in our community tomorrow, there would be very few people who would line up to get that vaccine. >> people want to know do i sign up someplace? is this going to cost folks anything? >> i can't wait until we can get back to the way it used to be. are we ever going to get to that place? >> we want children to be able to go to school. we want to be able to keep businesses open. we will get there. i think that's the promise of 2021. >> a special edition of "dateline." good evening. i'm lester holt. it is the moment the world has been holding its breathe for literally, vaccines for covid-19. but getting them into the arms of millions of americans may be as difficult as it was to create them. there are challenges with distribution, demand and fear. are the vaccines safe and effective as scientists say, and when will you be able to get one? ♪ >> these haunting scenes will stay with us forever, the before and the heartbreaking after of covid-19. the pandemic has claimed more than 270,000 american lives, a staggering number that will only grow as we head into what experts predict will be a dark winter. >> the united states is on fire with this virus. the next few months are going to be a despair, there's reason to hope. vaccines are coming. if the government approves them, people could start getting shots this month. it would be the fastest development of a vaccine in history by far. doctor paul offit is an infection disease specialist and director of the vaccine education center at children's hospital of philadelphia. >> are we potentially looking at medicines, at the pharmaceutical industry's finest hour? >> i think so. this is a technological marvel. if you asked a hundred scientists in the united states in january of 2020, i think zero would have said that was possible. >> it's been a breathtaking and dramatic effort and it started before anyone had even heard the name covid-19. this year's new years celebration had a familiar feel. who had even heard of social distancing back then? soon enough, we'd know all about it. but what most people don't know is that back in january when china reported its first covid death, it also published the virus's genetic sequence nap's when the ra -- that's when the race for the vaccine began. dozens of companies around the world jumped in. a scientist and businessman who has helped develop several vaccines. >> we were not competing between these vaccines. we were competing against the virus. >> just two months after the genetic sequence was published, a covid vaccine made with an unproven technology called mrna was ready for testing and was injected into a person for the first time. is there anything in the back of your mind that bugs you that worries you about the pace we're on? >> this has been fast, certainly faster than any vaccine that's ever been made. >> trials to study the safety and effectiveness of new vaccines are complicated and really expensive. they can take years to complete. but with deaths mounting through the spring, waiting years for trial results did not seem like an option. so behind the scenes the government came up with a plan to accelerate the process. president trump announced the initiative on may 15th, a day when covid deaths topped 80,000. >> it's called operation warp speed. that means big and it means fast. >> warp speed got its name from a government scientist as a tribute to star trek. the president named slowy as its chief advisor. >> operation warp speed was about integrating the efforts of all the players involved and nothing could fall between the cracks. it was just super tight, super aligned, super focused and super motivated. >> companies partnering with operation warp speed have received enormous government subsidies, $12 billion so far. >> it has allowed to make these vaccines in record time. the cost of the lockdown was $22-23 billion per day, so the return investment on this $12 billi billion. >> how well has operation warp speed worked? >> you have to give credit to an administration that basically took the risk out of it for pharmaceutical companies. >> the government helped pay for trials and also manufacturing, an unprecedented convention busting move to stockpile millions of doses before vaccines are even approved. >> we'll pay to mass produce this vaccine at risk, meaning not knowing whether the vaccine is safe, not knowing whether it's effective. if it's neither safe nor effective, we will throw hundreds of millions of doses away. >> there are also a lot of unsung american heros who deserve credit in this vaccine effort, the volunteers taking unproven vaccines, knowing they might not work, it might not even be safe. hundreds of thousands of people literally putting their lives on the line. >> i'm a part of the trial. >> karla arnold is one of them. she volunteered after seeing what was happening in new york city. >> it was scary to see that they had those trucks out there and they had bodies in them. i want people of color to be represented. i want women to be represented. i want it to be for everyone. >> now, a young biotech company called moderna and apartme pharmaceutical giant pfizer have applied for approval to use their vaccines, a rare piece of good news during a pandemic that has felt like a slow, painful marathon. >> our objective is to now be able to immunize the population by the middle of 2021. >> that goal is realistic, but there will be challenges along the way. just today we learned because of temporary supply chain problems, pfizer had to lower its estimate of how many doses it can deliver this month. next, how