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Hope arrived in a plain white box. It weighed 40 pounds and bore the label “heavy.”

But the mood was far from heavy early Monday morning when a FedEx truck delivered the container of 1,950 doses of the Pfizer-BioNTech coronavirus vaccine to Boston Medical Center.

“There’s this feeling of having a new tool and beginning a different phase of how we are addressing this,” said David Twitchell, chief pharmacy officer of the Boston Medical Center Health System.

Boston Medical Center was among 145 sites nationwide, including five in Massachusetts, that received the vaccine Monday, as part of a massive and expedited effort to stem the spread of a virus that has upended the lives of people across the world over the past year and killed 300,000 in the United States as of Monday.

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Brockton Hospital, Cape Cod Hospital, Falmouth Hospital, and the VA Bedford Healthcare System also received doses Monday. State health officials said that, by the end of the week, a total of 59,475 vaccine doses would be distributed to 21 hospitals. That number does not include the VA hospital.

But while health care workers are at the front of the line, most members of the public won’t have access to the vaccine for months.

Andrew Miller, a housekeeper at the VA Bedford Healthcare System, may have been the first person in Massachusetts to get the vaccination. The Bedford hospital posted a tweet saying that he was the first employee there to receive the shot, on Monday at 12:20 p.m.

A few minutes later, the hospital tweeted that Margaret Klessens, a 96-year-old World War II veteran, became the first Veterans Administration patient in the country to receive the COVID-19 vaccine.

Rhode Island also celebrated its first vaccine recipient. Dr. Christian Arbelaez, vice chair of academic affairs for emergency medicine at Rhode Island Hospital, accepted the needle in his arm before a gaggle of reporters and photographers, declaring, “I am filled with adrenaline and happiness.”

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William Senior, a pharmacy technician (left), unpacked two trays comprising the first shipment of Pfizer's COVID-19 vaccine delivered to Boston Medical Center.
William Senior, a pharmacy technician (left), unpacked two trays comprising the first shipment of Pfizer's COVID-19 vaccine delivered to Boston Medical Center. Jessica Rinaldi/Globe Staff

Rhode Island Hospital was able to launch its vaccination effort within hours of receiving its doses because it had helped Pfizer with planning for the logistical challenges.

Most hospitals in Massachusetts plan to start administering the shots Wednesday or later this week. But Tufts Medical Center announced that its first five doses would be administered Tuesday afternoon.

The Pfizer vaccine is the first authorized for use against COVID-19, but Cambridge-based Moderna Inc. is seeking emergency authorization this week for its vaccine candidate, and others are in the pipeline.

In accordance with guidance from the federal government and a state advisory panel, hospitals will give priority to the thousands of health care workers at greatest risk of exposure to the coronavirus. That includes doctors, nurses, respiratory therapists, social workers, as well as workers in dietary, transport, and environmental services — anyone who comes near COVID-19 patients.

Health care workers will not be required to take the vaccine, but hospital officials are optimistic that the majority will step forward to receive them.

“Since we’ve been on the front lines for nine months, we see how devastating this illness is,” said Katie Murphy, president of the Massachusetts Nurses Association. “When we go to work, we could be putting our lives in danger and the lives of our families and [those of our] communities. Remember, when we walk out of the hospital, we walk into your neighborhood.”

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Murphy, an intensive care unit nurse at Brigham and Women’s Hospital, said that over 90 percent of the roughly 23,000 nurses and health care workers in the union typically get a seasonal flu shot each year, and she expects even more will take a COVID-19 vaccine.

Still, she acknowledged that some nurses are concerned about the breathtaking speed with which the vaccine was approved, and others worry because two British health care workers had severe allergic reactions after taking the Pfizer vaccine. Both were said to be recovering well.

Federal health officials said Monday at an online press briefing that they expect 20 million Americans to receive the first dose of the Pfizer vaccine by the end of December and 100 million will be fully immunized by the end of March. To be fully effective, the Pfizer vaccine requires two doses three weeks apart.

An additional 30 million people could get their first dose of the Pfizer or Moderna vaccines in January, officials said.

With the Pfizer vaccine, and others nearing approval, “we feel confident we’ll have enough vaccine doses to immunize the US population,” said Dr. Moncef Slaoui, chief adviser to Operation Warp Speed, the White House group overseeing vaccine development and distribution.

Richard Guarino (center) is accompanied by Victor Ruiz (left) as they deliver the first shipment of Pfizer's COVID-19 vaccine to the pharmacy at Boston Medical Center.
Richard Guarino (center) is accompanied by Victor Ruiz (left) as they deliver the first shipment of Pfizer's COVID-19 vaccine to the pharmacy at Boston Medical Center. Jessica Rinaldi/Globe Staff

Army General Gustave F. Perna, chief operating officer of Operation Warp Speed, said officials are prepared to face obstacles ranging from bad weather to accidents to computer glitches but foresee “a constant flow of available vaccine” to hospitals, long-term-care facilities, and other injection sites across the country in the coming weeks.

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At Boston Medical Center, about 3,000 of the hospital’s 12,000 employees qualify for the first round of vaccines because they have frequent contact with COVID-19 patients, Twitchell said, and more doses are expected next week. Their names will be randomly listed and they will receive e-mails in groups of 300 asking them to schedule an appointment, he said.

Participants will be scheduled to ensure social distancing and to leave time for the 15-minute observation period after the shot, he said.

An additional 3,000 Boston Medical Center employees who have less-frequent contact with COVID-19 patients are next on the priority list. Twitchell said the hospital hopes to vaccinate all 6,000 people who have contact with COVID-19 patients within the next two months and eventually reach all its employees. Then it will start offering the vaccine to the public.

Mass General Brigham is anticipating the arrival of the first shipment of vaccine on Tuesday. “We are receiving shipments of vaccine as a system and will distribute among our 12 hospitals,” said spokesman Rich Copp. Employees in the first wave will be asked to schedule their own appointments online.

South Shore Hospital in Weymouth expects to receive a shipment of 1,950 vials on Tuesday and plans to vaccinate 520 employees a day, starting Wednesday. That initial shipment will cover most of the hospital employees who are eligible for the first phase of vaccinations, said Dr. Allen Smith, chief executive of South Shore. This includes doctors and nurses as well as non-clinical hospital staff who have exposure to COVID patients.

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“It really is a staff preservation strategy,” Smith said.

Some employees have questions about the vaccine’s side effects and will not take it as soon as they are eligible, he added, “but they may be willing to do it day two, day three, day four, after they see the first folks did fine.”

At Beth Israel Lahey Health, a team has been working “at breakneck speed” to prepare for the vaccine’s arrival, including developing communication materials for staff members considering the vaccine, said Dr. Richard Nesto, chief medical officer and incident commander for the COVID-19 response. He expects to receive doses Tuesday to distribute among the system’s 13 hospitals, to be administered to an estimated 4,000 people who work in “high-risk COVID environments,” such as the emergency department.

“This is a massive campaign for what will hopefully be a once-in-a-lifetime event,” Nesto said. “It’s a remarkable show of human force to do this on short notice.”

Robert Weisman, Priyanka Dayal McCluskey, Jonathan Saltzman, Deanna Pan, John R. Ellement, and Travis Andersen of the Globe staff contributed to this report.





Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.