Vaccination and Immunization

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      Behind One New York Times Pulitzer: Hundreds of Journalists

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      When The New York Times was honored with the prestigious prize in the category of public service for its coverage of the coronavirus pandemic, it reflected the contributions of the entire newsroom.Times Insider explains who we are and what we do, and delivers behind-the-scenes insights into how our journalism comes together.This month, from a steep red staircase overlooking The New York Times’s newsroom, Dean Baquet, the executive editor, announced that the staff had won the Pulitzer Prize for public service for its coverage of the coronavirus.The Times, which has received 132 Pulitzers since they were first awarded in 1917, has won in the public service category, regarded as the most prestigious of the prizes, six times. Wesley Morris, a Times critic at large, also received a Pulitzer, his second, for criticism for his writing on the intersection of race and culture in America.The Pulitzer board recognized several facets of the coronavirus coverage. The Times reported early on the outbreak in China in January 2020. Tracked cases across the nation and the world through an intensive data project. Relayed developments 24 hours a day. Reported on the race to understand the virus and the failure of governments to respond. Documented racial and social inequities of the pandemic. Provided vivid accounts of suffering worldwide. And observed the monumental death toll.That coverage encompassed not just articles but graphics, video, data journalism, design, photography and podcasting. The effort drew upon the full resources of the newsroom, with many staff members putting themselves at personal risk and others taking on new roles to meet the demands of the coverage or provide support. And all of it was executed with nearly all employees working remotely and as The Times also covered the nation’s racial unrest, the impact of climate change and a tumultuous presidential campaign and election.Speaking to employees, many of whom were watching the livestreamed awards ceremony at home, Mr. Baquet, along with other newsroom leaders, reflected on what it meant to be honored at this time.“I just want to pause for a moment on the full power of these prizes and what they say about what you accomplished in a year when many of you suffered from your own loss and disruption,” he said. “Literally, hundreds of people had a hand in this coverage.”A key component of the coverage was a tracking project that compiled virus data on a variety of measures. The Times released the data, which has been used by medical researchers and government officials.More than 100 people from across the newsroom, as well as 50 freelancers and students, have worked on the tracking effort. Reporters and researchers filed more than 700 public records requests for data on populations like nursing homes and prisons. Engineers created a database to manage hundreds of data sources.The team has now published more than 3,000 daily tracking pages, covering subjects that include country, state and county trends, reopenings and vaccinations.“It was easily the largest and probably the most ambitious data project our newsroom has ever taken on,” Archie Tse, the graphics director, said.At the same time, the National desk helped reveal the disproportionate toll that the virus took on people of color. And when the overall U.S. death toll reached 100,000 people, a team of journalists marked the staggering figure with a front page consisting of victims’ names and biographical details.“We strove every day not to be so focused on the numbers that we forgot the people behind them,” said Marc Lacey, an assistant managing editor and the former National editor.On the Health and Science desk, journalists followed the efforts to explain how the virus spread, its effect on the body and the development of a vaccine. Members of the desk edited more than 1,100 online articles on the virus and assisted other journalists in the newsroom on hundreds more.“We covered Ebola and Zika, but none of us had ever experienced such a ravenous hunger for science news,” said Celia Dugger, the Health and Science editor.Some of the earliest work began with the International desk, which reported from the front lines in Wuhan, China, where the outbreak first emerged, then charted the failures in Italy and later examined the impact of the virus all over the world.The desk also was instrumental in the live briefing on the virus, a constantly updated news feed that would go on to involve multiple departments in the newsroom and that remains a staple of the coverage, more than 500 days later. Chris Buckley, a Times correspondent previously based in China, was on a train on his way to cover the lockdown in Wuhan in January 2020 when his editor called him and asked him to start writing for the live briefing. At the time, Mr. Buckley was skeptical: “Live briefing? About this story? From a train? So, that call was one of those reminders that sometimes our editors are actually right,” he said, joking.“Since then our coverage of Covid has never stopped.”Many of the leaders and staff members who played critical roles in the two Pulitzer Prizes this year gathered for the ceremony.Damon Winter/The New York Times More

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      Troubled Vaccine Maker and Its Founder Gave $2 Million in Political Donations