were the vaccines developed so fast? you'll hear the inside story from the people in charge. e insy from the people in charge. shingles doesn't care. i get as much fresh air as possible. good for you, but shingles doesn't care. because 1 in 3 people will get shingles, you need protection. but no matter how healthy you feel, your immune system declines as you age, increasing your risk for getting shingles. so what can protect you? shingrix protects. for the first time ever, you can protect yourself from shingles with a vaccine proven to be over 90% effective. shingrix is a vaccine used to prevent shingles in adults 50 years and older. shingrix does not protect everyone and is not for those with severe allergic reactions to its ingredients or to a previous dose. the most common side effects are pain, redness, and swelling at the injection site, muscle pain, tiredness, headache, shivering, fever, and upset stomach. talk to your doctor or pharmacist about protecting yourself with shingrix. shingles doesn't care. shingrix protects. shingles doesn't care. you can crush ice, make nismoothies, and do even more. chop salsas, spoon thick smoothie bowls, even power through dough, and never stall. the ninja foodi power pitcher. rethink what a blender can do. a livcustomizeper iquickbooks for me. okay, you're all set up. thanks! that was my business gi, this one's casual. get set up right with a live bookkeeper with intuit quickbooks. ♪ but when i started seeing things, i didn't know what was happening... so i kept it in. he started believing things that weren't true. i knew something was wrong... but i didn't say a word. during the course of their disease around 50% of people with parkinson's may experience hallucinations or delusions. but now, doctors are prescribing nuplazid. the only fda approved medicine... proven to significantly reduce hallucinations and delusions related to parkinson's. don't take nuplazid if you are allergic to its ingredients. nuplazid can increase the risk of death in elderly people with dementia-related psychosis and is not for treating symptoms unrelated to parkinson's disease. nuplazid can cause changes in heart rhythm and should not be taken if you have certain abnormal heart rhythms or take other drugs that are known to cause changes in heart rhythm. tell your doctor about any changes in medicines you're taking. the most common side effects are swelling of the arms and legs and confusion. we spoke up and it made all the difference. ask your parkinson's specialist about nuplazid. ask ythe team's been workingist around the clock.wire, we've had to rethink our whole approach. we're going to give togetherness. logistically, it's been a nightmare. i'm not sure it's going to work. it'll work. i didn't know you were listening. ♪ these three company leaders are in the biggest race of our time chargesing into the history books to make a covid vaccine. we brought these executives together for the first time to talk about what they've accomplished. dr. steven hogue, president of moderna, the biotech upstart. albert boarla ceo of pfizer. both pfizer and moderna have broken speed records to come up with new vaccines. and alex golf coursrski is clos. >> have you created a revolution in how this company creates vaccines. >> i think we've changed game pretty dramatically. >> how about you, albert? >> the power of science, the power of the private sector. >> alex, how about you? >> we've never done anything at this scale. >> moderna was testing how quickly it could make a vaccine using that mrna technology. then covid hit. >> dr. fauci gave an interview. he said we're going to have this within a phase one trial within 100 days. we're now on a clock publicly. before it was something we thought we're going to give it our best shot. >> we had to go all in. that was going to be a break or break moment. >> pfizer partnering with a gentleman biotech company went with the same mrna technology as moderna. albert, talk about the very beginning of your approach and how you guys decided to go the direction you did? >> i just followed the recommendations of our scientists. they recommended that mrna is the way to go for multiple reasons, including the speed with which you can develop it. >> pfizer turned down funding from operation warp speed, risking $2 billion of its own money. johnson & johnson and moderna, on the other hand, took the government money and teams of scientists worked relentlessly to protect the world from the striers, all the while tryi ing protect themselves. how has covid affected your ability to produce the vaccine and to really go about your research? >> i knew that we need to maintain our manufacturing facilities open, while protecting the safety of our people. >> reporter: and stephen, has covid cost you time in terms of production? >> the short answer is yes. you know, we have people getting sick -- sometimes very sick. we need to do the best we can to protect them. >> in addition to trying to help save the world, it's also very personal. >> reporter: alex gorsky lost his longtime head of security to covid. >> and so the sense of mission, it's incredibly inspirational to each and every one of us. >> reporter: years were compressed into months during this race, as the pandemic raged and the world waited desperately. >> we felt the pressure, of the billions of people in this world, and millions of businesses in this world, and the hundreds of governments in this world, because they were all investing their hope in this industry to find a solution. >> reporter: that was pressure