Pace of U.S. Vaccinations Accelerates

Credit…James Estrin/The New York Times

President Biden’s call for every adult American to be eligible for a coronavirus vaccine by May 1 comes at a time when doses are being administered at an accelerated pace.

In the past month alone, the rate of vaccinations has ramped up about 40 percent, to an average of 2.3 million shots a day as of Friday, up from an average of about 1.7 million shots a day on Feb. 12, according to a New York Times database.

The increased pace of inoculations comes as vaccine production has ramped up. Mr. Biden’s team has made key decisions that quickened the manufacturing and distribution, though some of that success is owed to the Trump administration which had a vaccine production effort in place when Mr. Biden assumed office.

But now that the vaccine supply is getting closer to meeting the demand of the eligible, the country faces the challenge of getting all those shots into arms, an operation that requires not only enough doses, but also improving access to communities of color, as well as space, manpower and messaging to convince Americans wary for a variety of reasons that getting vaccinated is safe and effective.

Already, mass vaccination sites are opening and expanding across the country, and some places are extending the hours that shots are available. The White House on Friday announced that another vaccination site run by the Federal Emergency Management Agency would open at a football stadium in Detroit that will be able to administer 6,000 shots a day.

More and more states have also been expanding the criteria for people now eligible to sign up for vaccines as well.

Since the vaccination campaign began in December, 101 million doses have been administered across the country, according to the Centers for Disease Control and Prevention. The number of shots had been gradually increasing, and since Jan. 20, more than 84 million doses that have been administered as of Thursday. The president initially set a goal of 100 million shots in his first 100 days in office and, later, said he was aiming for an average of 1.5 million shots per day. At the current pace of 2.3 million shots a day, the country would surpass the point of 100 million shots during his administration in about a week.

In mid-February, Mr. Biden said there should be enough vaccine supply available to any adult in the country by the end of July. By early March, he said that timeline moved up to the end of May. Mr. Biden also recently announced that his administration would secure an additional 100 million doses of the Johnson & Johnson single-shot vaccine by the end of this year, a boost that could eventually make the vaccines available to children. The additional doses could also be used for booster shots, if necessary.

Getting the country vaccinated has become a race against time, with new variants emerging around the country and state leaders becoming antsy to ease restrictions as the weather gets warmer. Mr. Biden’s health team has warned that now is not the time to lift restrictions, especially leaving in place mask mandates that have been shown to successfully stem the spread of infections.

“We need everyone to keep washing their hands, stay socially distanced, and keep wearing the mask as recommended by the C.D.C.,” Mr. Biden said during a national address on Thursday. “Because even if we devote every resource we have, beating this virus and getting back to normal depends on national unity.”

Amy Schoenfeld Walker and Noah Weiland contributed reporting.

President Biden and Vice President Kamala Harris met virtually with Prime Minister Narendra Modi of India, Prime Minister Scott Morrison of Australia, and Prime Minister Yoshihide Suga of Japan at the White House on Friday.
Credit…Doug Mills/The New York Times

The Biden administration, under intense pressure to donate excess coronavirus vaccines to needy nations, is moving to address the global shortage in another way: by partnering with Japan, India and Australia to finance a dramatic expansion of the vaccine manufacturing capacity.

The agreement was announced Friday at the Quad Summit, a virtual meeting between the heads of state of those four countries, which President Biden and Vice President Kamala Harris attended Friday morning. The goal, senior administration officials said, is to address an acute vaccine shortage in Southeast Asia, which in turn will boost worldwide supply

The United States has fallen far behind China, Russia and India in the race to marshal coronavirus vaccines as an instrument of diplomacy. At the same time, Mr. Biden is facing accusations of “vaccine hoarding” from global health advocates who want his administration to channel supplies to needy nations that are desperate for access.

Insisting that Americans come first, the president has so far refused to make any concrete commitments to give away American-made vaccines.




W.H.O. Grants Johnson & Johnson Vaccine Emergency Authorization

The World Health Organization’s approval on Friday makes Johnson & Johnson’s single-shot Covid-19 vaccine eligible for distribution by Covax, an initiative providing vaccines to low- and middle-income countries.