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      Emergent BioSolutions faces scrutiny in Congress for ruining Covid-19 vaccines and securing lucrative federal contracts. Executives will appear before some lawmakers who benefited from the company’s spending.WASHINGTON — When Fuad El-Hibri, founder and executive chairman of Emergent BioSolutions, appears Wednesday before a House subcommittee to explain how the company’s Baltimore plant ruined millions of doses of coronavirus vaccine, he will be questioned by lawmakers he and his employees spent tens of thousands of dollars helping to elect.Since 2018, federal campaign records show, Mr. El-Hibri and his wife, Nancy, have donated at least $150,000 to groups affiliated with the top Republican on the panel, Representative Steve Scalise of Louisiana, as well as Mr. Scalise’s campaigns. At least two other members of the subcommittee received donations during the 2020 election cycle from the company’s political action committee, which has given about $1.4 million over the past 10 years to members of both parties.Mr. El-Hibri and his wife have made additional donations totaling more than $800,000 over the same period, with the majority going to Republican candidates and organizations.Political giving is nothing new in Washington. But with the federal government as Emergent’s prime customer, Mr. El-Hibri and the company he founded have spent years cultivating ties on Capitol Hill, helping Emergent carve out a lucrative niche market as a government contractor under both Democratic and Republican administrations.Now Emergent and its top executives find themselves under scrutiny from some of the very elected officials they have sought to influence.Members of Congress are demanding answers from the company, which was awarded a $628 million contract last year to manufacture Covid-19 vaccines but has yet to produce a single dose deemed usable by federal regulators. Along with Mr. El-Hibri, Emergent’s chief executive, Robert G. Kramer, will testify beginning at 10:30 a.m. before the House Select Subcommittee on the Coronavirus Crisis, which has opened a sprawling inquiry.Like nearly everything else about the coronavirus pandemic, the hearing is bound to be colored by politics.Democrats, led by Representative Jim Clyburn of South Carolina, the panel’s chairman, are expected to use the session to put a spotlight on the company’s relationship with Trump administration officials, including Robert Kadlec, the former assistant secretary of health and human services for preparedness and response, who had previously consulted for Emergent. Dr. Kadlec has said that he was not involved in negotiating the company’s coronavirus contract but that he did sign off on it.Democrats have also signaled that they will zero in on the executives’ stock trades. Emergent’s stock performed so well in 2020 that Mr. El-Hibri cashed in shares and options worth over $42 million, The New York Times reported in March. Mr. Kramer sold slightly more than $10 million in stock this year, according to filings with the Securities and Exchange Commission reported earlier by The Washington Post.“They all made millions in stock transactions while they seem to be hiding stuff from the public,” Mr. Clyburn said in a recent interview with CNN.Republicans, led by Mr. Scalise, who as the No. 2 Republican holds the title of whip, are likely to point out that the company’s contracts date at least to the Obama administration, which designated its Baltimore facility a center for innovation in advanced development and manufacturing — meaning it would be ready to make vaccines and other needed treatments in the event of a crisis.Representative Steve Scalise of Louisiana received campaign donations from Mr. El-Hibri and his wife, Nancy.Anna Moneymaker for The New York TimesA spokeswoman for Mr. Scalise said that Mr. El-Hibri would receive no special treatment at the hearing. “The Democrats invited him as a witness, and Whip Scalise will treat him as he would any other witness that has been invited before the committee,” the spokeswoman said.Until recently, Emergent was an obscure player in Washington, but a dominant force in the highly specialized market for drugs and vaccines aimed at countering a biological attack. The company burst into the limelight earlier this spring after The Times reported that workers at its Bayview plant in Baltimore had accidentally conflated the ingredients of two vaccines that rely on live viruses, forcing Emergent to discard up to 15 million doses of the Johnson & Johnson vaccine.Food and Drug Administration inspectors subsequently raised concerns about possible further contamination, and the company has recently submitted a quality improvement plan to regulators. The equivalent of about 70 million more doses of Johnson & Johnson’s vaccine, mostly for domestic use, are on hold and may never be cleared for use in the United States.“The collaboration with BARDA was designed to create a higher probability of success but was not without risk,” an Emergent spokesman, Matt Hartwig, said in a statement to The Times, using the acronym for the Biomedical Advanced Research and Development Authority, the federal agency that awarded the contract. “Our motivation in collaborating with BARDA was to help play a role in bringing the pandemic to an end and we are proud of the work of Emergent’s employees.”Mr. Kramer, the chief executive, is likely to use the hearing to outline the company’s corrective action plan and to cast Emergent as a company committed to helping the country in crisis. During a recent earnings call with investors, Mr. Kramer announced a management shake-up and took “full responsibility” for the problems in Baltimore.But he also cast some blame on the government, saying that federal officials had asked Emergent to manufacture the two live-virus vaccines — one developed by Johnson & Johnson and the other by AstraZeneca — despite the risk of contamination. He said that the company had taken precautions but that the contamination had most likely occurred when “one or more of these precautions did not function as anticipated.”Emergent’s chief executive, Robert G. Kramer, sold slightly more than $10 million in stock this year, according to filings with the Securities and Exchange Commission.Joe Andrucyk/Office of Governor Larry HoganThrough Mr. Hartwig, the Emergent spokesman, the El-Hibris declined to comment.The company is a longtime partner to the federal government. Then known as BioPort, it was founded by Mr. El-Hibri in 1998 after he and some investors paid the state of Michigan $25 million to buy the license for a government-developed anthrax vaccine and an aging manufacturing plant. In the two decades since, the company built its business largely around selling products to the Strategic National Stockpile, the nation’s emergency medical reserve.An investigation by The Times, published in March, found that the company’s anthrax vaccine had in some years accounted for roughly half of the stockpile’s budget and that the company’s aggressive tactics, broad political connections and penchant for undercutting competitors had given it remarkable sway over the government’s purchasing decisions related to the vaccines.The company’s board is stocked with former federal officials, and its lobbyists include former members of Congress and aides from both parties. The company’s government relations shop is similarly stocked with partisans; Chris Frech, its top in-house lobbyist, worked for former President George W. Bush, and Grant Barbosa, a senior director for government affairs, was a legislative assistant to Vice President Kamala Harris when she was a senator.Senate lobbying disclosures show that the company has spent an average of $3 million a year on lobbying over the past decade — much more than similarly sized biotech firms but about the same as two pharmaceutical giants, AstraZeneca and Bristol Myers Squibb, whose annual revenues are at least 17 times higher.During the first three months of this year, Emergent reported spending $1.47 million on lobbying, enlisting the services of more than two dozen lobbyists from 10 firms.Federal campaign disclosure records show that donations to the Emergent BioSolutions Inc. Employees PAC run the gamut. Board members and executives like Mr. El-Hibri give as much as $5,000, the maximum allowable amount per year under federal election rules. Some employees have contributed on a biweekly basis in amounts as small as $3.47. Three former employees said the company offered a payroll deduction program to make giving easier.The employee group tends to spend in small dollar amounts, typically $1,000 to $2,500 on incumbents, including lawmakers representing states where it operates, like Maryland and Michigan. Representative Steny Hoyer, Democrat of Maryland and the No. 2 Democrat in the House, was a top beneficiary in the 2020 election cycle; he and an affiliated organization received a total of $10,000.Two members of the House panel conducting Wednesday’s hearing — Representative Jim Jordan, Republican of Ohio, and Representative Jamie Raskin, Democrat of Maryland — each received $1,000 contributions over the same election cycle.In an interview, Mr. Raskin said that he had been unaware of the donation until he was contacted by a Times reporter and that he had returned the money. A spokesman for Mr. Jordan said that the congressman had raised more than $18 million during the 2020 election cycle and that contributions had no bearing on his work as a legislator.Mr. Hartwig, the Emergent spokesman, said in an email message that the PAC “supports incumbent Members of Congress of both chambers and from both parties who represent our employees and our facilities, and who are committed to preparedness and response for the next biological, chemical, or public health threat.”Sharon LaFraniere contributed reporting. More

