Health and Human Services Secretary Alex Azar said that the first coronavirus vaccinations outside a clinical trial could begin as early as Monday.

Azar’s announcement follows a key Food and Drug Administration panel’s vote of confidence Thursday for Pfizer’s coronavirus vaccine, clearing the way for the agency to issue an emergency use authorization.

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The FDA said authorization would be announced later Friday, and that it was communicating with the Centers for Disease Control and Prevention and Operation Warp Speed to ensure the most efficient distribution possible.

“We should be seeing the authorization of this first vaccine … in the next couple days,” Azar said on ABC’s “Good Morning America.”

NEW: HHS Azar says FDA will proceed with emergency use authorization for Pfizer-BioNTech COVID-19 coronavirus vaccine and vaccinations could come as soon as Monday or Tuesday of next week. https://t.co/v1dsjMAvCK pic.twitter.com/48CGRJRTVs

— Good Morning America (@GMA) December 11, 2020

“We will work with Pfizer to get that shipped out and so we could see people getting vaccinated Monday, Tuesday of next week,” Azar said.

Public health officials have said that up to 20 million Americans could be vaccinated before 2021, which Azar echoed Friday.

“We’re looking at 20 million Americans being vaccinated in the next couple weeks. Up to 50 million total by the end of January,” Azar said. “We believe we could have 100 million actual vaccinations in arm by the end of February.”

HHS Sec. Azar tells @GStephanopoulos, “We’re looking at 20 million Americans being vaccinated just in the next coming weeks. Up to 50 million total by the end of January…” https://t.co/v1dsjMAvCK pic.twitter.com/xPsZZC9rjP

— Good Morning America (@GMA) December 11, 2020

Though vaccinations may begin distribution only hours after the FDA grants emergency authorization, the first batches will go to front-line health care workers and long-term nursing home residents. Azar said Tuesday that the vaccine will be widely available by the second quarter of 2021.

Despite the vaccine announcements, public health officials have warned Americans that the coming months will likely be very challenging. CDC Director Robert Redfield said last week that “December, January, and February are going to be tough times” due to the surge in coronavirus cases, hospitalizations, and deaths.

“I actually believe they’re going to be the most difficult time in the public health history of this nation, largely because of the stress that’s going to be put on our health care system,” Redfield said.

The coronavirus has infected over 15.5 million Americans and killed over 292,000, according to a Johns Hopkins University database. Wednesday was the deadliest day of the pandemic so far, with 3,157 deaths reported.

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