enough. president trump was applying pressure of his own, and it was happening in the heat of an election campaign. >> so we're gonna have a vaccine very soon. maybe even before a very special date. you know what date i'm talking about. >> reporter: finally, in early september things came to a head. these executives decided to take a public stand. >> albert and i had a chance to speak on the phone. and based upon the political atmosphere that we were in, both of us started working the phones that weekend, and we were able to get our colleagues on board. >> reporter: in the end, nine vaccine-makers issued a public statement saying science would dictate the timeline of any vaccine. >> we know that we have got to continue to win the trust, the confidence of the american public. >> reporter: clinical trials continued through the fall, with everyone hoping for an effective vaccine -- tempering their expectations. what were you internally aiming for as a measure of success? >> i thought 80, 85% would've felt like a homerun. >> what i was hoping was something on the seventies. >> reporter: they both did way better than that. pfizer and moderna stunned us all with vaccines that are at or near an efficacy rate of 95%. albert, can you describe what that moment was when you found out that you had apparently a successful vaccine? >> oh, it's an incredible moment. the next day when i went home with my wife and kids, and i sat in the couch with a glass of wine, i -- i realized what does this mean for the world. >> reporter: and stephen, can you describe that moment? >> they notified us of the vaccine efficacy and i don't think i remember another thing for about 20 minutes. there was this overwhelming sense of relief. >> reporter: remember, all three of these companies started making vaccines months ago, long before they had any trial results. in this race, the cart was set before the horse -- deliberately. >> it was something that we felt we had to do. because if we waited, there would be no way that we would be in a position to have adequate capacity, to have an adequate number of vaccines to really make a difference. >> reporter: but making the vaccines is only half the job, getting them into people's arms may be the hardest part of all. that's next. like you, my hands are everything to me. but i was diagnosed with dupuytren's contracture. and it got to the point where things i took for granted got tougher to do. thought surgery was my only option. turns out i was wrong. so when a hand specialist told me about nonsurgical treatments, it was a total game changer. like you, my hands have a lot more to do. learn more at factsonhand.com today. i'm a talking dog. the other issue. oh...i'm scratching like crazy. you've got some allergic itch with skin inflammation. apoquel can work on that itch in as little as 4 hours, whether it's a new or chronic problem. and apoquel's treated over 8 million dogs. nice. and...the talking dog thing? is it bothering you? no...itching like a dog is bothering me. until dogs can speak for themselves, you have to. when allergic itch is a problem, ask for apoquel. apoquel is for the control of itch associated with allergic dermatitis and the control of atopic dermatitis in dogs. do not use apoquel in dogs less than 12 months old or those with serious infections. apoquel may increase the chance of developing serious infections and may cause existing parasitic skin infestations or pre-existing cancers to worsen. do not use in breeding, pregnant, or lactating dogs. most common side effects are vomiting and diarrhea. feeling better? i'm speechless. thanks for the apoquel. aw...that's what friends are for. ask your veterinarian for apoquel next to you, apoquel is a dog's best friend. optum perks can save you up to 80%. and everyone can do it. it's from optum, a health care company that's trusted by millions of people. opt in and save big today. >> reporter: once the covid-19 vaccines have been approved, the big question will be, "how do they get to the people who need them?" it starts with the military. handling the massive logistics, helping vaccine companies get manufacturing equipment and software. but the actual distribution will fall to the private sector. according to general gustav perna, chief operating officer for operation warp speed. >> we knew if we brought pfizer, moderna, mckesson, ups, fedex, cvs, walgreen, and hundreds others together, that we would come up with the best solutions. >> reporter: but dr. paul offit says even the private sector will be scrambling to make this work. >> reporter: i think a lot of people may look at some of the problems, many of the big problems we've had with testing and thinking, "wow, you take that same disorganization and apply it to vaccine distribution, and you've got a problem." >> it was hard enough for us to just make masks and distribute them, which is a much easier thing to do, than what we're about to do with vaccines. >> reporter: doctor indu lew will be rolling out the vaccine for rwj barnabas health. one of the largest hospital systems in new jersey. >> i first want to get a sense of a scale of what we're talking about, new jersey alone. potentially how many million people will you need to vaccinate? >> if we're thinking about vaccinating new jersey, we're looking at over nine million people. it's a large number in a small state. >> reporter: have you ever approached anything along that scale? >> um, no. >> reporter: the last time the united states did anything close to this scale was in the 1950s, when polio was the scourge that gripped