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      Mayoral Candidates Respond to the Shooting in Times Square

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      [Want to get New York Today by email? Here’s the sign-up.]It’s Tuesday. Weather: Sunny early, turning cloudy and breezy later, with scattered showers. High in the mid-60s. Alternate-side parking: In effect until Thursday (Solemnity of the Ascension and Eid al-Fitr). Gabriela Bhaskar for The New York TimesA shooting near Seventh Avenue and West 45th Street on Saturday afternoon left three bystanders wounded: a 4-year-old Brooklyn girl who was shopping for toys with her family, a 23-year-old tourist from Rhode Island and a 43-year-old woman from New Jersey.But coming six weeks before the June 22 mayoral primary, and as the city is gearing up to welcome back throngs of tourists, the episode quickly became more than just a disturbing act of violence in one of New York City’s most familiar locales.Mayoral candidates said the shooting was emblematic of the city’s growing crime problem and moved quickly to showcase how they would address the issue.[The shooting became a flash point in the race for mayor, further cementing public safety as a top political issue.]Eric AdamsMr. Adams, the Brooklyn borough president, said he would hire officers with the skills and temperament to work in a plainclothes anti-violence unit. Mayor Bill de Blasio disbanded such a unit last year. Mr. Adams would also create a special citywide prosecutor for illegal-gun cases.“This gun violence has been real for countless New Yorkers for years, and as the chief executive, the mayor of the city, we can’t wait until crises happen in the center of Manhattan,” he said. “We have to respond before then.”Kathryn GarciaMs. Garcia, a former sanitation commissioner, said she would increase community policing and boost an N.Y.P.D. division focused on identifying people or groups that traffic or sell illegal guns.“We must see the full picture and prioritize efforts to prevent the underlying causes of crime, including access to jobs, housing, education, and by working with violence prevention programs at the community level,” she said.Andrew YangMr. Yang, a former presidential candidate, said he would reinstitute the plainclothes unit and populate it with better-trained officers with clean records. He said New York could not afford to “defund the police.”“Nothing works in our city without public safety, and for public safety, we need the police,” Mr. Yang said. “My message to the N.Y.P.D. is this: New York needs you. Your city needs you.”Raymond J. McGuireMr. McGuire, a former Citi executive, said the city should increase the number of officers focused on reducing the number of guns available to people. He said courts should keep repeat offenders off the streets.“As gun violence continues to rise in our city at alarming rates, the fix isn’t to defund and disarm, leaving the most vulnerable and often forgotten neighborhoods unprotected,” he said, “nor is the answer going back to Giuliani-era police tactics like some have suggested.”Maya WileyMs. Wiley, a former counsel to Mr. de Blasio, said she would invest in “trauma-informed” mental health care and in summer youth employment programs.“We will right-size the New York City Police Department to focus on its job so it does it effectively and efficiently, because we have a police department that’s the size of an army,” she said.Dianne MoralesMs. Morales, a nonprofit executive, has said she wants to more than halve the Police Department’s operating budget.“We need bigger solutions than the police,” she said on Twitter. “We have enough resources to finally address the conditions that got us here. This is our time to do just that.”Scott StringerMr. Stringer, the New York City comptroller, said on Twitter, “Once again we are witness to another terrible tragedy.”“Enough,” he continued. “We must end gun violence in our communities, get guns off our streets, and enact change to keep New Yorkers safe.”Shaun DonovanMr. Donovan, a former White House budget director, said in a recent television interview that officers should be more focused on addressing gun violence than on ticketing motorists or addressing mental health issues.“N.Y.C. will never truly recover if we fail to address the pandemic of gun violence that continues to grip our city and country,” he said in a statement on Monday.Read more about the mayor’s race:Yang’s Latest Endorsement Shows Momentum With a Key Voting BlocMost of Stringer’s Supporters Have Fled. Not the Teachers’ Union.From The TimesAs Cuomo Fights for Survival, He Revives His Combative ImageThe Strange New Life of Vaccine SitesRough Trade Record Store Has an Unlikely New Home: 30 RockWant more news? Check out our full coverage.The Mini Crossword: Here is today’s puzzle.What we’re readingA team of advisers — and fame, charisma and hustle — have helped make Andrew Yang a front-runner in the New York City mayoral race. [New York Magazine]In an unprovoked attack, a tourist was stabbed with a screwdriver by a stranger on a subway train in Manhattan. [Daily News]A bill signed by Gov. Andrew M. Cuomo restoring voting rights to formerly incarcerated people expands the number of eligible voters for the primary election. [Gothamist].css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-1rh1sk1{margin:0 auto;overflow:hidden;}.css-1rh1sk1 strong{font-weight:700;}.css-1rh1sk1 em{font-style:italic;}.css-1rh1sk1 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#ccd9e3;text-decoration-color:#ccd9e3;}.css-1rh1sk1 a:visited{color:#333;-webkit-text-decoration-color:#ccc;text-decoration-color:#ccc;}.css-1rh1sk1 a:hover{-webkit-text-decoration:none;text-decoration:none;}And finally: Pop-up vaccinations in subway stations Vaccinations have helped drive down Covid-19 positivity rates and hospitalizations across New York State. Gov. Andrew M. Cuomo said on Monday that the number of hospitalizations statewide was 2,016, the lowest since Nov. 15. The statewide seven-day average rate of positive test results announced by the state on Sunday — 1.45 percent — was the lowest since Oct. 28.But Mr. Cuomo warned that the pace of vaccinations was tapering off, both in New York and nationwide, potentially allowing the coronavirus to linger.So New York, like other states and cities, is trying to get creative.Mr. Cuomo announced a new pilot program to boost the flagging vaccination campaign: setting up temporary walk-in vaccination sites at eight subway and train stations for the next few days.From Wednesday to Sunday, the walk-in sites will be open from 8 a.m. to 1 p.m. at 179th Street in Jamaica, Queens; East 180th Street in the Bronx; and at Stillwell Avenue in Coney Island, Brooklyn.Another site will be open from 3 p.m. to 8 p.m. at Broadway Junction in Brooklyn.Sites at the Long Island Rail Road station in Hempstead and a Metro-North Railroad station in Ossining will be open from 3 p.m. to 8 p.m.Walk-in vaccination sites will also be open at Penn Station in Manhattan from 3 p.m. to 8 p.m. and at Grand Central Terminal from 8 a.m. to 1 p.m.People vaccinated at the subway and rail locations can get a free seven-day MetroCard or two free one-way tickets for the Long Island Rail Road or Metro-North. Officials will use the Johnson & Johnson vaccine at the stations, Mr. Cuomo said, adding that the program may be extended.It’s Tuesday — take a ride.Metropolitan Diary: Model citizen Dear Diary:For my daily commute between Chelsea and the East Village, sometimes I walked, but mostly I took the subway.I was on a mission to practice my drawing, and I filled many small sketchbooks with spontaneous portraits of riders as they napped, meditated and read.Some riders enjoyed looking at my pencil marks, and I had many delightful, and occasionally rather meaningful, conversations.One day, I noticed a young man in soldier’s fatigues watching me as I sketched a rider who was reading. When that person left the car, I began to glance around for my next sketching opportunity.The young man in the fatigues placed himself directly across from me, smiled coyly, pointed at himself and posed.He was proud, handsome and a great model. In the few minutes we had, I sketched him with care, hoping he would remain safe.— Robin KappyNew York Today is published weekdays around 6 a.m. Sign up here to get it by email. You can also find it at nytoday.com.What would you like to see more (or less) of? Email us: nytoday@nytimes.com More

