Green light needed this morning in order for you to get it. Now the race is on to make it, pack it, ship it, and administer it. But tonight theres a problem we need to get out in front of in this country, and it starts with each and every one of us. Having confidence in the vaccine our government says is safe. Anyone can be forgiven for discrepant schism. The president s rhetoric has contributed to it, especially in communities that need this vaccine the most. The africanamerican community, were not trusting because we feel were the first group they want to test it on. We dont know if its going to be acceptable to everybodys body, would everybody immune system be able to take it. We dont want to be guinea pigs, test dummies, anything like that. Our Community Still carry tuskegee experiment syndrome. Not only do they not trust the Science Behind it, they dont trust the government. Heres more proof. This chart shows how black and Latin Americans say they are much less likely to get the vaccine. Nonetheless, the rollout is under way. Trucks are being packed with the lifesaving viles as we speak. They will head out tomorrow. And then from there theyre going to the east, some to the west. Our key focus tonight, how to bridge that divide in skepticism because the vaccine is worthless if not everyone takes it. Lets hash it out. Dr. Susan lopez, assistants professor at Rush University medical center. Dr. Vin gupta is a Critical Care pulmonologist and affiliate assistant professor at the institute for health and metrics and evaluation in seattle. Hes also an msnbc medical creditor. And Francis Dietz setters, Health Reporter at the washington post. Dr. Gupta, lets talk about the basics of this vaccine for a moment. The cdc just published a list of recommendations and guidelines for who can take this. Among them, it encourages pregnant women to check with their doctors, warns those with allergies to other vaccines, to avoid it altogether. I wonder when you make of the guidelines and how concerned you are about possible side effects. Good evening, alicia. This is what ill say. The data that we do have is what we should focus on. We have a pfizer phase 3 latestage trial that shows that amongst 40,000 individuals this was a broadly welltolerated vaccine. Those are two really good metrics there. There is some concern that if you had a prior very serious allergic event, technically called an anaphylactic reaction, that means you developed a skin rash, maybe shortness of breath, something along those lines, your throat swells up in really severe cases, those are exceedingly rare to foods and medicines. In that case, that needs to be a conversation with ones provider to see when and where the individual should get a vaccine. Theres going to be alternative platforms coming online, so it may not be the Pfizer Vaccine they get necessarily. Theres a lot of enthusiasm given the efficacy of this vaccine, proven efficacy. Thats why youll see a lot of clinicians messaging on this getting it. Im hoping thats going to build confidence once other people start to qualify and once we have more different types of Vaccines Available in the marketplace. Dr. Lopez, you wrote this week about how this pandemic is uniquely difficult for black doctors, for latinx doctors like yourself. What are the additional challenges that you are up against as a Health Care Provider . Well, i think in general m t most i think because we understand these communities, we also understand the history of the mistrust. Earlier there was a discussion about the tuskegee experiments, but it impose beyond that. A lot of these things things are historical. We understand in order to regain that trust, thats going to have to be to be hardearned, were going to have to partner with trusted partners within the community, communitybased organizations, houses of faith, in order to gain that trust in order to try and win people over and try and get people to take this vaccine. Dr. Lopez, i have to ask, when you were with the communities you serve, are you hearing resistance to this vaccine . I do. I do hear resistance. I have colleagues who work in the community. I specifically only work within the hospital setting. But i do hear resistance, especially concerns about whether or not someone can get the virus from this vaccine. And the reality is you cant get the virus from this vaccine. Francis, we know frontline workers, people in Nursing Homes are going to be the first in line for the vaccine. Who, then, comes next . Essential workers. This group of essential workers, which could include many people from communities of color, thats the hope. Were talking about people who drive the buses, who do serve in restaurants, do a lot of the work that needs to be done to keep the country functioning. But one of the things were hearing now is theres been this remarkable achievement to get the vaccine 10 billion investigated in this extraordinary achievement of getting it within a year. But theres a mantra in public health, and it is vaccines dont save lives, vaccination does. Thats process were entering now where theres enormous logistical challenges lying ahead and enormous challenge of persuading people, not just people in communities of color, but many people across the whole spectrum in the United States that this vaccine