W.H.O. gave emergency-use listing to Johnson & Johnson’s Covid-19 vaccine, making it the fourth vaccine to receive W.H.O.’s approval. Emergency-use listing is the green light for a vaccine to be procured and rolled out by Covax. As you know, the J&J vaccine is the first to be listed as a single-dose regime. W.H.O. will convene its strategic advisory group on immunization experts next week to formulate recommendations on the use of this vaccine. We hope that this new vaccine will help to narrow vaccine inequalities, and not deepen them. The Covax facility has booked 500 million doses of the J&J vaccine, and we look forward to receiving them as soon as possible.

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The World Health Organization’s approval on Friday makes Johnson & Johnson’s single-shot Covid-19 vaccine eligible for distribution by Covax, an initiative providing vaccines to low- and middle-income countries.CreditCredit…Damian Dovarganes/Associated Press

The World Health Organization granted emergency authorization on Friday to Johnson & Johnson’s Covid-19 vaccine, adding the first one-dose option to the W.H.O.’s global arsenal against the pandemic.

The designation makes the vaccine eligible for distribution through Covax, a global initiative to ensure that low- and middle-income countries have access to vaccines. Many of those countries have barely begun their vaccination campaigns.

The Johnson & Johnson vaccine has advantages for countries in that program. Besides providing powerful protection against severe Covid-19 and death with a single shot, the vaccine can be stored for three months at refrigerator temperatures. This makes it well-suited for use in countries and locations that may not have access to the freezers and ultra-cold storage required by some other vaccines.

“As new vaccines become available, we must ensure they become part of the global solution and not another reason some countries and people are left further behind,” Dr. Tedros Adhanom Ghebreyesus, the director general of the W.H.O., said in a briefing on Friday. “We hope that this new vaccine will help to narrow vaccine inequalities and not deepen them.”

The W.H.O. will convene an advisory group next week to develop formal guidelines for the vaccine’s use.

Covax has reserved 500 million doses of the vaccine, but Johnson & Johnson has been working through production problems and has contracts to provide the United States with 200 million doses. A new production partnership with a rival pharmaceutical giant, Merck, is expected to help speed up the manufacturing process.

“We’re hoping by at least July that we have access to doses that we can be rolling out, if not even earlier,” said Dr. Bruce Aylward, a senior adviser to the W.H.O., at the Friday briefing.

The kitchen of a restaurant in Dallas on Saturday. Only about a third of states have opened vaccine eligibility to restaurant workers. 
Credit…Cooper Neill for The New York Times

More and more of the United States has relaxed restrictions on indoor dining, but the number of states allowing workers in the restaurant industry to get a Covid-19 vaccine has been slow to rise.

Almost every state is vaccinating some subset of essential workers, following a recommendation by a committee of the Centers for Disease Control and Prevention, but the rollout of the vaccine to workers in the restaurant industry has been inconsistent.

Only about a third of states — at least 17 — have allowed some restaurant workers to get shots, according to a New York Times survey, though some workers are only eligible in certain counties. In comparison, at least 26 states and Washington, D.C., have begun allowing grocery store workers to be vaccinated.

Eligible only in some counties

Eligible only in some counties

Eligible only in some counties

The pressure to return the country to normal life has been mounting. States like Texas this week allowed all businesses to fully open, and places like New York City and New Jersey announced a loosening of indoor dining limits. How soon states give shots to restaurant workers has become an urgent question for workers in an industry that has been hit particularly hard by the pandemic.

Gov. Andrew M. Cuomo of New York signed a bill on Friday that grants employees time off to receive a Covid-19 vaccine. The bill, which also went into effect on Friday, allows for up to four hours of leave per injection.

“This legislation will allow both public and private employees to take time off to get vaccinated without exhausting the leave they have earned, putting us one step closer to getting every single New Yorker vaccinated and defeating this virus once and for all,” Mr. Cuomo said in a statement.