america. the tots are the first to face the soft vaccine needle. millions of doses of vaccine had to get to children in every part of the country. but distribution of the covid vaccines, particularly pfizer's, will be even more difficult. >> vaccine has to be shipped and stored at -70°c to -80c. which is something we have no experience with in the united states. >> reporter: and it has to be kept at those arctic temperatures through the entire shipping process. one break in that cold chain, and precious vaccine may become ineffective. let's start with the beginning of the chain. most vaccines are shipped in glass vials. here's what can happen in extreme cold. at corning glass company's research facility in western new york, engineers have come up with a solution, valor glass. corning engineers say valor glass has reduced breakage by 99%. so perhaps that's a solution to one problem, but there's another issue. keeping that vaccine cold on the road. pfizer's vaccine will be shipped in boxes filled with dry ice. >> they're gonna need a lot of dry ice to ship this vaccine. >> reporter: john natuzzi, president of the natuzzi ice company in queens, new york, says there's a shortage. one reason, more americans are ordering their food online. much of it packed in dry ice. >> we service one of the city's largest online food grocers. they're usin' probably around 20 tons a day, if not more. >> reporter: so demand is up, but there's another problem. the carbon dioxide needed to make dry ice is in short supply. moderna, and johnson & johnson vaccines will not require dry ice for shipping. their vaccines can be transported in the same cold chain that delivers our frozen groceries, like ice cream. once the vaccines are packaged, it will be up to those big shipping companies like mckesson, ups, and fedex to get the vaccine quickly and safely out to the state health departments. united airlines has already flown several shipments of pfizer's vaccine. getting them in position so they're ready to send out if the fda approves the vaccine for emergency use. some states already have super cold freezers, and the wherewithal to administer the vaccine, but some states do not. they're going to need help. >> is the administration going to be willing to spend the money to allow states to do what we need to do to set up a system to -- to give these vaccines? we can figure that out. >> reporter: some private hospital systems aren't counting on their states to store their vaccine. northwell health in new york, for instance, has bought its own freezers. >> we thought it was very important to get these type of freezers in place. >> reporter: doctor onisis stefas, northwell's chief pharmacy officer, says the vaccine can be safely stored here for up to six months, but once the vials are thawed it's a tight timeline. >> you have six hours at room temperature to administer what is in that vial. these are coming as multi-dose vials that have five doses in each one. so you're gonna have to line people up, and make sure you're getting vaccination after vaccination after vaccination, or else those vaccines are gonna be bad. and that's a challenge. >> reporter: and all of this could happen very soon. possibly within the next two weeks, when the first vaccine may be approved by the fda. so this could happen very quickly. you could get the call that it's shipping in two days, get ready. >> absolutely. absolutely. and i liken the analogy to on december 14th, you're having this really big dinner party, but you don't know exactly how many guests you're having. you don't know what time they're arriving, and you don't really know what's on the menu. so we're putting all of those contingency plans in place so we will be ready to go. >> reporter: but will people be ready to take it? that's next. and later -- everything you need to know when you're ready to take it. did you know that 70% of the soils on your clothes are invisible? under u.v. light, you see the invisible dirt trapped deep down. try new tide pods hygienic clean heavy duty. for a deep clean, just toss in a pac. formulated with 10 concentrated cleaning actives, that clean deep down into the fabric to remove invisible dirt. see the difference, after being washed with tide hygienic clean. for a deep clean, try tide hygienic clean! with a 100% money back guarantee! if it's got to be clean, it's got to be tide. who invented we're car vending machines and buying a car 100% online. now we've created a brand-new way for you to sell your car. whether it's a year old or a few years old. we wanna buy your car. so go to carvana and enter your license plate answer a few questions. and our techno wizardry calculates your car's value and gives you a real offer in seconds. when you're ready, we'll come to you, pay you on the spot and pick up your car, that's it. so ditch the old way of selling your car, and say hello to the new way at carvana. the lack of control whenover my business kai, made me a little intense. but now quickbooks helps me get paid, manage cash flow, and run payroll. and now i'm back on top... with koala kai. save over 30 hours a month with intuit quickbooks. >> reporter: we've developed covid vaccines in record time. we're harnessing the power of government and corporations to deliver it to millions. but dr. marcella nunez-smith, a co-chair of president-elect biden's covid task force, says the biggest challenge is yet to come. persuading those whose lives are on the line to get in line for the shot. >> in some of our hardest hit communities, we know that there is quite a degree of