is what they want to take. In that context, the initial Health Care Workers who take the vaccine in the next few days are going to be acting as role model for the rest of the country to watch and potentially follow. But we need to get to 70 or more of people taking this vaccine. Have we seen anything that it 70 people have rallied around, thats the question. Fair. Dr. Gupta, to that point, you need 70 of americans to take the vaccine for it to work. You have americans who are nervous about it because of the history of racism in medical and scientific testing in this country. You have americans who are nervous about this because of the politicalization weve seen around this vaccine. How do officials and influencers combat those some very legitimate concerns and ensure americans that they can trust this vaccine . Well, alicia, a key piece here, i dont like that we have to ration vaccine supply, but one of the potential Silver Linings here, as francis said, im getting the vaccine on wednesday, as are my colleagues in icus across the country. Theres going to be a time for people to look at that, influencers at the national level, at the local level, and see them leading by example, seeing what theyre experience is, what happens after that first and second doses four years ago later. That, i hope, is going to be a confidencebuilding measure. Youre right, were not going to get to 70 right away. Its going to require that trust. But right now were looking at the same set of phase 3 trials from moderna and from pfizer. Theres only so much we can look at that data. We need to draw from experience now and from anecdotes, thats going to get us to that goal of 70 before long because people want normalcy, and this is the quickest way to normalcy. Dr. Lopez, you were the one on the front lines. What are you seeing in the hospital setting that the rest of us are not . Its a lot of adjustments with the first wave. I think we all adjusted as quickly as we could. We learned as much as we could in the first wave in terms of stopping elective procedures in order to be able to prepare to take care of those patients. We learned some lessons. Weve learned how to continue to expand the hospital as much as we can. We have what we call surge planning. But i think right now what were learning, what were experiencing is with that first wave a lot of people afraid to come to the hospital. And now the reality is that we still have our usual patients coming into the hospital. Were, of course, treating everyone that comes into the hospital, but on top of that, in addition to that, were also taking care of Covid Patients on our covid floors. So it definitely were doing the best that we can, but i think with the help of everyone in the public and the continued messaging between using masks well until vaccines can be available, are widely available, i think thats going to help us out in the long run so we dont burn out our health care system. Right, which is something weve been talking so much about. Dr. Gupta, how concerned are you that this vaccine news is going to make americans overconfident . Why snow not the time to let up on everything you and i have been talking about for months, the masking, the social distancing, the proper hygiene . Well, alicia, in the short term, vaccine is not going to get us out of our current predicament. We dont have enough vaccine quick enough to vaccinate 70 of america. So we still have the next three months ahead. Respiratory viruses likes covid like cold, dry air. It has dire predictions. Frankly, the reality is even slightly worse than what we predicted, and its not going to get better. What im seeing in Critical Care units across the country from colleagues firsthand is shortages of adequately trained staff to care for patients that need that type of service. So thats number one. Number two is, once you get the vaccine, its not like the next day you dont have to mask and socially distance. We still dont know yet if this vaccine only prevents severe illness or does it actually also prevent the transmission of the virus. We dont know that yet. Were going to know it soon, but not yet. Francis, what are the greatest concerns officials face when it comes to supply chain and Raw Materials issue with this vaccine . Yeah. Well, this is an enormously complex undertaking thats beginning right away now. Theres the process of cold storage. The Pfizer Vaccine is very finicky in how it can be handled. Theres a whole new storage facility. Many other hospitals have had to bring in, you know, individual freezers to keep this vaccine. But because its a twodose vaccine, it gets a lot more complicated. Its very important that we have these priorities. But if somebody doesnt come back for their second dose, do you wait or give the second dose as a first dose to somebody else. There has to be flexibility, and thats going play out all along. I wrote recently about the 2009 rollout of the h1n1 vaccine, which was a bit over ten years ago. And there the manufacturing slowed down. There were hitches and people lost confidence because clinics were set up and then they had to be closed down because there wasnt vaccine available. This is a far greater challenge. We would be affordable to think everything is going to align straight away. We have to have confidence that it