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      Vaccine Fan Fiction, Boom Time for America’s Forests and Political Apathy in N.Y.C.: The Week in Narrated Articles

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      Five articles from around The Times, narrated just for you. This weekend, listen to a collection of narrated articles from around The New York Times, read aloud by the reporters who wrote the stories.When Vaccines Become an Internet Personality Test Written and narrated by Amanda HessWhen Vaccines Become an Internet Personality TestFor months, social media has been operating as if mass death and collective trauma could be processed (or at least ignored) by rigorously serving up topical memes on our phones. Now, the long-running Covid dramedy appears to be nearing its finale, in the form of an orgiastic flurry of vaccine content.Images of filled-out vaccine cards are status symbols. The syringe emoji is spurting everywhere. There are vaccine fan-fiction TikToks where the pharmaceutical brands are spun into whole personalities. There is even a vaccine heartthrob: Huge Ma, the “Vaccine Daddy” behind the Twitter account @TurboVax, which surfaces open appointment slots in New York.◆ ◆ ◆The Island Is Idyllic. As a Workplace, It’s Toxic.Written and narrated by Julia MoskinSarah Letchworth is one of several young women from Lummi Island who worked at the Willows as a teenager, and who said they experienced sexual harassment by Blaine Wetzel’s kitchen crew.Jessica Pons for The New York TimesThe Island Is Idyllic. As a Workplace, It’s Toxic.Since Blaine Wetzel took over the kitchen at the Willows Inn, a restaurant on Lummi, a tiny island near the San Juan archipelago of Washington State, it has become a global destination. Culinary pilgrims come for multicourse dinners of foraged dandelions, custards infused with roasted birch bark and salmon pulled from Pacific waters they can see from the dining room. Beyond the food, guests come for the story, and pay at least $500 to live in it for a night.But 35 former staff members who spoke to The New York Times said that story — the one Mr. Wetzel tells to diners, to the media and to aspiring chefs who come to Lummi to learn from him — is deeply misleading.◆ ◆ ◆The Biggest Mayor’s Race in Years? New Yorkers’ Minds Are Elsewhere.Written and narrated by Michael WilsonAndrew Yang speaking at an event in the Bronx last week. “The only thing I’m thinking about is Covid,” said one woman who recently saw Mr. Yang in the borough. Gabriela Bhaskar for The New York TimesThe Biggest Mayor’s Race in Years? New Yorkers’ Minds Are Elsewhere.The next mayor of New York faces a staggering slate of extraordinary challenges: resuscitating tourism and refilling the empty skyscrapers of Midtown Manhattan, bringing jobs back and the commuters to perform them, lowering crime while raising confidence in the city’s police and law enforcement.And yet, a seemingly large portion of New Yorkers, with only eight weeks left before the Democratic primary, remain utterly disengaged and oblivious to the race. For many, the ongoing toils of living with the coronavirus and lingering weariness from the 2020 presidential campaign have crowded out time or energy for local politics.◆ ◆ ◆There’s a Booming Business in America’s Forests. Some Aren’t Happy About It.Written and narrated by Gabriel PopkinA tree being dragged to a wood chipper, a first step toward being transformed into wood pellets and shipped overseas.Erin Schaff/The New York TimesThere’s a Booming Business in America’s Forests. Some Aren’t Happy About It.In barely a decade, the wood pellet industry in America’s Southeast has grown from almost nothing to 23 mills with capacity to produce more than 10 million metric tons annually for export. It employs more than 1,000 people directly, and has boosted local logging and trucking businesses.Supporters see the thriving industry as a climate-friendly source of rural jobs. For others, it’s a polluter and destroyer of nature.◆ ◆ ◆Rural Ambulance Crews Have Run Out of Money and VolunteersWritten and narrated by Ali WatkinsStephanie Bartlett, left, and Cheryl Rixey pulling out a stretcher at a hospital in Sweetwater County, Wyo., for a patient transfer this month.Kim Raff for The New York TimesRural Ambulance Crews Have Run Out of Money and VolunteersThe ambulance crews that service much of rural America have run out of money and volunteers, a crisis exacerbated by the demands of the pandemic and a neglected, patchwork 911 system.The situation is particularly acute in Wyoming, where nearly half of the population lives in territory so empty it is still considered the frontier. At least 10 localities in the state are in danger of losing ambulance service, some imminently, according to an analysis reviewed by The New York Times.Want to hear more narrated articles from publishers like The New York Times? Download Audm for iPhone and Android.The Times’s narrated articles are made by Parin Behrooz, Carson Leigh Brown, Anna Diamond, Aaron Esposito, Elena Hecht, Emma Kehlbeck, Marion Lozano, Anna Martin, Tracy Mumford, Tanya Perez, Margaret Willison, Kate Winslett and John Woo. Special thanks to Sam Dolnick, Ryan Wegner, Julia Simon and Desiree Ibekwe. More

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      Will Israel’s Strong Vaccination Campaign Give Netanyahu an Election Edge?