Restaurant workers in Michigan, who are only eligible for the vaccine in some counties, have urged the state to allow them to get shots, arguing that the pandemic had “decimated” the industry and that vaccinating them would prevent further job loss.

“There is no more important step the governor can take to get Michigan’s economy back on track,” Justin Winslow, president of the Michigan Restaurant and Lodging Association, said in a statement.

A bartender in Austin, Texas, Jeannette Gregor, said in a phone interview that she and her coworkers responded with “anger, frustration and fear” after Gov. Greg Abbott lifted all limits on indoor dining along with other coronavirus restrictions on Wednesday. Texas has not made restaurant workers eligible for shots.

Ms. Gregor said she has helped organize rallies in support of prioritizing restaurant workers for the vaccines with advocacy groups like the Restaurant Organizing Project.

“It cannot be stressed how urgent it is,” the group said in a petition. “These vaccinations can no longer wait.”

Isabella Grullón Paz contributed to reporting.

A vaccination in Benton Harbor, Mich., on Tuesday. Gov. Gretchen Whitmer is opening up eligibility for the vaccine to all residents of the state over the age of 16.
Credit…Don Campbell/The Herald-Palladium, via Associated Press

Michigan is expanding vaccine eligibility to everyone age 50 and over as of March 22 and adding everyone 16 and over as of April 5, Gov. Gretchen Whitmer said Friday. The announcement came a day after President Biden’s prime-time address, in which he directed states to expand eligibility to all adults by May 1.

“Nearly 1 million Michiganders of all races have already been safely vaccinated,” Ms. Whitmer, a Democrat, said in a statement. “I urge all eligible Michiganders to get one of the three Covid-19 vaccines.”

Currently, everyone in Michigan 65 and older is eligible for vaccination, as are people over 50 who have health conditions that would increase their risk of serious complications from Covid-19, including obesity, hypertension or diabetes. On March 22, all adults with such health conditions will also be eligible.

According to a New York Times database, 19 percent of Michiganders have received at least one dose of vaccine and 11 percent have been fully vaccinated, putting the state’s pace roughly at the U.S. average.

Earlier this week, Alaska became the first state to open eligibility to everyone 16 or older, and Gov. Spencer Cox of Utah announced that all adults would be eligible for the vaccine there on April 1.

In a news briefing on Friday, Gov. Jared Polis of Colorado said he expects that all adults would be eligible in his state by mid-April, though he did not set a specific date.

“Last night President Biden directed that all Americans should be able to receive the vaccine by May 1,” Mr. Polis said in making the announcement. “In Colorado we always aim to do better. We’re very competitive.”

Mr. Polis said that as of next Friday, when vaccine eligibility will be expanded to include people 50 and over as well as essential workers in a variety of occupations, about half of Coloradans would be able to get the vaccine.

A number of other states, including Texas and New York, have announced expansions of eligibility to new categories this week.

In Connecticut, the state had already planned to allow people aged 16 and older to get a vaccination appointment starting May 3.

Gov. Jay Inslee of Washington spoke with a pre-K teacher in her classroom at Phantom Lake Elementary School in Bellevue last week.
Credit…Pool photo by Ellen M. Banner

SEATTLE — Gov. Jay Inslee of Washington on Friday said that he would order the state’s schools to reopen classrooms for students of all ages in April, pressing for action at a time when school leaders in Seattle have struggled to agree on a plan for returning.

Mr. Inslee is the latest in a series of state leaders around the country, both Democratic and Republican, who have mandated reopening plans as some districts, particularly in large cities, have struggled to bring back students a year into the pandemic.

On Friday, Gov. Kate Brown of Oregon followed through on her proposal, announced earlier this month, to issue an executive order that would begin bringing more students back by April 19. In Arizona, Gov. Doug Ducey said earlier this month that all schools must return to in-person learning by Monday or after their spring breaks. Governors in Massachusetts, Maryland and elsewhere have taken similar action.