vaccine hesitance and caution. >> reporter: the numbers are startling. according to recent polls, almost half of all americans say they will not get the covid vaccine, among them a surprising 36% of all frontline nurses. and seven states so far are saying, "not so fast." >> some states have expressed the plan to take their own reviews of these vaccines before accepting them at face value. do you blame them? >> yeah, i think that we have a significant challenge right now in our country, because we've walked away from science. >> this isn't gonna work unless enough of us buy in and roll up our sleeves and take the shot. >> you know, i think what we have to do is find out what questions people have. at the same time, we have to acknowledge that trust has decayed between americans and the federal government and it will take work to rebuild and restore that confidence. >> reporter: dr. fauci and his colleagues have hit the airwaves to assure the public the vaccines will not be approved unless they're safe. >> i will take the vaccine. >> reporter: but joe smyser, the ceo of public good projects or pgp, a non-profit that specializes in promoting public health initiatives, says that may not be enough. >> this old model of, you know, a public health official standing up in front of an american flag telling you that you should trust vaccines 'cause they say so. that's not where the world is anymore. >> reporter: the real battle for the public's trust, says smyser, takes place on the internet. according to pgp's own analysis, anti-vaccine crusaders have almost doubled their posts since march, peddling covid-vaccine myths and wild conspiracies that are shared millions of times a day online. >> if you're not having someone reinforce the truth every single day, then that's a vacuum. every vacuum gets filled. and we're allowing it to be filled with misinformation. >> reporter: so smyser's organization decided to fight fire with fire. this is their online emergency center in san diego. here, computers powered by artificial intelligence are in hot pursuit of covid vaccine lies 24/7. recently they zeroed in on a widely debunked conspiracy theory, that the vaccines will be used to implant microchips in millions of people so the government could track them. >> and it's being spread by fake news websites, by leaders of the anti-vaccination movement. they're talking about it again. so we saw this big spike. >> reporter: data scientists sprang into action alerting a group of media specialists in atlanta who crafted a counter-message within hours. >> this is one of three things that we made. it says, "microchips not included." >> reporter: then it was up to the micro-influencers, a hand-picked group with millions of followers in areas where people are reluctant to get vaccinated. >> you know, like, beyonce is not going to be sharing our misinformation outbreak alert. these are basically, like, a lot of little beyonce's, people who are beyonce where they live. >> we are asking you to be merciful to all those who are suffering among us." >> reporter: in pittsburgh, pennsylvania, this grassroots campaign is decidedly less high-tech, but as pivotal. led by father paul abernathy, volunteers from a group called the neighborhood resilience project went door to door and face to face. black residents in this inner-city neighborhood are more than twice as likely to be hospitalized or die of covid than white people. and yet -- >> i believe that if the vaccine were available in our community tomorrow, that there would be very few people who would line up to get that vaccine. >> reporter: in fact, right now, according to an extensive washington post survey, less than a third of all african-americans nationwide trust that covid vaccines will be safe or shield them from the virus. >> how you doing? >> we're talking to our neighbors about the vaccine that pfizer has out and we wanted to know your opinion about it? >> i don't trust none of it. >> why? >> as far as i'm concerned, it could be givin' us the virus. >> alright, miss carla. >> reporter: one of the volunteers is carla arnold, who, as you may remember, is a proud participant in the moderna vaccine trials. but when she tells people -- >> i already had my second inoculation. >> reporter: the response, she says, usually turns from skepticism to disbelief. >> are you crazy? did you really let them shoot you with something that you don't know what it is or if it's gonna help? you know what they have always done to black people or brown people. >> reporter: the mistrust runs deep here, and, unlike the theories of the anti-vaxxers, it is rooted in historical fact. there have been several notorious medical experiments on people of color in the u.s. most infamous. the tuskegee syphilis study, in which government scientists lied to hundreds of black sharecroppers who had the disease, and deliberately left them untreated for 40 years, so they could study its effects. >> we need to bear witness to that and understand that there is a deeper pain that fuels that mistrust. and in fact, these experiences have worked their way into the narrative, the broader narrative of communities, the broader narrative of families, which certainly impacts the perspective of individuals. >> i'm trusting them to be honest about what they're doing. >> i'm trying to let people know that fear shouldn't always rule your actions. sometimes you have to trust. >> reporter: but can we trust vaccines that came about so fast? we'll ask the people who made them. for skin that never holds you back don't settle for silver #1 