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      Prime Minister Benjamin Netanyahu is banking on voters crediting him for beating the pandemic. But many worry that the country’s reopening may be premature and politically driven.JERUSALEM — Vaccinated Israelis are working out in gyms and dining in restaurants. By this weekend they will be partying at nightclubs and cheering at soccer matches by the thousands.Prime Minister Benjamin Netanyahu is taking credit for bringing Israel “back to life” and banking on the country’s giddy, post-pandemic mood of liberation to put him over the top in a close election on Tuesday.But nothing is quite that simple in Israeli politics.While most Israelis appreciate the government’s impressive, world-leading vaccination campaign, many worry that the grand social and economic reopening may prove premature and suspect that the timing is political.Instead of public health professionals making transparent decisions about reopening, “decisions are made at the last minute, at night, by the cabinet,” complained Prof. Hagai Levine, an epidemiologist at the Hebrew University-Hadassah School of Public Health in Jerusalem. “The timing, right before the election, is intended to declare mission accomplished.”The parliamentary election on Tuesday will be the country’s fourth in two years. For Mr. Netanyahu, who is on trial on corruption charges, his best chance of avoiding conviction lies in heading a new right-wing government, analysts say, and he has staked everything on his handling of the coronavirus crisis.He takes personal credit for the vaccination campaign, which has seen about half the country’s 9 million people receive a second Pfizer shot, outpacing the rest of the world, and has declared victory over the virus.“Israel is the world champion in vaccinations, the first country in the world to exit from the health corona and the economic corona,” he said at a pre-election conference this week.A vaccination site at a mall in Givatayim, Israel. Half of the country’s 9 million people have received a second shot of the Pfizer vaccine, outpacing the rest of the world.Oded Balilty/Associated PressHe has presented himself as the only candidate who could have pulled off the deal with Pfizer to secure the early delivery of millions of vaccines, boasting of his personal appeals to Pfizer’s CEO, Albert Bourla, who, as a son of Holocaust survivors, had great affinity for Israel.Mr. Netanyahu even posted a clip from South Park, the American animated sitcom, acknowledging Israel’s vaccination supremacy.But experts said his claim that the virus was in the rearview mirror was overly optimistic.Just months ago, Israel’s daily infection rates and death rates were among the worst in the world. By February, Israel was also leading the world in the number of lockdown days. About two million Israelis under 16 are so far unable to get vaccinated and about a million eligible citizens have so far chosen not to.With much of the adult population now vaccinated, weekly infection rates have been dropping dramatically. But there are still more than a thousand new cases a day, an infection rate that, adjusted for population, remains higher than those of the United States, Canada, Britain, Germany, Spain and others.Health officials approved the reopening of businesses and leisure activities. But they sharply criticized a High Court decision this week lifting the quotas on airport arrivals, in part to allow Israeli citizens abroad to get back and vote.“The High Court is taking responsibility for the risk of mutations entering Israel,” Yoav Kish, the deputy health minister, wrote on Twitter. “Good luck to us all.”Critics blame the government for having failed to establish a reliable system to enforce quarantine for people entering the country, and health experts warn that they could bring in dangerous variants of the virus that are more resistant to the vaccine.The dizzying mix of health policy and electioneering has left many Israelis in a state of confusion, out celebrating but also fearing that the rapid reopening may be reckless.“I believe after the elections things will close again,” said Eran Avishai, the part-owner of a popular Mediterranean restaurant in Jerusalem. “It’s political and not logical that I can open a restaurant while my son, who’s in 10th grade, can only go to school for a few hours twice a week. There are hidden agendas.”Israelis are celebrating new freedoms, like eating in restaurants, but many fear the country’s rapid reopening may be reckless.Atef Safadi/EPA, via ShutterstockBut as a businessman, he added, “I thank Bibi every morning when I wake up,” referring to Mr. Netanyahu by his nickname.The reopening did not lead to an immediate boost for Mr. Netanyahu’s conservative Likud party in pre-election opinion polls, suggesting that his claim of vanquishing the virus may not be enough to persuade those who voted against him in the last three elections to change their minds.For at least two years, Israel has been stuck in political gridlock, roughly divided between pro- and anti-Netanyahu voters. A stalemate in the last three elections prevented either side from securing a majority in Parliament that would allow it to form a stable coalition government.Mr. Netanyahu’s critics accuse him of having mismanaged the health crisis over much of the last year by putting politics and personal interests ahead of the public’s, for example by going easy on those members of the ultra-Orthodox community who flouted lockdown rules in order to maintain the loyalty of his ultra-Orthodox coalition allies.“It’s a mixed bag,” said Gadi Wolfsfeld, a professor of political communication at the Interdisciplinary Center Herzliya. “On the one hand Netanyahu gets credit for bringing the vaccines quickly and making Israel the most vaccinated society. On the other hand, a lot of people are angry at the way the ultra-Orthodox got away with everything, and he is identified with that. And people are mad about the lockdowns.”The hasty reopening was a “cynical strategy,” he said, because any resulting increase in infection would only become apparent after the election.Even as many businesses have reopened, other storefronts across the country were displaying “For Sale” or “To Let” signs after the pandemic left them permanently shuttered.Mr. Netanyahu’s political rivals have homed in on his failures in handling the pandemic, which has taken the lives of more than 6,000 Israelis.“6,000 victims of the government’s failed management will not be coming ‘Back to Life,’” Yair Lapid, leader of the centrist opposition to Mr. Netanyahu, wrote on Twitter. “Israel needs a sane government.”Mr. Netanyahu has been criticized by his rivals for his failures in handling the pandemic, which has killed more than 6,000 Israelis.Menahem Kahana/Agence France-Presse — Getty ImagesA rival from the right, Naftali Bennett, brought out a booklet late last year titled, “How to Beat an Epidemic,” suggesting that he could have done a better job. But it’s impossible to know if he would have fared better than Mr. Netanyahu.“Even if his opponents’ criticism is very harsh, they don’t have the deeds to prove they could have done any better in combating the virus,” said Gayil Talshir, a political scientist at the Hebrew University of Jerusalem.For once, she said, Mr. Netanyahu was running a positive campaign largely based on his achievements, rather than a divisive one that pitted different segments of the population against each other.The logistics of holding an election during a pandemic, however, could skew the projections. The Central Elections Committee has decided to place ballot boxes inside nursing homes, a measure that may increase voter turnout among the older population. There will also be polling stations at the airport.There will be more ballot boxes than usual, as well as 50 mobile voting stations to reduce overcrowding. There will be special transportation and separate polling stations for people infected with the virus or in quarantine.But Israel does not offer voting by mail or absentee voting except for diplomats or other officials serving abroad, and some people may still be anxious about coming out to vote.Whether the vaccination campaign and the reopening of the economy can break Israel’s political impasse remains unclear.“It is too soon to judge,” said Ayelet Frish, a strategic consultant, days before the election. The electorate and the politicians remained split, she said, between what she called the pro-Netanyahu “I brought the vaccines” camp and the anti-Netanyahu “Because of you we have 6,000 dead” camp.So far, she said, “It’s a draw.” More

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      The First Post-Reagan Presidency