In some parts of the country, students have been in classrooms at least part time for much of the school year, and about three-quarters of K-12 students around the United States are now attending schools that offer some level of in-person instruction. Other districts, including the Los Angeles Unified School District — the nation’s second-largest school system — have announced plans to reopen in the coming weeks.

But in some areas, including Seattle, agreements between officials and educators have been elusive. The city’s teachers’ union and its school district were locked in discussions focused on how to bring back students in kindergarten and first grade.

Union leaders, citing health and safety concerns for workers, had voted last week to continue teaching remotely, but negotiations produced a plan to bring back preschool and special education students later this month. In a statement on Friday, the Washington Education Association, the state teachers’ union, said that while most school districts in the state are already providing in-person instruction, others “are not yet prepared to safely welcome students back to buildings.” The union didn’t say whether it would challenge Mr. Inslee’s order.

Governor Inslee’s announcement — which requires that a mix of in-person and online classes be provided to younger students by April 5 and high school students by April 19 — came roughly one year after he issued a statewide school-closure order as the Seattle area dealt with an early outbreak of the virus. Schools in much of the state have since reopened for in-person instruction.

“We are doing this because we have experienced a mental-health crisis for many of our children,” the governor said. “This will provide them an option that suits the needs of their families.”

Following the direction of federal officials, Washington State began allowing all teachers to get vaccinated earlier this month. The Centers for Disease Control and Prevention has said that many schools can at least be partly reopened even before all staff members are vaccinated.

New C.D.C. guidelines de-emphasize the role that surfaces play in the transmission of the virus, stressing instead the need for aggressive air ventilation to curb the spread.
Credit…Kirsten Luce for The New York Times

Federal health officials on Friday urged child care providers to get vaccinated against Covid-19 and to implement measures to curb its spread: separating children into small groups who don’t mix, staggering caregiving schedules, and bringing in as much fresh air as possible to dilute the airborne pathogen floating indoors.

The new guidance marks the first time since July that the Centers for Disease Control and Prevention has updated recommendations for child care programs during the pandemic, said Dr. Greta Massetti, a senior scientist at the agency and lead of its community interventions task force.

The new guidelines de-emphasize the role that fomites, or surfaces, play in the transmission of the virus, stressing instead the need for aggressive air ventilation to curb the spread. Strategies to improve air flow include opening doors and windows if safe to do so, using child-safe fans and exhaust fans, and working with local professionals to maximize air ventilation, the agency said.

Ventilation systems should be serviced regularly, and filters should be updated and meet requirements. Systems should be set so they do not recirculate indoor air and instead bring in as much outdoor air as possible.

Portable high-efficiency particulate air (or HEPA) cleaners may also help slow the coronavirus, by trapping particles that people exhale when they’re talking, singing, coughing or sneezing.

“Air exchange is the name of the game,” Dr. Massetti said. “There are ways to set the system to bring in as much outdoor air as the system will safely allow, and setting it so it doesn’t recirculate air.”

Windows should be kept open on school buses, as well: “Just cracking a window open is going to help a lot,” she said.

Young children in child care centers should be split into small groups, or cohorts, who don’t mix, in order to minimize the potential for transmission, Dr. Massetti said. Drop-off and pick-up times, meal schedules and use of common play areas should be staggered to avoid congestion and crowding.

Child care providers cannot maintain distance from young children, who often need to be held, changed or comforted, the C.D.C. acknowledged. But providers should take certain precautions: They must wear masks, as should children aged 2 and older, and should wash hands frequently, especially after feeding or changing a child.

Providers may use clear masks if they are working with children with special needs, such as those who are hearing-impaired or who use lip-reading to communicate.

“In a child care setting, you can’t do physical distancing — they’re so young,” Dr. Massetti said. “You can’t diaper a child from six feet away, and keeping them away from each other as well is more difficult.”

“We encourage child care providers to wash their hands frequently, and if they’re touching a child’s bodily fluids, they may want to wash their hands and neck, avoid touching their eyes, avoid touching their face while they hold a child,” Dr. Massetti said.

When child care centers have used small groups and kept them apart, she said, “they can keep the spread quite low.”