will eventually, but there are going to be hiccups almost certainly. All right. Dr. Lopez, dr. Gupta, and francis, thank you all. Later this hour, the economic cliff. The crisis is upon us and about to get worse for families across america. Well explain why. And then theres this. Ive never seen so much loss. You know, i heard this from doctors, from nurses, from respiratory therapists that have been doing this for years that theyve never seen so much loss. How hospitals are on the brink due to a postthanksgiving covid surge. Well talk to a doctor who wants to share an Important Message with you. First to richard lui standing by with the other stories were tracking. Richard . Good day to you, alicia. Right now on msnbc, Country Music icon Charley Pride as died. The 86yearold passed due to complications from covid19. Pride made history as the first black super star. His name shines in the Country Music hall of fame. Pfizer packaging the first doses of its vaccine. The fda approved it today. They will be shipped in the morning and the first doses to americans as expected on monday. President trump lost a federal lawsuit today. It sought to force Wisconsin State Legislature to overturn the 2020 election. It comes day after the Supreme Court handed blow to the president s efforts, rejecting a lawsuit from the state of texas. More american voices right after this short break. After thk and unmatched overall value. 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[narrator] grubhub on the food you love doorbell ringing the kind of deals that make you boogie upbeat music [man] mmm mm mm. [narrator] get the food you love with perks from [crowd] grubhub [narrator] grub what you love. Covid cases in the u. S. Have officially surpassed 16 million. Deaths are inching closer and closer to 300,000. This latest surge left an average of 1 in 8 hospital icus with little or no space for patients, creating a crisis for Health Care Workers. Heres nbc. Battling a forest fire of infections, icus reaching capacity across the state. What im worried about is that we cant keep up. And in some cases you may end up denying care to people who arent likely to make it. Thats a real tough one. In austin thursday, patricia perezs family held her funeral. The 70yearold grandmother believed she was infected with covid while volunteering as a poll worker during the election. She just wanted you to get out there to vote. When you hear people say this pandemic is a hoax, what do you have to say to them . People dont take it seriously until it hits their family. Reporter this crisis is now coast to coast. Since thanksgiving, 20 states have seen covid deaths surge by more than 50 . Health experts worry with the hodgepodge of regulations state to state, theres still no uniform response to this crisis. Were in this time frame now that probably for the next 60 to 90 days were going to have more deaths per day than we had on 9 11 or at pearl harbor. Reporter in michigan six hospitals have reached capacity this week. In california, icus in ten Rural Counties have no available beds. The same is true in City Hospitals like in silicon valley. The exhausted staff at st. Joseph says its personal. I dont get to see my mom theyre scared they might get something from me. Reporter hospitals having to choose between caring for Covid Patients and those with other Serious Health conditions. Like utah mom, lori terry. In october her heart suddenly stopped. Doctors say the icu beds she needed were filled, many by Covid Patients. Her family now left heartbroken. Because she couldnt Access Medical care, she died. If one less sick person had been in the hospital that day, she would be here right now. Covid cases in the u. S. Have officially surpassed 16 million. Deaths are inching closer and closer to 300,000. We were talking about what this surge has meant for doctors and for Health Care Workers. I want to bring in dr. Cleveland gill, emergency medical physician in arizona. Doctor, thank you so much for being with us. You reportedlily were fired before for talking about the lack of icu beds in arizona. I wonder, first, how are you holding up . Im good. Theres been a lot of uncertainty here, but ive had a huge outpouring of support here in arizona, which has really been amazing. But we are in a war right now, and were not acting as such, and people are dying as a result. When you say that we are in a war, can you pull back the curtain for me, paint a picture of what it is that you were seeing at work every day . Yeah. So what were seeing is a virus that is infecting people of our state, our country. These patients are presenting to the e. R. Hypoxic, unable to breathe, theyre being put on bipap, ventilators as well. I think the other aspect thats not really being appreciated of this is that the war is being waged in the hospitals. Its not being waged on the streets. Also, you can go into the hospital to treat a patient and have that trojan horse and bring it home to your family and infect them as well. Its devastating. The hospital responded and said what happened with our firing was a misunderstanding and you were scheduled to work this weekend. Your response . Yeah, it was not a misunderstanding at all. What happened is i was on a shift. I was unable to transfer any of my icu patients out. The next da