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      Credit…Timo LenzenSkip to contentSkip to site indexOpinionThe First Post-Reagan PresidencySo far, Joe Biden has been surprisingly progressive.Credit…Timo LenzenSupported byContinue reading the main storyOpinion ColumnistJan. 28, 2021, 8:50 p.m. ETDuring Donald Trump’s presidency, I sometimes took comfort in the Yale political scientist Stephen Skowronek’s concept of “political time.”In Skowronek’s formulation, presidential history moves in 40- to 60-year cycles, or “regimes.” Each is inaugurated by transformative, “reconstructive” leaders who define the boundaries of political possibility for their successors.Franklin Delano Roosevelt was such a figure. For decades following his presidency, Republicans and Democrats alike accepted many of the basic assumptions of the New Deal. Ronald Reagan was another. After him, even Democrats like Bill Clinton and Barack Obama feared deficit spending, inflation and anything that smacked of “big government.”I found Skowronek’s schema reassuring because of where Trump seemed to fit into it. Skowronek thought Trump was a “late regime affiliate” — a category that includes Jimmy Carter and Herbert Hoover. Such figures, he’s written, are outsiders from the party of a dominant but decrepit regime.They use the “internal disarray and festering weakness of the establishment” to “seize the initiative.” Promising to save a faltering political order, they end up imploding and bringing the old regime down with them. No such leader, he wrote, has ever been re-elected.During Trump’s reign, Skowronek’s ideas gained some popular currency, offering a way to make sense of a presidency that seemed anomalous and bizarre. “We are still in the middle of Trump’s rendition of the type,” he wrote in an updated edition of his book “Presidential Leadership in Political Time,” “but we have seen this movie before, and it has always ended the same way.”Skowronek doesn’t present his theory as a skeleton key to history. It’s a way of understanding historical dynamics, not predicting the future. Still, if Trump represented the last gasps of Reaganism instead of the birth of something new, then after him, Skowronek suggests, a fresh regime could begin.When Joe Biden became the Democratic nominee, it seemed that the coming of a new era had been delayed. Reconstructive leaders, in Skowronek’s formulation, repudiate the doctrines of an establishment that no longer has answers for the existential challenges the country faces. Biden, Skowronek told me, is “a guy who’s made his way up through establishment Democratic politics.” Nothing about him seemed trailblazing.Yet as Biden’s administration begins, there are signs that a new politics is coalescing. When, in his inauguration speech, Biden touted “unity,” he framed it as a national rejection of the dark forces unleashed by his discredited predecessor, not stale Gang of Eight bipartisanship. He takes power at a time when what was once conventional wisdom about deficits, inflation and the proper size of government has fallen apart. That means Biden, who has been in national office since before Reagan’s presidency, has the potential to be our first truly post-Reagan president.“Biden has a huge opportunity to finally get our nation past the Reagan narrative that has still lingered,” said Representative Ro Khanna, who was a national co-chair of Bernie Sanders’s presidential campaign. “And the opportunity is to show that government, by getting the shots in every person’s arm of the vaccines, and building infrastructure, and helping working families, is going to be a force for good.” More

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      Trump Isn’t Out the Door Yet

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      #masthead-section-label, #masthead-bar-one { display: none }Covid-19 VaccinesVaccine QuestionsWhich States are Increasing AccessRollout by StateHow 9 Vaccines WorkAdvertisementContinue reading the main storyOpinionSupported byContinue reading the main storyThe conversationTrump Isn’t Out the Door YetBut after a few terrible weeks, there are reasons for Americans to be cautiously optimistic.Gail Collins and Ms. Collins and Mr. Stephens are opinion columnists. They converse every week.Jan. 18, 2021, 5:00 a.m. ETCredit…Damon Winter/The New York TimesBret Stephens: Gail, given what’s happened in the past two weeks, Martin Luther King Jr. Day feels particularly meaningful this year. It seems as if the country is just holding its breath, waiting for the next Capitol Hill mob to descend, somewhere, somehow, on something or someone.Is this 1968 all over again, or do you feel any sense of optimism?Gail: Well Bret, I was actually around in 1968 — politically speaking.Bret: Ah, but do you actually remember it?Gail: There were certainly a lot of … distractions, what with a cultural revolution around every corner. And a terrible string of assassinations — after King, I can remember when Robert Kennedy was killed in June, feeling like nobody was safe from crazy people and right-wing racists.Bret: Now it’s like déjà vu all over again. Donald Trump spent five years stoking the paranoia and loathing of his crowds, and now it has been unleashed. We’ll be living with it for years.Gail: But here’s the other thing. I remember in the 1970s, when I had a news service in Connecticut, listening to the state Legislature arguing vehemently about whether King deserved a holiday. It was controversial, even in the Northeast.Now, we’re a different nation. On the dark side we have crazy people publicizing bring-your-own AR-15 rifle rallies. We have appalling racists conspiring with each other on the internet. But on the other hand, we live in a multiracial society that agrees, at least in theory, that everybody is equal. Even though, I know, the acting out part can be terrible.Bret: Very true. The other day I was reading a dazzling essay in Tablet Magazine by its editor, Alana Newhouse, called “Everything Is Broken.” Alana is a brilliant thinker, but one of my own thoughts after reading her piece was: “Everything? Really?”We’re so fixated on what is wrong today that we forget how much was far more wrong 50 years ago. We have serious racial problems today. They were a whole lot worse when King was murdered. We have this terrible pandemic. Unlike in 1968, we also have the medical know-how to develop a vaccine in less than a year. We breathe cleaner air than we did 50 years ago, fly safer planes, drive better cars and watch better TV (though literature has gotten considerably worse). Women have choices, opportunities and role models today that were only being dreamed about 50 years ago. We have a polarized and angry electorate, but probably not as polarized as it was when George Wallace won 46 electoral votes, the Vietnam War was raging and the draft was still in effect. In 1968 Richard Nixon was on his way into the White House. In 2021 Donald Trump is on his way out.Gail: Yeah, and in 1968, as far as the world knew, the only gay celebrity in America was Sal Mineo.Bret: That, too. It’s not like we don’t have terrible problems. But I take a lot of comfort in a few things. Donald Trump lost the popular vote by seven million votes. The Capitol Hill barbarians are being tracked down and arrested. Mike Pence didn’t pull a Tammy Wynette and stand by his man. And Joe Biden, centered and sane, is about to become president.In other words, I’m not throwing in the towel on America. We are more resilient than we’ve probably seemed to the outside world in recent years..css-c7gg1r{font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:0.875rem;line-height:0.875rem;margin-bottom:15px;color:#121212 !important;}@media (min-width:740px){.css-c7gg1r{font-size:0.9375rem;line-height:0.9375rem;}}.css-1sjr751{-webkit-text-decoration:none;text-decoration:none;}.css-1sjr751 a:hover{border-bottom:1px solid #dcdcdc;}.css-yoay6m{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-yoay6m{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}.css-k59gj9{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;width:100%;}.css-1e2usoh{font-family:inherit;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;border-top:1px solid #ccc;padding:10px 0px 10px 0px;background-color:#fff;}.css-1jz6h6z{font-family:inherit;font-weight:bold;font-size:1rem;line-height:1.5rem;text-align:left;}.css-1t412wb{box-sizing:border-box;margin:8px 15px 0px 15px;cursor:pointer;}.css-hhzar2{-webkit-transition:-webkit-transform ease 0.5s;-webkit-transition:transform ease 0.5s;transition:transform ease 0.5s;}.css-t54hv4{-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-1r2j9qz{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-e1ipqs{font-size:1rem;line-height:1.5rem;padding:0px 30px 0px 0px;}.css-e1ipqs a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;}.css-e1ipqs a:hover{-webkit-text-decoration:none;text-decoration:none;}.css-1o76pdf{visibility:show;height:100%;padding-bottom:20px;}.css-1sw9s96{visibility:hidden;height:0px;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-1prex18{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;font-family:’nyt-franklin’,arial,helvetica,sans-serif;text-align:left;}@media (min-width:740px){.css-1prex18{padding:20px;}}.css-1prex18:focus{outline:1px solid #e2e2e2;}Covid-19 Vaccines ›Answers to Your Vaccine QuestionsWhile 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.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.Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.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.Gail: Once again we are on the same page, which makes me feel compelled to turn it and ask, How do you feel about Joe Biden’s agenda?Bret: A mixed bag. The best part is the promise to speed delivery of the vaccine, above all to the elderly. Ideally, by March, anyone who was born before, say, 1956, should be able to get a shot at their nearest pharmacy or stadium parking lot. And of course we need to continue helping small businesses, self-employed people, nonprofits, schools and so on to get through the next few months.Gail: So far we are in accord …Bret: Then again, to adapt Everett Dirksen’s old line: a trillion here, a trillion there, and pretty soon we’re talking real money. The government has already spent about $4 trillion on pandemic relief. Now Biden wants to spend another $1.9 trillion. I’m no deficit hawk, but there has to be some limit to how much a government can print, borrow and spend without creating serious problems for itself and posterity. I also have my doubts about some of Biden’s other ideas, like raising the minimum wage to $15, since a lot of the hardest hit businesses — restaurants in particular — will struggle with the extra labor costs.My biggest fear is that this becomes a new normal and government spending as a percentage of G.D.P. rises to French-style levels, with French-style economic results, but without French-style joie de vivre.I’m guessing you’re much more of a fan than I am.Gail: Well, yeah. We’re in a multiple crisis here. The country is in the throes of a pandemic, and Washington can’t expect everyone to go out and get a job or start a business when everyone is supposed to stay home as much as possible.Bret: Don’t get me wrong: I’m quibbling more than I’m quarreling. The pandemic put whole sectors of the economy on the edge of bankruptcy, and I’m all for heavy spending in an emergency. But the money should be well spent, unlike in 2009 when all those “shovel ready” projects we were promised never seemed to materialize. And we should be spending money on the people who need it most, not sending $1,400 more to most Americans.Gail: I agree about the upper-income folks. If you want to see the money plowed directly into the economy — not shoveled into savings accounts — the lower the income of the recipients the better. The Biden plan looks like it’ll be sending income-boosters for even many upper-middle-class families. I suspect I’ll support whatever he comes up with, but lower-income households not only need more money, they spend it faster, rather than stashing it away in banks in a way that won’t do anything much to boost the economy.Bret: Dear God we agree again.Gail: And about the “shovel ready” projects: Getting infrastructure projects going was one of Biden’s jobs in the Obama White House. Can’t say he was always perfectly successful, but he’s definitely a guy with practical experience.Bret: In the meantime, Gail, I bet you’d never find yourself cheering Liz Cheney. Her vote for impeachment read like the opening salvo in the Republican Conscience Recovery Act of 2021.Gail: Yes, but 147 of her fellow Republicans voted to overturn the results of the election. The party has a long way to go before it’s returned to the world of sanity.Bret: I know. The words for those Republicans are “nauseating,” “revolting” and “emetic.”Gail: First thing on the agenda: Republican leaders have to bring the party into a true reality-based, post-Trump world. Who do you think can do it?Bret: Probably someone who isn’t now in political life. With all of my newfound admiration for Mitt Romney and Arnold Schwarzenegger, they aren’t the ones. Should we ask our colleague Ross Douthat to volunteer?The larger question in my mind is whether the G.O.P. is the village that must be destroyed in order to be saved, or, alternatively, is it like a group of previously reasonable people who got taken in by a cult and now must go through some kind of deprogramming so that they can lead normal lives again? My hope is that once Republicans realize that Trump was both a moral and political disaster for them, they might recover their senses.I’d put the chance of that at around one in three.Gail: Totally agree. If the Republicans would only come around to your way of thinking on this, the nation would be a happier place.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.AdvertisementContinue reading the main story More

