Hospitals prepare for the first shots in America’s most ambitious vaccination campaign.

Trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine fanned out across the country on Sunday as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour. The inoculation effort, set in motion after the Food and Drug Administration’s emergency authorization of the vaccine on Friday night, comes as the U.S. coronavirus death toll approaches 300,000. Rollout of the Pfizer-BioNTech vaccine is less centralized in the United States than in other countries that are racing to distribute it.

Across the country, according to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites are set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.

New York’s first coronavirus vaccines have arrived, according to one hospital system on Monday morning, signaling a turning point in the battle against a pandemic that has profoundly scarred the state, killing more than 35,000 people and severely weakening the economy.

A majority of the first injections are expected to be given on Monday to high-risk health care workers. In many cases, this first, limited delivery would not supply nearly enough doses to inoculate all of the doctors, nurses, security guards, receptionists and other workers who risk being exposed to the virus every day. Because the vaccines can cause side effects including fevers and aches, hospitals say they will stagger vaccination schedules among workers.

Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin getting vaccinations next week. A vast majority of Americans will not be eligible for vaccinations until the spring or later.

Five of the first vaccinations will take place at what the Department of Health and Human Services is calling a national ceremonial “kickoff event,” scheduled for Monday afternoon at George Washington University Hospital.

The five people were selected with an algorithm the hospital is using to assign the first doses, the result of a survey hospital employees filled out that asked about age, underlying medical conditions and the risk they carry in their jobs, according to a federal health official familiar with the planning who was not authorized to speak publicly. The event is intended to demonstrate the way many health workers will be vaccinated this week, the official said.

The kickoff is part of what the official said will be a series of vaccination events featuring top health officials.

In Canada, the first shipments of the Pfizer-BioNTech vaccine arrived on Sunday, Prime Minister Justin Trudeau announced on Twitter. He called it an “important step in our fight against the virus.”

On the snowy plains of Fargo, N.D., Jesse Breidenbach, the senior executive director of pharmacy for Sanford Health, which operates hospitals and clinics across the Upper Midwest, refreshed his email again and again on Sunday, waiting to receive a FedEx tracking number that would confirm that some 3,400 doses were en route.

The Sanford hospital in Fargo was converting its Veterans Club into a vaccination site, and officials said they would start inoculating a first group of emergency and critical-care doctors and nurses within hours after the vaccine arrived. But when would that be?

The answer came on Sunday afternoon: Expected vaccine delivery, 10:30 a.m. Monday, with vaccinations starting early in the afternoon.

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