for diabetic dry skin* #1 for psoriasis symptom relief* and #1 for eczema symptom relief* gold bond champion your skin gold bond - [announcer] messes neither should your vacuum. typical vacuums have bristles that can leave gaps and wrap hair. so shark replaced bristles with flexible power fins. they directly engage floors and dig deep into carpets with duoclean power fins you can pick up more in every pass, for a better, faster clean. large and small particles, fine dust, and even hair with no hair wrap. shark vertex with duoclean power fins. pick up more in every pass. your lips have a unique print. ...and unique needs. your lips are like no others and need a lip routine that's just right for you. chapstick® has you covered. chapstick®. put your lips first®. but when i started seeing things, i didn't know what was happening... so i kept it in. he started believing things that weren't true. i knew something was wrong... but i didn't say a word. during the course of their disease around 50% of people with parkinson's may experience hallucinations or delusions. but now, doctors are prescribing nuplazid. the only fda approved medicine... proven to significantly reduce hallucinations and delusions related to parkinson's. don't take nuplazid if you are allergic to its ingredients. nuplazid can increase the risk of death in elderly people with dementia-related psychosis and is not for treating symptoms unrelated to parkinson's disease. nuplazid can cause changes in heart rhythm and should not be taken if you have certain abnormal heart rhythms or take other drugs that are known to cause changes in heart rhythm. tell your doctor about any changes in medicines you're taking. the most common side effects are swelling of the arms and legs and confusion. we spoke up and it made all the difference. ask your parkinson's specialist about nuplazid. >> reporter: the speedy development of the vaccines has raised hopes, but also questions, questions we brought up in our conversation with company leaders, albert bourla, ceo of pfizer and stephen hoge, president of moderna. we keep hearing that a typical vaccine takes, you know, maybe, a decade long to develop. you've done it in a year. so we can't help wonder, what ingredient was taken out? >> the quality standard we've held ourselves to was 30 thousand person, placebo-controlled trials. that really is the gold standard. we still met that bar, even though we've moved quickly. what's really the ingredient that's been taken out is some of the financial and business caution that normally slows the development of drugs. >> reporter: albert, have any corners been cut for the sake of time? >> no, absolutely not. as stephen said, to run a study of 30 thousand people, 44 thousand in our case, it is a golden standard, as he said, and that happened exactly as it would happen with any other vaccine. >> reporter: alex gorsky, ceo of johnson and johnson, agrees. his company is still conducting its phase three clinical trial. >> we want to ensure the american public, that accelerating, should not be confused with cutting corners. because we are absolutely following the regulatory guidelines that would be expected. >> reporter: last month, that monumental effort paid off. pfizer and moderna had collected the data required from their clinical trials. there's two months of safety data that have been put out there by -- by both of your companies. is that enough? >> for most vaccines you will see adverse events or safety issues arise really within the first five, six weeks after vaccination. so two months allows you to be sure as you can be, and the real threat to life and health that covid faces, far outweighs any remaining, very small risk, we think, that over the coming year we'd see any concerns arise. but there is still so much we don't know about these new vaccines. >> reporter: we don't know how long these vaccines will protect us and when we'll need a follow up. >> certainly, when we're seeing efficacy 94%-95%, there's great reasons for hope that these vaccines are gonna be very effective and beat back the virus, but there's a chance that a year from now, three years from now, we'll see that people need a booster. not dissimilar to what we see with other vaccines. >> reporter: and then what about the question, albert, of -- of even though i've -- i've had the protection, am i still able to transmit it to other people? >> i think this is something that -- that needs to be examined. we are not certain about that right now with what we know. >> reporter: the clinical trials are still underway, and many of these questions will be answered, but that brings up another issue, thousands of trial volunteers didn't get the real vaccine. given the fact that you've got a number of volunteers who received placebos, at this point, given your success, do you intend to give them the actual vaccine? >> it is a moral and ethical-dilemma and obligation i think that we have to these people. we should find a way. so sooner rather than later, give-to all the placebo participants-the vaccine. >> reporter: there's one more hurdle. the fda still has to decide if the new vaccines are safe. next week an advisory committee will discuss whether to recommend emergency use authorization for pfizer's vaccine. moderna's turn comes later this month. dr. paul offit is on that committee. >> reporter: what does an advisory meeting look like when you're reviewing a vaccine? >> we sort of have a million questions to make sure that we understand exactly what the safety issues are and exactly what the efficacy issues