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      In Trump’s Final Chapter, a Failure to Rise to the Covid-19 Moment

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      #masthead-section-label, #masthead-bar-one { display: none }Covid-19 VaccinesVaccine QuestionsDoses Per StateAfter Your VaccineHow the Moderna Vaccine WorksWhy You’ll Still Need a MaskAdvertisementContinue reading the main storySupported byContinue reading the main story‘Covid, Covid, Covid’: In Trump’s Final Chapter, a Failure to Rise to the MomentAs the U.S. confronted a new wave of infection and death through the summer and fall, the president’s approach to the pandemic came down to a single question: What would it mean for him?President Trump not only ended up soundly defeated by Joseph R. Biden Jr., but missed his chance to show that he could meet the defining challenge of his tenure.Credit…Doug Mills/The New York TimesMichael D. Shear, Maggie Haberman, Noah Weiland, Sharon LaFraniere and Dec. 31, 2020Updated 9:57 p.m. ETWASHINGTON — It was a warm summer Wednesday, Election Day was looming and President Trump was even angrier than usual at the relentless focus on the coronavirus pandemic.“You’re killing me! This whole thing is! We’ve got all the damn cases,” Mr. Trump yelled at Jared Kushner, his son-in-law and senior adviser, during a gathering of top aides in the Oval Office on Aug. 19. “I want to do what Mexico does. They don’t give you a test till you get to the emergency room and you’re vomiting.”Mexico’s record in fighting the virus was hardly one for the United States to emulate. But the president had long seen testing not as a vital way to track and contain the pandemic but as a mechanism for making him look bad by driving up the number of known cases.And on that day he was especially furious after being informed by Dr. Francis S. Collins, the head of the National Institutes of Health, that it would be days before the government could give emergency approval to the use of convalescent plasma as a treatment, something Mr. Trump was eager to promote as a personal victory going into the Republican National Convention the following week.“They’re Democrats! They’re against me!” he said, convinced that the government’s top doctors and scientists were conspiring to undermine him. “They want to wait!”Throughout late summer and fall, in the heat of a re-election campaign that he would go on to lose, and in the face of mounting evidence of a surge in infections and deaths far worse than in the spring, Mr. Trump’s management of the crisis — unsteady, unscientific and colored by politics all year — was in effect reduced to a single question: What would it mean for him?The result, according to interviews with more than two dozen current and former administration officials and others in contact with the White House, was a lose-lose situation. Mr. Trump not only ended up soundly defeated by Joseph R. Biden Jr., but missed his chance to show that he could rise to the moment in the final chapter of his presidency and meet the defining challenge of his tenure.Efforts by his aides to persuade him to promote mask wearing, among the simplest and most effective ways to curb the spread of the disease, were derailed by his conviction that his political base would rebel against anything that would smack of limiting their personal freedom. Even his own campaign’s polling data to the contrary could not sway him.His explicit demand for a vaccine by Election Day — a push that came to a head in a contentious Oval Office meeting with top health aides in late September — became a misguided substitute for warning the nation that failure to adhere to social distancing and other mitigation efforts would contribute to a slow-rolling disaster this winter.His concern? That the man he called “Sleepy Joe” Biden, who was leading him in the polls, would get credit for a vaccine, not him.The government’s public health experts were all but silenced by the arrival in August of Dr. Scott W. Atlas, the Stanford professor of neuroradiology recruited after appearances on Fox News.With Dr. Deborah L. Birx, the coordinator of the White House virus task force, losing influence and often on the road, Dr. Atlas became the sole doctor Mr. Trump listened to. His theories, some of which scientists viewed as bordering on the crackpot, were exactly what the president wanted to hear: The virus is overblown, the number of deaths is exaggerated, testing is overrated, lockdowns do more harm than good.The president has long seen testing not as a vital way to track and contain the pandemic but as a mechanism for making him look bad by driving up the number of known cases.Credit…William DeShazer for The New York TimesAs the gap between politics and science grew, the infighting that Mr. Trump had allowed to plague the administration’s response from the beginning only intensified. Threats of firings worsened the leadership vacuum as key figures undercut each other and distanced themselves from responsibility.The administration had some positive stories to tell. Mr. Trump’s vaccine development program, Operation Warp Speed, had helped drive the pharmaceutical industry’s remarkably fast progress in developing several promising approaches. By the end of the year, two highly effective vaccines would be approved for emergency use, providing hope for 2021.The White House rejected any suggestions that the president’s response had fallen short, saying he had worked to provide adequate testing, protective equipment and hospital capacity and that the vaccine development program had succeeded in record time.“President Trump has led the largest mobilization of the public and private sectors since WWII to defeat Covid-19 and save lives,” said Brian Morgenstern, a White House spokesman.But Mr. Trump’s unwillingness to put aside his political self-centeredness as Americans died by the thousands each day or to embrace the steps necessary to deal with the crisis remains confounding even to some administration officials. “Making masks a culture war issue was the dumbest thing imaginable,” one former senior adviser said.His own bout with Covid-19 in early October left him extremely ill and dependent on care and drugs not available to most Americans, including a still-experimental monoclonal antibody treatment, and he saw firsthand how the disease coursed through the White House and some of his close allies.Yet his instinct was to treat that experience not as a learning moment or an opportunity for empathy, but as a chance to portray himself as a Superman who had vanquished the disease. His own experience to the contrary, he assured a crowd at the White House just a week after his hospitalization, “It’s going to disappear; it is disappearing.”Weeks after his own recovery, he would still complain about the nation’s preoccupation with the pandemic.“All you hear is Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid, Covid,” Mr. Trump said at one campaign stop, uttering the word 11 times.In the end he could not escape it.Supporters of Mr. Trump outside Walter Reed National Military Medical Center, where he was treated for the coronavirus, in October. He largely rejected aides’ efforts to use his bout with the illness to demonstrate a new compassion.Credit…Oliver Contreras for The New York Times‘The Base Will Revolt’By late July, new cases were at record highs, defying Mr. Trump’s predictions through the spring that the virus was under control, and deaths were spiking to alarming levels. Herman Cain, a 2012 Republican presidential candidate, died from the coronavirus; the previous month he had attended a Trump rally without a mask.With the pandemic defining the campaign despite Mr. Trump’s efforts to make it about law and order, Tony Fabrizio, the president’s main pollster, came to the Oval Office for a meeting in the middle of the summer prepared to make a surprising case: that mask wearing was acceptable even among Mr. Trump’s supporters.Arrayed in front of the Resolute Desk, Mr. Trump’s advisers listened as Mr. Fabrizio presented the numbers. According to his research, some of which was reported by The Washington Post, voters believed the pandemic was bad and getting worse, they were more concerned about getting sick than about the virus’s effects on their personal financial situation, the president’s approval rating on handling the pandemic had hit new lows and a little more than half the country did not think he was taking the situation seriously.But what set off debate that day was Mr. Fabrizio’s finding that more than 70 percent of voters in the states being targeted by the campaign supported mandatory mask wearing in public, at least indoors, including a majority of Republicans.Mr. Kushner, who along with Hope Hicks, another top adviser, had been trying for months to convince Mr. Trump that masks could be portrayed as the key to regaining freedom to go safely to a restaurant or a sporting event, called embracing mask-wearing a “no-brainer.”Mr. Kushner had some reason for optimism. Mr. Trump had agreed to wear one not long before for a visit to Walter Reed National Military Medical Center, after finding one he believed he looked good in: dark blue, with a presidential seal.But Mark Meadows, the White House chief of staff — backed up by other aides including Stephen Miller — said the politics for Mr. Trump would be devastating.“The base will revolt,” Mr. Meadows said, adding that he was not sure Mr. Trump could legally make it happen in any case.The president removed his mask upon arriving at the White House on Oct. 5, after being hospitalized with Covid-19. He was rarely seen wearing one again.Credit…Anna Moneymaker for The New York TimesThat was all Mr. Trump needed to hear. “I’m not doing a mask mandate,” he concluded.Aside from when he was sick, he was rarely seen in a mask again.The president had other opportunities to show leadership rather than put his political fortunes first..css-fk3g7a{font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:0.875rem;line-height:1.125rem;color:#121212 !important;}@media (min-width:740px){.css-fk3g7a{font-size:0.9375rem;line-height:1.25rem;}}.css-1sjr751{-webkit-text-decoration:none;text-decoration:none;}.css-1sjr751 a:hover{border-bottom:1px solid #dcdcdc;}.css-rqynmc{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.9375rem;line-height:1.25rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-rqynmc{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-rqynmc strong{font-weight:600;}.css-rqynmc em{font-style:italic;}.css-zs9392{margin:10px auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-zs9392{font-size:1.25rem;line-height:1.4375rem;}}#NYT_BELOW_MAIN_CONTENT_REGION .css-zs9392{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.75rem;margin-bottom:20px;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-zs9392{font-size:1.5rem;line-height:1.875rem;}}.css-121grtr{margin:0 auto 10px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:’Collapse’;}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:”;background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-qmg6q8{background-color:white;margin:1.5rem auto 1.9rem;max-width:600px;}#NYT_BELOW_MAIN_CONTENT_REGION .css-qmg6q8{padding:0;width:calc(100% – 40px);max-width:600px;margin-right:auto;margin-left:auto;}.css-qmg6q8 strong{font-weight:700;}.css-qmg6q8 em{font-style:italic;}@media (min-width:740px){.css-qmg6q8{margin:40px auto;}}.css-qmg6q8:focus{outline:1px solid #e2e2e2;}.css-qmg6q8 a{color:#326891;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ccd9e3;}.css-qmg6q8 a:visited{color:#333;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ddd;}.css-qmg6q8 a:hover{border-bottom:none;}.css-qmg6q8[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-qmg6q8[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-qmg6q8[data-truncated] .css-5gimkt:after{content:’See more’;}.css-qmg6q8[data-truncated] .css-6mllg9{opacity:1;}.css-11uwurf{border:1px solid #e2e2e2;padding:15px;border-radius:0;margin:0 auto;overflow:hidden;}@media (min-width:600px){.css-11uwurf{padding:20px;}}#NYT_BELOW_MAIN_CONTENT_REGION .css-11uwurf{border-top:1px solid #121212;border-bottom:none;}Covid-19 Vaccines ›Answers to Your Vaccine QuestionsWith 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.After he recovered from his bout with the virus, some of his top aides, including Mr. Kushner and Jason Miller, a senior campaign strategist, thought the illness offered an opportunity to demonstrate the kind of compassion and resolve about the pandemic’s toll that Mr. Trump had so far failed to show.When Mr. Trump returned from the hospital, his communications aides, with the help of Ivanka Trump, his daughter, urged him to deliver a national address in which he would say: “I had it. It was tough, it kicked my ass, but we’re going to get through it.”He refused, choosing instead to address a boisterous campaign rally for himself from the balcony of the White House overlooking the South Lawn.Mr. Trump never came around to the idea that he had a responsibility to be a role model, much less that his leadership role might require him to publicly acknowledge hard truths about the virus — or even to stop insisting that the issue was not a rampaging pandemic but too much testing.Alex M. Azar II, the health and human services secretary, briefed the president this fall on a Japanese study documenting the effectiveness of face masks, telling him: “We have the proof. They work.” But the president resisted, criticizing Mr. Kushner for pushing them and again blaming too much testing — an area Mr. Kushner had been helping to oversee — for his problems.