Customers line up to enter a store in downtown Tijuana, Mexico on Saturday, amid the COVID-19 pandemic. Despite the stringent restrictions, citizens are mobile with most businesses remaining open. Photo: AFP

The Pfizer-BioNTech COVID-19 vaccine is expected to reach hospitals and other sites across the US by Monday morning, a top official said Saturday, ready to be injected into the arms of millions of the most vulnerable Americans as the world's death toll approached 1.6 million.

The imminent start of the mass vaccination campaign in the world's hardest-hit country came as Italy overtook Britain as the European nation with the highest coronavirus death toll.

"I am worried about the two weeks of Christmas holidays. We are up against a dramatic pandemic which is ongoing - the battle still has not been won," Italian Health Minister Roberto Speranza told a symposium as the country recorded 64,036 deaths, surpassing Britain's 64,026.

Regional affairs minister Francesco Boccia told Italian television that unless people adopted a careful approach, "the risk of a third wave is almost certain."

As the world was shortly expected to cross the grim threshold of 1.6 million deaths, infections in the US were soaring, with 1.1 million new cases confirmed in the past five days and a death toll nearing 300,000.

Doses of the Pfizer vaccine will begin leaving the company's factory in Kalamazoo, Michigan on Sunday, stored in boxes containing dry ice that is capable of staying at -70 C, the frigid temperature needed to preserve the drug.

General Gus Perna, who is overseeing the massive logistical operation as part of the government's Operation Warp Speed, likened the moment to D-Day, the turning point of World War II.

"I am absolutely 100 percent confident that we are going to distribute safely, this precious commodity, this vaccine, needed to defeat the enemy COVID[-19]," he told reporters.

Over the past two weeks the US has repeatedly exceeded 2,000 COVID-19-related deaths per day.

Perna said hundreds of sites, including hospitals and other distribution centers, would receive the vaccines from Monday to Wednesday, which would cover the first wave of about 3 million people to be vaccinated. 

Federal health authorities have recommended that health care workers and nursing home residents be at the front of the line, but the final decisions have been left to states. 

The US is seeking to inoculate 20 million people in December alone.

The US became the sixth country to green-light the Pfizer vaccine on Friday, after the UK, Bahrain, Canada, Saudi Arabia and Mexico.

AFP