PITTSBURGH — Some of the very medical centers that have endured the worst of the coronavirus outbreak in the United States found the gloom that has long filled their corridors replaced by elation and hope on Monday as health care workers became the first to take part in a mass vaccination campaign aimed at ending the pandemic.

Hundreds of those who have been on the front lines of fighting Covid-19 — a nurse from an intensive care unit in New York, an emergency room doctor from Ohio, a hospital housekeeper in Iowa — received inoculations in emotional ceremonies watched by people around the country.

“I feel like healing is coming,” said Sandra Lindsay, an intensive care nurse who was among the first health care workers to be vaccinated on Monday morning, at Long Island Jewish Medical Center in Queens, an early center of the virus.

But the vaccinations came as the nation surpassed 300,000 coronavirus deaths, a toll larger than any other country. Even as applause rang out at hospitals nationwide, many intensive care units remained near capacity and public health experts warned that life would not return to normal until well into next year.

Plunking down in wooden chairs and rolling up their sleeves were physicians, nurses, aides, cleaners and at least one chief executive who said he was getting the vaccine early to encourage everyone on his staff to do the same.

Dr. Jason Smith, the first Kentuckian to receive the Covid-19 vaccine, showed off the smiley-face Band-Aid a health care worker applied to his arm. “Didn’t even feel it,” he said. A group of nuns in Sioux Falls, S.D., blessed the vaccine as it arrived, before it was whisked into a freezer.

Seth Jackson, a nurse in Iowa City, found himself crying on the way to the hospital to get his shot. Robin Mercier, a Rhode Island nurse, rejoiced in feeling one step closer to being able to kiss her grandchild.

“This is the marking of getting back to normal,” said Angela Mattingly, a housekeeper at the University of Iowa Hospital, who was fifth in line as shots were dispensed on the 12th floor.

One of those who had spent months studying the safety of the vaccine was herself vaccinated.

“This is the culmination of a lot of hard work in our clinical trials,’’ said Dr. Patricia Winokur, 61, the principal investigator of the clinical trial of the vaccine and a professor at the University of Iowa. “Our team has worked hard, and I am so proud to have been a part of it.”

Not far from the White House, five health workers at George Washington University Hospital were given shots in a small auditorium at a national ceremonial kickoff event staged by the Department of Health and Human Services. Alex M. Azar II, the health secretary, said that the vaccinations in Washington were “representative of what’s happening across America right now,” adding that he would visit other vaccination sites in the coming weeks.

The first vaccinations come at the bleakest moment of the pandemic in the United States. The country is averaging more than 2,400 deaths a day, even more than in the spring. More than twice as many deaths are being announced each day than just a month ago.

Reports of new cases and hospitalizations have also reached records in recent days. Even as infection numbers have started falling in parts of the Midwest and the Mountain West, some of the country’s largest population centers are worsening rapidly.

California recently became the first state to announce more than 30,000 cases in a day. New York is averaging nearly five times as many cases statewide as it was at the beginning of November. Pennsylvania, Ohio, Tennessee and Georgia were among 12 states that set weekly case records on Sunday.

For many Americans who have lost loved ones to Covid-19, news of the vaccination rollout was bittersweet. It did not come soon enough for Mary Smith’s husband, Mike, who died from the virus in November at the age of 64 after rapidly becoming fatigued, short of breath and feverish.

“It was so close,” Ms. Smith, who lives outside Peoria, Ill., said on Monday.

She voiced frustration with people who said they did not trust the vaccine. An Associated Press poll, released last week, found that half of Americans were ready to take a vaccine, a percentage that public health experts said could jeopardize its benefits.

“These people who say, ‘I’m not getting it,’ all I can say is, ‘Why? Have you lost your mind?’” Ms. Smith added. “Have you not seen how many people have died? This is real.’”

Ms. Lindsay, the nurse from Long Island Jewish Medical Center, who is Black, volunteered to be among the first New Yorkers to be vaccinated, saying that she wanted to encourage people skeptical of vaccines to get a shot, and particularly Black Americans, who have died from the virus at disproportionate rates.

“I’ve been waiting for this day not only for myself, but to show people it’s safe,” Ms. Lindsay, the director of critical care nursing, said. “I want people who look like me and are associated with me to know it’s safe.”

About 600 sites — many of them hospitals — were scheduled to receive the first of nearly three million doses of the vaccine this week. Some 500,000 doses were delivered on Monday to 142 of the sites around the country. The rollout, starting with high-risk health care workers and nursing home residents, is a monumental logistical challenge, and there so far is no uniform approach to publicly reporting where vaccines have been received and how many doses have been administered.

Puerto Rico’s efforts to vaccinate the public hit a logistical snag on Monday, when the government received half the expected doses and had to scramble to readjust its plan.

Several states and hospital systems announced that they had received initial shipments or started giving shots on Monday, though usually without much numerical detail. Other states provided more specifics, including Alaska, where 35,100 doses landed on a UPS plane, and Mississippi, where 25,000 doses were spread across several facilities.

But by day’s end, it was unclear exactly how many Americans had received an initial dose of the approved vaccine, made by Pfizer-BioNTech.

Another vaccine, made by the biotech company Moderna, is likely to receive emergency authorization on Friday. The shipping of six million doses to 3,285 U.S. locations would start on the weekend, officials said, with the first vaccinations taking place by next Monday.

The available supply of the Pfizer-BioNTech vaccine is not enough to inoculate all of the doctors, nurses, security guards, receptionists and other workers at risk of daily exposure to the virus, forcing hospitals to decide whom to give priority.

There was no single method. The group in Washington was selected by an algorithm based on a survey of hospital employees that asked about age and underlying medical conditions. At the University of Pittsburgh Medical Center, an advisory group devised an order that took into consideration prevention of transmission and underlying conditions, as well as the hospital’s ability to continue its own operations, said Dr. Graham Snyder, its medical director of infection prevention.

The Road to a Coronavirus Vaccine ›

Answers to Your Vaccine Questions

With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:

• • If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
  • When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
  • If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.
  • Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.
  • Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

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