“I’m going to lose,” Mr. Trump told Mr. Kushner during debate preparations. “And it’s going to be your fault, because of the testing.”Mr. Morgenstern, the White House spokesman, said that exchange between the president and Mr. Kushner “never happened.”Mr. Azar, who was sometimes one of the few people wearing a mask at White House events, privately bemoaned what he called a political, anti-mask culture set by Mr. Trump. At White House Christmas parties, Mr. Azar asked maskless guests to back away from him.Dr. Stephen M. Hahn, center, the commissioner of the Food and Drug Administration, Dr. Deborah L. Birx, the coordinator of the White House virus task force, and Alex M. Azar II, the secretary of health and human services, in the Oval Office in May. Conflicts on the president’s team only intensified as the year went on.Credit…Erin Schaff/The New York TimesDivisions and DisagreementsThe decision to run the government’s response out of the West Wing was made in the early days of the pandemic. The idea was to break down barriers between disparate agencies, assemble public health expertise and encourage quick and coordinated decision-making.It did not work out like that, and by fall the consequences were clear.Mr. Trump had always tolerated if not encouraged clashes among subordinates, a tendency that in this case led only to policy paralysis, confusion about who was in charge and a lack of a clear, consistent message about how to reduce the risks from the pandemic.Keeping decision-making power close to him was another Trump trait, but in this case it also elevated the myriad choices facing the administration to the presidential level, bogging the process down in infighting, raising the political stakes and encouraging aides to jockey for favor with Mr. Trump.The result at times was a systemwide failure that extended well beyond the president.“What we needed was a coordinated response that involved contributions from multiple agencies,” said Dr. Scott Gottlieb, who was commissioner of the Food and Drug Administration for the first two years of the Trump administration.“Someone needed to pull that all together early,” he said. “It wasn’t the job of the White House, either. This needed to happen closer to the agencies. That didn’t happen on testing, or on a whole lot of other things.”The relationship between Mr. Azar and Dr. Stephen M. Hahn, the commissioner of the Food and Drug Administration, grew increasingly tense; by early November, they were communicating only by text and in meetings.Dr. Birx had lost the clout she enjoyed early on in the crisis and spent much of the summer and fall on the road counseling governors and state health officials.Mr. Meadows was at odds with almost everyone as he sought to impose the president’s will on scientists and public health professionals. In conversations with top health officials, Mr. Meadows would rail against regulatory “bureaucrats” he thought were more interested in process than outcome.Some of the doctors on the task force, including Dr. Anthony S. Fauci and Dr. Robert R. Redfield, were reluctant to show up in person at the White House, worried that the disdain there for mask wearing and social distancing would leave them at risk of infection.Vice President Mike Pence was nominally in charge of the task force but was so cautious about getting crosswise with Mr. Trump as they battled for re-election that, in public at least, he became nearly invisible.The debates inside the White House increasingly revolved around Dr. Atlas, who had no formal training in infectious diseases but whose views — which Mr. Trump saw him deliver on Fox News — appealed to the president’s belief that the crisis was overblown.Dr. Scott W. Atlas, the Stanford professor of neuroradiology recruited after appearances on Fox News, became the sole doctor Mr. Trump listened to.Credit…Anna Moneymaker for The New York TimesHis arrival at 1600 Pennsylvania Avenue was itself something of a mystery. Some aides said he was discovered by Kayleigh McEnany, the White House press secretary. Others said John McEntee, the president’s personnel chief, had been Googling for a Trump-friendly doctor who would be loyal.Marc Short, Mr. Pence’s chief of staff, opposed hiring Dr. Atlas. But once the president and his team brought him in, Mr. Short insisted that Dr. Atlas have a seat at the task force table, hoping to avoid having him become yet another internal — and destructive — critic.Once inside, Dr. Atlas used the perch of a West Wing office to shape the response. During a meeting in early fall, Dr. Atlas asserted that college students were at no risk from the virus. We should let them go back to school, he said. It’s not a problem.Dr. Birx exploded. What aspect of the fact that you can be asymptomatic and still spread it do you not understand? she demanded. You might not die, but you can give it to somebody who can die from it. She was livid.“Your strategy is literally going to cost us lives,” she yelled at Dr. Atlas. She attacked Dr. Atlas’s ideas in daily emails she sent to senior officials. And she was mindful of a pact she had made with Dr. Hahn, Dr. Fauci and Dr. Redfield even before Dr. Atlas came on board: They would stick together if one of them was fired for doing what they considered the right thing.Health officials often had a hard time finding an audience in the upper reaches of the West Wing. In a mid-November task force meeting, they issued a dire warning to Mr. Meadows about the looming surge in cases set to devastate the country. Mr. Meadows demanded data to back up their claim.One outcome of the meeting was a Nov. 19 news conference on the virus’s dire threat, the first in many weeks. But while Mr. Pence, who led the briefing, often urged Americans to “do their part” to slow the spread of the virus, he never directly challenged Mr. Trump’s hesitancy on masks and social distancing. At the briefing, he said that “decision making at the local level” was key, continuing a long pattern of the administration seeking to push responsibility to the states.Mr. Azar had been cut out of key decision-making as early as February, when Mr. Pence took over the task force. Mr. Azar would complain to his associates that Mr. Pence’s staff and task force members went around him to issue orders to his subordinates.On tenterhooks about his job status, Mr. Azar found an opening that offered a kind of redemption, steering his attention through the summer and fall to Operation Warp Speed, the government’s effort to support rapid development of a vaccine, lavishing praise on Mr. Trump and crediting him for nearly every advance.Behind the scenes, Mr. Azar portrayed Dr. Hahn to the White House as a flailing manager — a complaint he also voiced about Dr. Redfield. In late September, he told the White House he was willing to fire Dr. Hahn, according to officials familiar with the offer.For their part, Dr. Hahn, Dr. Redfield, Dr. Birx and other senior health officials saw Mr. Azar as crushing the morale of the agencies he oversaw as he sought to escape blame for a worsening crisis and to strengthen his own image publicly and with the White House.Health officials on the task force several times took their complaints about Mr. Azar to Mr. Pence’s office, hoping for an intervention.Caitlin B. Oakley, a spokeswoman for Mr. Azar, said he had “always stood up for balanced, scientific, public health information and insisted that science and data drive the decisions.”Once eager to visit the White House, Dr. Hahn became disillusioned with what he saw as its efforts to politicize the work of the Food and Drug Administration, and he eventually shied away from task force meetings, fearing his statements there would leak.If there was a bureaucratic winner in this West Wing cage match, it was Dr. Atlas.He told Mr. Trump that the right way to think about the virus was how much “excess mortality” there was above what would have been expected without a pandemic.Mr. Trump seized on the idea, often telling aides that the real number of dead was no more than 10,000 people.As of Thursday, 342,577 Americans had died from the pandemic.Two coronavirus vaccines arrived at sites across the country this month. Mr. Trump was furious that a successful vaccine was not announced until after the election.Credit…Bryan Anselm for The New York TimesTrump vs. Vaccine RegulatorsIn an Oval Office meeting with senior health officials on Sept. 24, the president made explicit what he had long implied: He wanted a vaccine before the election, according to three people who witnessed his demand.Pfizer’s chief executive had been encouraging the belief that the company could deliver initial results by late October. But Mr. Trump’s aides tried in vain to make clear that they could not completely control the timing.Dr. Fauci and Dr. Hahn reminded West Wing officials that a company’s vaccine trial results were a “black box,” impossible to see until an independent monitoring board revealed them. A vaccine that did not go through the usual, rigorous government approval process would be a “Pyrrhic victory,” Mr. Azar told them. It would be a shot no one would take.Dr. Moncef Slaoui, the scientific leader of Operation Warp Speed, said the president never asked him to deliver a vaccine on a specific timetable. But he said Mr. Trump sometimes complained in meetings that “it was not going to happen before the election and it will be ‘Sleepy Joe’” who would ultimately get credit.In late October, science and regulations worked against Mr. Trump’s waning hopes for pre-Election Day good news. At the F.D.A., scientists had refined the standards for authorizing a vaccine for emergency use. And at Pfizer, executives realized that the agency was unlikely to authorize its vaccine on the basis of so few Covid-19 cases among its clinical trial volunteers.They decided to wait for more data, a delay of up to a week.When Pfizer announced on Nov. 9 — two days after Mr. Biden clinched his victory — that its vaccine was a stunning success, Mr. Trump was furious. He lashed out at the company, Dr. Hahn and the F.D.A., accusing “deep state regulators” of conspiring with Pfizer to slow approval until after the election.The president’s frustration with the pace of regulatory action would continue into December, as the F.D.A. went through a time-consuming process of evaluating Pfizer’s data and then that of a second vaccine maker, Moderna.On Dec. 11, Mr. Meadows exploded during a morning call with Dr. Hahn and Dr. Peter Marks, the agency’s top vaccine regulator. He accused Dr. Hahn of mismanagement and suggested he resign, then slammed down the phone. That night, the F.D.A. authorized the Pfizer vaccine.In the weeks that followed, Mr. Pence, Mr. Azar, Dr. Fauci and other health officials rolled up their sleeves to be vaccinated for the cameras.Mr. Trump, who after contracting Covid-19 had declared himself immune, has not announced plans to be vaccinated.Michael D. Shear More