WASHINGTON (BLOOMBERG) - Hospitals are going into overdrive in the final hours before they receive the first US shipments of Pfizer Inc and BioNTech SE's Covid-19 vaccine, ensuring they are ready for the final payoff from months of planning.

"It's very exciting," Ms Fran Hixson, director of clinical quality at Chesterfield, Missouri-based Mercy Health, said in an interview on Sunday (Dec 13).

"We've learned along the way how we can protect ourselves from the virus, and adding a vaccine to our toolbox is a very exciting time for us to be moving this ahead."

Shipments started leaving Pfizer's Michigan plant early on Sunday morning, less than two days after the Food and Drug Administration authorised the vaccine for emergency use.

They are scheduled to arrive at 145 sites on Monday, 425 on Tuesday and the final 66 on Wednesday.

These 2.9 million shots will end up in the arms of healthcare workers and nursing home residents.

The vaccine's arrival comes amid a nationwide surge, with about 200,000 cases being reported every day this month, hospitalisations setting records and total deaths nearing 300,000.

Mr Jesse Breidenbach, senior executive director of pharmacy at Sioux Falls, South Dakota-based Sanford Health, exchanged celebratory text messages with colleagues when the news of the FDA's approval broke on Friday.

That night, Sanford received an e-mail from Pfizer that its order was being prepared.

Five of Sanford's 46 hospitals in the Upper Midwest will receive shipments in the coming week.

Shipments begin

Pfizer is sending its vaccine in specially made containers packed with dry ice to keep the formula at -70 degrees Celsius.

Sanford attended webinars that Pfizer hosted earlier in the week to review details for moving the vials into ultra-cold freezers, Mr Breidenbach said - training that he can't remember receiving for other vaccines.

Representatives from the Centres for Disease Control and Prevention will attend the delivery at Sanford's hospital in Bismark to ensure workers transfer the vials correctly.

Sanford is waiting for all the tracking information to get a more solid idea of when to expect its first doses, whether on Sunday, Monday, Tuesday or Wednesday.

FedEx Corp shared details for shipments to Sanford's Bismark and Fargo facilities on Sunday afternoon, saying to expect delivery by Monday afternoon.

Once the shots arrive, Sanford will start e-mailing eligible employees telling them they can start scheduling appointments.

"We want to start as soon as possible, but we don't want to complicate things by having people start before we can actually give the vaccine," Mr Breidenbach said in an interview on Sunday.

Final instructions

Mercy Health had been anxiously awaiting information from the FDA and the CDC's immunisation advisory committee detailing specific guidelines for the vaccine, Ms Hixson said.

These documents answered questions about who should receive the vaccine, including people who already had Covid-19.

The details will help hospitals perfect their plans before vaccinations begin.

Dr Mark Jarrett, chief quality officer at New Hyde Park, New York-based Northwell Health, has been working all weekend to complete training materials for those workers giving the shots.

Northwell plans to start giving shots on Monday or Tuesday, depending on when the vaccine arrives, Dr Jarrett said in an interview on Sunday.

The system has 23 hospitals in the New York City area.

"This is not a sprint, this is a marathon," Dr Jarrett said.

"Therefore, whether we deliver the first vaccine the day they arrive, depending on when they arrive, or next day I think is less critical than making sure people are giving it in a safe fashion."

Starting small

Mercy could start vaccinating a limited number of workers as soon as Monday, Ms Hixson said.

The health system wants to start small so it can identify any gaps before it starts inviting a large number of people.

In Virginia, Riverside Health System plans to conduct a test run on Monday before it starts vaccinating employees, currently scheduled for Wednesday, Ms Cindy Williams, vice-president and chief pharmacy officer, said in an interview on Saturday.

"You plan and you plan and you plan" with the expectation that tweaks will need to be made, Ms Williams said.