are. is it effective in people over 65? is it equally effective among racial groups, ethnic groups? is it effective in people who have various medical conditions? >> reporter: the stakes couldn't be higher. >> the standard we're gonna hold this to is would i give this vaccine to myself or my own family? and if the answer to that question is, "i'm not sure," then we're not gonna move forward. >> reporter: this week, the united kingdom became the first country to approve pfizer's vaccine for emergency use, clearing the way for mass vaccinations there. both pfizer and moderna are confident they'll win approval in the u.s. and if you are given approval, how fast will things snap into motion? how -- how fast will the distribution begin? >> we are aiming hours after the approval to be able to distribute. >> reporter: once approval comes, how quickly does moderna spring into action and begin shipping the product? >> so like the others -- we're partnered with general perna and his team at operation warp speed. i've been told they want trucks rolling within hours, if not a day. >> reporter: coming up next, what you need to know. (burke) deep-sea driving, i see... (customer) something like that... (burke) well, here's something else: with your farmer's policy perk, new car replacement, you can get a new one. (customer) that is something else. (burke) get a whole lot of something with farmers policy perks. ♪ we are farmers. bum-pa-dum, bum-bum-bum-bum ♪ now, there's skyrizi. ♪ things are getting clearer ♪ yeah i feel free ♪ to bare my skin, yeah that's all me. ♪ ♪ nothing and me go hand in hand ♪ ♪ nothing on my skin that's my new plan. ♪ ♪ nothing is everything. woman: keep your skin clearer with skyrizi. with skyrizi, 3 out of 4 people achieved 90% clearer skin at 4 months. of those, nearly 9 out of 10 sustained it through 1 year. and skyrizi is 4 doses a year, after 2 starter doses. ♪ i see nothing in a different way ♪ ♪ and it's my moment so i just gotta say ♪ ♪ nothing is everything. skyrizi may increase your risk of infections and lower your ability to fight them. before treatment, your doctor should check you for infections and tuberculosis. tell your doctor if you have an infection or symptoms, such as fevers, sweats, chills, muscle aches, or coughs or if you plan to or recently received a vaccine. ♪ nothing is everything. woman: now is the time to ask your dermatologist about skyrizi. to syour body needs routine. system, woman: now is the time to ask your dermatologist centrum helps your immune defenses every day, with vitamin c, d and zinc. season, after season. ace your immune support, with centrum. my hands are everything to me. but i was diagnosed with dupuytren's contracture. and it got to the point where things i took for granted got tougher to do. thought surgery was my only option. turns out i was wrong. so when a hand specialist told me about nonsurgical treatments, it was a total game changer. like you, my hands have a lot more to do. learn more at factsonhand.com today. like you, my hands have a lot more to do. [what's this?] oh, are we kicking karly out? we live with at&t. it was a lapse in judgment. at&t, we called this house meeting because you advertise gig-speed internet, but we can't sign up for that here. yeah, but i'm just like warming up to those speeds. you've lived here two years. the personal attacks aren't helping, karly. don't you have like a hot pilates class to get to or something? [ muffled scream ] stop living with at&t. xfinity can deliver gig to the most homes. if the fda gives the thumbs up to pfizer's vaccine next week, the first approved shots could be administered just nine days from now with moderna's vaccine hot on its heels. >> these vaccines have the possibility of ending this pandemic. >> but the first batch of pfizer doses will only be enough for just over 3 million people. perhaps, ramping up with moderna's vaccine for some 50 million people by the end of january. so it falls to dr. jose romero. >> i'm gaveling the meeting to order. >> chairing an emergency meeting of the cdc's vaccine advisory group this week to lay out the sequence of who gets vaccinated. though states can tweak the order according to their needs. >> in the first tier of individuals it will be health care providers, number one. >> he means not just doctors and nurses treating covid, but also those assisting in close proximity. there are more than 20 million health care workers nationwide. dr. marcella nunez-smith is advising president-elect biden. from what you know right now, does the order of distribution make sense? >> i think it's well appreciated and understood that those who are on the front lines risking themselves for us, you know, can be at the front of the line. >> also among those first to get a vaccine will be those living or working in long-term-care facilities, like nursing homes. >> then we would come to essential personnel. >> who exactly are deemed essential personnel will vary from state to state, but vaccination guidelines will be equitable, says dr. romero, who's also health secretary in arkansas. >> if we look at, for example, poultry plants, which are very significant in our state, meat processing plants, those plants have a significant number of underrepresented minorities in those occupations. we are getting the vaccine to those individuals. we made them one of the tier-one populations to receive it. >> also likely to be close to the front of the line are those over age 65 with underlying conditions. identified by state health departments. the cdc estimates about 100 