses.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- 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 only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- 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 into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Health Minister Salvador Illa said on Monday that 82,000 doses had been administered in Spain since the rollout began on Dec. 27, a pace far short of a stated goal of vaccinating 70 percent of 47 million people by the end of this summer.
“It is incomprehensible that there are not enough staff and resources to continue to vaccinate every day,” Manuel Perez-Alonso, a genetics professor at the University of Valencia, wrote on Twitter.
Germany also began its national immunization campaign on Dec. 27, and has now vaccinated more than 316,960 people, with the focus largely on nursing home residents and those aged 80 and older.
Yet the country has become engulfed in a politicized debate over the wisdom of waiting for vaccine approval from the European Medical Agency and coordinating purchases with its European partners.
The federal government in Berlin is responsible for acquiring vaccine doses, while the country’s 16 states are responsible for administering them under a strategy centered on immunization centers. From the centers, teams are dispatched to vaccinate the estimated 40,000 people living in nursing homes and their caregivers.
“It is more difficult to immunize people in nursing homes with mobile teams,” said Hanno Kautz, a Health Ministry spokesman. “If we were to start handing out appointments at the immunization centers, we would have very different numbers. But we intentionally prioritized the most vulnerable groups and that is where we are beginning.”
The situation in the Netherlands, by contrast, is inexplicable.
In a country where many pay 50 percent of their wages in taxes, expecting top government performance in return, there is widespread anger that the Netherlands will be the last nation in Europe to start vaccinations.
“We are the village idiot of Europe,” the right-wing politician Geert Wilders said in Parliament on Tuesday, “It’s simply incomprehensible that we are the last country in Europe to start.”
Health Minister Hugo de Jonge is facing increasing criticism from legislators wanting to know why vaccinations will only start Wednesday when the shots arrived on Dec. 26.
He has defended the vaccination process, which critics call overly bureaucratic and slow, saying it needed to be “diligent.”
Italy has been more successful, vaccinating 178,939 people, the second-largest number in the European Union after Germany.
But that still only accounts for only 37.3 percent of the doses it received, and less than 0.3 percent of the population. At the current rate, it would take six years to vaccinate the nation of 60 million.
While health officials have said that the process of freezing and unfreezing doses has slowed efforts, experts blame bureaucracy and a shortage of staff.
“There are a number of critical aspects in this vaccination campaign,” Giovanni Toti, president of the northwestern region of Liguria, said in a phone interview. “It takes a long procedure to receive the informed consent from those patients who are incapacitated and live in retirement homes.”
Mr. Toti said hospitals in his region had also received the wrong needles for the Pfizer vaccine.
In the northern region of Lombardy, the epicenter of Italy’s first wave of the coronavirus, the opposition has urged the region’s top health official to quit after he justified vaccination campaign delays by saying that he refused to call back doctors and nurses on vacation.
French health officials have argued that the pace of vaccinations — with only 7,000 doses administered — is deliberately cautious, in part to convince the country’s many vaccine skeptics that nothing will be forced on them. Critics also say that the effort has been hampered by red tape in the medical system.
President Emmanuel Macron, who has said that he would not tolerate an “unjustified slowness” in the campaign, has pressed aides to make sure the pace of inoculations accelerates, according to the Journal du Dimanche.
One group of several dozen French doctors and health professionals warned in an open letter on Tuesday that “vaccination must be seen today as a race against time.”
“And even if this vaccine, while not mandatory, is worrying to some of our fellow citizens,” they wrote in the letter, first published by Le Parisien newspaper, “state authorities have the duty to rapidly address the expectations of millions of French people who are impatiently waiting to get vaccinated.”
Melissa Eddy in Germany, Matina Stevis-Gridneff in Brussels, Monika Pronczuk in Brussels, Emma Bubolo in Rome, Aurelien Breeden in Paris, Thomas Erdbrink in Amsterdam, Elian Peltier in London and Anatol Magdziarz in Warsaw contributed reporting for this article.