The European Union approves the Moderna vaccine after criticism for being too slow. As the virus variant makes inroads in the U.S., there is no good system to track it, experts warn.

Here’s what you need to know:

• As the lagging U.S. vaccine rollout accelerates, more pharmacies will begin distributing doses to high-risk groups.
• The U.S. has no robust national program to track the new virus variant, experts warn.
• The E.U. drug regulator approves the Moderna vaccine.
• A C.D.C. analysis describes anaphylaxis after people have received the Pfizer-BioNTech vaccine as ‘rare.’
• Arizona is facing ‘dire circumstances,’ its outbreak even worse than summer’s surge.
• As New York’s sluggish vaccine distribution continues, de Blasio says ‘we want to go further.’
• The W.H.O. criticizes China for not letting its experts into the country.
• After rumors flared that Trump may be heading to Scotland on Jan. 19, the country’s leader says he will not be allowed in.

The next phase of the U.S. vaccine rollout will expand the number of pharmacies distributing coronavirus vaccines to high-risk groups.Credit…Jeenah Moon for The New York Times

As the lagging rollout of coronavirus vaccines begins to pick up its pace in its fourth week, the Trump administration this week will launch a federal program to give out vaccines at pharmacy stores to high-risk groups, including older people and frontline workers, federal health officials said at a news conference on Wednesday.

“The next big push is to bring those online and make sure the governors have those available really to hopefully expand out to much larger swathes of individuals,” said Alex M. Azar II, the secretary of health and human services.

Some states have already begun using their pharmacies to give out vaccines, mainly to health care workers and older people. The program being activated this week, which was announced in November without a time table for its launch, is a partnership with 19 pharmacy chains and associations, including Walmart, CVS, Walgreens and Costco.

States will be able to allocate doses of vaccines directly to these pharmacies, which can then give out the vaccines to high-risk groups designated by each state. Across the country, 40,000 pharmacy locations have enrolled to participate in the program, although in the first days of the program, only a few thousand pharmacies are expected to begin giving out vaccines.

Even as the vaccines have started becoming available, the virus continues to spread at an alarming pace. More than 21 million coronavirus cases and more than 357,000 virus-related deaths have been reported in the United States.

So far, most vaccines have been given out at hospitals and other health care settings, such as clinics and nursing homes. But pharmacies are increasingly entering the mix.

In Louisiana, about 100 pharmacies across the state this week will start to give doses of the Moderna vaccine to people over 70, health care workers, and patients on dialysis, Gov. John Bel Edwards announced on Monday. In Florida, seniors will be able to start making appointments on Thursday to get the Moderna vaccine at 22 Publix Supermarkets pharmacy locations across the state, Gov. Ron DeSantis announced on Tuesday.

As of Wednesday morning, nearly 17.3 million doses of vaccines from Pfizer and Moderna had been shipped out across the country. But according to data from the Centers for Disease Control and Prevention,, only 5.3 million people have received their first shots.

The rollout is beginning to accelerate: More first shots were reported given in the third week of the vaccine drive than in the first two combined, and the C.D.C.’s count increased by 470,000 between Tuesday and Wednesday. Still, the number of vaccinations is far fewer than the 20 million people that the Trump administration hoped would get their first shots by the end of 2020.

Pharmacies in the program will face the challenge of verifying that the people they give vaccines to are eligible to receive them because of their age, job or medical conditions. Mr. Azar said on Wednesday that verification is a less urgent concern than getting out doses quickly.

“We need to not be overly prescriptive in that, especially as we see governors who are leaving vaccines sitting in freezers rather than getting it out into people’s arms,” Mr. Azar said. “The perfect cannot be the enemy of the good here.”

Other vaccines nearing the final stages of development could increase the supply of vaccines and help accelerate their distribution.

Johnson & Johnson is on track to file by the end of this month for emergency authorization for its vaccine, said Moncef Slaoui, the chief scientific adviser for Operation Warp Speed, the federal effort to fast-track vaccines. That vaccine only involves a single dose, which will be easier to deliver than all the other leading vaccines, which require two shots.

Another vaccine, developed by AstraZeneca and the University of Oxford, is being tested in a late-stage trial in the United States that is nearing its final stages. It is right around its goal of recruiting 30,000 participants, though a few sites are still recruiting minority populations, Dr. Slaoui said. He said AstraZeneca could seek emergency authorization as early as the first week of March. Dr. Slaoui said last month that the AstraZeneca vaccine — which has been authorized in Britain, India, Mexico and several other countries — likely will not be available in the United States until at least April.

Dr. Slaoui confirmed on Wednesday that he will stay on as a consultant under the new Biden administration, though he suggested the role would be more limited than his current position.

— Rebecca Robbins

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With no robust system to identify genetic variations of the coronavirus, experts warn that the United States is woefully ill-equipped to track a dangerous new mutant, leaving health officials blind as they try to combat the grave threat.

The variant, which is now surging in Britain and burdening its hospitals with new cases, is rare for now in the United States. But it has the potential to explode in the next few weeks, putting new pressures on American hospitals, some of which are already near the breaking point.

The United States has no large-scale, nationwide system for checking coronavirus genomes for new mutations, including the ones carried by the new variant. About 1.4 million people test positive for the virus each week, but researchers are only doing genome sequencing — a method that can definitively spot the new variant — on fewer than 3,000 of those weekly samples. And that work is done by a patchwork of academic, state and commercial laboratories.

Scientists say that a national surveillance program would be able to determine just how widespread the new variant is and help contain emerging hot spots, extending the crucial window of time in which vulnerable people across the country could get vaccinated. That would cost several hundred million dollars or more. That may seem like a steep price tag, but it’s a tiny fraction of the $16 trillion in economic losses that the United States is estimated to have sustained because of Covid-19.

“We need some sort of leadership,” said Dr. Charles Chiu, a researcher at the University of California, San Francisco, whose team spotted some of the first California cases of the new variant. “This has to be a system that is implemented on a national level. Without that kind of dedicated support, it’s simply not going to get done.”

With such a system in place, health officials could warn the public in affected areas and institute new measures to contend with the variant — such as using better masks, contact tracing, closing schools or temporary lockdowns — and do so early, rather than waiting until a new surge flooded hospitals with the sick.

The incoming Biden administration may be open to the idea. “The president-elect supports a national testing program that can help stop the spread of Covid-19 and find variants,” said T.J. Ducklo, a spokesman for the transition. “That means more tests, increased lab capacity and genome sequencing. This is vital to control Covid-19 and to prepare the United States to detect and stop future disease threats.”