million americans have conditions that put them at risk for covid complications. so it could take months before vaccines are available to the broader population. >> possibly, enough vaccine would be available to distribute to the general public sometime in the middle of next year. >> we acted dr. romero and dr. lu some of the key questions you're probably asking about covid shots. people want to know, do i sign up someplace, how do i know when it's my turn? >> we'll be hearing messaging from our department of health, from our governors. >> television, radio, press, social media, anything that we have at our disposal to transmit this to the public will be used. >> so people won't exactly sign up but will be told when and where they can get a shot and should be able to make an appointment without having to wait. >> they could potentially get it in their retail pharmacies. they might go to their primary care physician's office, they might go to an urgent care clinic. they could potentially go to a type of covid vaccine clinic. they should be able to get a vaccine very, very similar to the flu vaccine. >> but while jaunohnson & johnss covid shot is similar to the flu vaccine, needing just one dose, pfizer's and moderna's need two. will i as a consumer have a choice and say, no, i think i want the johnson & johnson, no, no, give me the ffiz pfizer. >> it begins on supply. you may not have a choice in the beginning. >> are you worried about people getting the first and not showing up a month later for the second? >> absolutely. it will be tricky to ensure that if you are getting the first dose of pfizer that you get it on day 1 and return on day 21. it's critical. if you're receiving moderna's vaccine, you need to come back on day 28. there will be a calendar link pushed out to say, you must schedule your second dose right now. >> and states will also keep a tally of who's been vaccinated. >> everybody that's vaccinated in our state will be logged into a registry and we'll be able to keep track of who's gotten what vaccine and when. >> right now, the covid vaccines are only for people over 18. i'd like to talk about what the plan is for vaccinating children. >> well, right now we don't have any information on giving these vaccines to children. >> while trials are under way on teens and betweens, younger children and infant s won't geta shot until there's more data. what many americans are asking in economically challenged times is how much they're going have to lay out for a shot. is this going to cost folks anything or will this be free of charge? >> the covid vaccine will be free of charge to the american public. >> that's because taxpayers are picking up the bill. so, after you get vaccinated, what then? once i get my second shot, can i throw my mask away? >> you know, i think about this a lot because we have to continue to practice the cdc recommendations of wearing a mask. >> this vaccine, if it works as we think it's going to work, will protect you, but that doesn't necessarily mean that you can't have a low-level infection and spread the virus. >> but as more and more people are vaccinated, health care experts believe the overwhelming number of cases, hospitalizations, and deaths, will come down. keep wondering how do we know when this is over? >> you're alluding to potentially herd immunity, right? in new jersey i know our department of health is saying that we would like 70% of our state vaccinated. right? that's a large number. it could take a while. it would potentially take until the end of the year. >> that's the end of 2021. but right now, doctors say we're in for some tough times. >> you're now heading into drier, cooler, less humid, climates. this is the time when this kind of virus thrives. >> we have to get through right now what is a very, very dark winter. so i think it is important for us not to get complacent and we have to double down and commit always to still wear our mask and stay socially distanced. >> you know, i hear people all the time, i say it myself, man, i can't wait until we get back to the way it used to be. are we ever going to get to that place? >> you know, what we want is for children to be able to g o to school. we want to be able to keep businesses open. i'm feeling very confident that, you know, we will get to a place where, you know, the things that we hold dear, we're able to do. i think that's the promise of 2021. we will get there. >> what months ago was a distant ray of rope in an ocean of despair is almost here. it appears science has delivered a way out of this pandemic. a way to stop the dying, a way to help us find our way back to that normalcy we all crave. not all of our questions can be answered, yet, the time is here for each of us to now decide, will we roll up our sleeves and take the next step? that's all for now. i'm lester holt. thanks for joining us. this sunday -- a covid crisis out of control. >> i actually believe they're going to be the most difficult time in the public health history of this nation. >> record hospitalizations. >> once they get to us, we're not seen a lot that make it out of here. >> record number of cases. >> i think we've not yet can seen the post-thanksgiving peak. >> record number of deaths. >> my dad thought me so much about life but never how to live without him. >> health care workers overworked and falling ill. >> when you're gone, there's just nobody who's going to take care of you when you're the hospital, and that should scare everyone. >> this morning i will talk to deborah birx, white house coronavirus response