Despite the start of vaccinations, deaths and disruptions in the United States are likely to persist for months, since virus cases have soared across the country and the vast majority of Americans will not be eligible for vaccinations until this spring or later. Credit... Wilfredo Lee/Associated Press A handful of states are getting an early start on vaccinating some of their most vulnerable citizens, beginning with West Virginia, which began inoculating residents and staff at long-term care facilities on Tuesday, nearly a week before the majority of nursing homes around the United States are scheduled to get started. “I know you’ve seen the weather report,” General Perna said, noting that the storm “could be a problem.” He continued, “My responsibility to deliver safe and effective vaccines means get ahead of that problem.” About 600 sites, many of them hospitals, were scheduled to receive the vaccine this week, nearly three million doses in all. 