| Nobody said a historic U.S. vaccination campaign would be easy. The push to distribute millions of Covid-19 vaccine doses suffered its first hiccups this week. Shipments in two states had to be replaced when the vaccine got too cold, and federal officials said only 2 million doses from Pfizer and BioNTech would ship next week, down from 2.9 million this week. And in Alaska, a health-care worker with no history of allergies experienced flushing and shortness of breath 10 minutes after receiving a shot, the state health department said Wednesday. The person was admitted to the emergency room, given intravenous medication and is in stable condition after an overnight stay, according to the state health department. The episode followed reports of a handful of similar reactions in the U.K. The vaccine distribution program is still working out the kinks. Four trays of the Pfizer-BioNTech vaccine were pulled back from delivery to California and Alabama this week, according to Gustave Perna, the army general who serves as chief operations officer for Operation Warp Speed, the U.S. program to accelerate Covid drugs and vaccines.  A vial of the Pfizer-BioNTech Covid-19 vaccine. Photographer: Cole Burston/Bloomberg The vaccine must be stored at minus 94 degrees Fahrenheit: The four trays were even colder than that, and were sent back to the company, Perna said. The affected shots number 3,900. "We were taking no chances," Perna said Wednesday in a news briefing. Pfizer and federal health agencies are working to determine whether the formula can still be used when it reaches such low temperatures, he said. In a press briefing, U.S. health officials didn't explain why shipments of Pfizer's vaccine will decline next week. Operation Warp Speed has said it expects to have enough doses between Pfizer and another shot on deck from Moderna to inoculate 20 million Americans in December. Pfizer is "producing at their maximum capacity to deliver on the 100 million that is in the first tranche of the contract with us, and we're providing manufacturing support," Health and Human Services Secretary Alex Azar said in a briefing. Pfizer spokeswoman Sharon Castillo said in an email that the company hasn't experienced any production issues. Azar said that the government is talking with the company about getting more information on any challenges they're facing. It's a long road to vaccinate most of the U.S. population, so some bumps along the way can be expected.—John Tozzi and Angelica LaVito | 
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