“We know that nurturing healthy child care is really important, and we want to encourage those types of interactions, but also give providers the information they need to make sure they’re minimizing spread,” Dr. Massetti said. “Good hygiene and respiratory etiquette is really important.”

Virginia, the last team to win the men’s college basketball championship, pulled off a thrilling victory over Syracuse on Thursday, and then withdrew from the conference tournament on Friday because of coronavirus cases.
Credit…Gerry Broome/Associated Press

Two of college basketball’s marquee teams, Kansas and Virginia, withdrew from their conference tournaments on Friday because of coronavirus cases, imperiling their prospects to contend for a national championship in a season defined — and routinely complicated — by the pandemic.

The hasty exits, one day after Duke and North Carolina A&T pulled out of conference tournaments, deepened the sense that the sport’s greatest disruptions this March will arise not from thrilling upsets on the court during the N.C.A.A. tournament, but from coronavirus testing and contact tracing.

“We went from an exhilarating game-winning shot to beat Syracuse to a gut punch,” Virginia’s coach, Tony Bennett, said Friday.

Indeed, the events of the day emphasized that some of college basketball’s most celebrated programs have only so much control over their title ambitions this postseason, their title quests at the mercy of medical protocols.

The N.C.A.A.’s sprawling men’s championship competition is, even in the most orderly years, difficult to assemble. Although 31 teams will automatically qualify through their conferences, a selection committee will pick most of the 68-team field. This season, outbreaks, quarantines and truncated schedules have created new challenges for the panel and complications for the N.C.A.A. that could easily persist once the national tournament begins in Indiana next week.

But college basketball must first lurch to the tournament’s starting line. Two days before Sunday’s bracket announcement — one of the most important events on the sport’s calendar — no one could say with any certainty who might actually wind up playing. The bracket itself will, at best, be tentative until Tuesday evening.

A crucial deadline for Kansas and Virginia will come late Saturday night, when teams up for at-large bids must notify the N.C.A.A. if they will “be unable to meet the medical protocols and participate” in their first potential games.

President Biden’s promise of a return to a semblance of normalcy by the Fourth of July depends on the American public continuing to wear masks, maintain social distancing rules and getting vaccinated.
Credit…Doug Mills/The New York Times

Having used a national address Thursday night to offer Americans hope — and the tantalizing promise of a Fourth of July with friends and family — President Biden now faces a pair of logistical challenges that may shape the arc of his presidency.

First, he must use the power of the government he leads to administer the coronavirus vaccine to most of the country in less than four months. To do that, he will have to press the limits of a public health system that has not faced a pandemic of this magnitude in more than a century.

At the same time, Mr. Biden needs to ensure that his $1.9 trillion American Rescue Plan delivers on the promise of its name — to bolster the economy, provide emergency cash for the unemployed, enable students to return to classrooms and restart the businesses that will allow people to return to work.

If he can do both, the president will most likely be rewarded by a weary public that is eager to cast off the heavy burdens that the pandemic has placed on their lives. In his speech, the president was explicit about his belief that his administration would meet those challenges.

“It’s never, ever a good bet to bet against the American people,” he said as he concluded. “America is coming back.”

But Mr. Biden’s speech was a risky moment for a new president who faces real challenges ahead, any of which could undermine the public’s confidence in his ability to govern and create openings for Republicans.

His promise of a return to a semblance of normalcy by the Fourth of July depends, as he made clear during the speech, on the American public continuing to follow the rules: wearing masks, maintaining social distancing rules and getting the vaccine when it is available to them.

But there is already evidence that it may not be that easy. The recent decision by Gov. Greg Abbott of Texas to abandon the state’s mask mandate was just the latest example of how deeply torn the country remains over following onerous restrictions. The more states that follow Texas’ lead, the harder it will be for Mr. Biden to make good on his promise.

Despite the president urging Americans to get vaccinated, a portion of the public remains deeply suspicious about the vaccines. Even if Mr. Biden can make doses available to every adult American by the end of May, as he has promised, he may still fall short if too many people refuse it.

The president has also in effect taken responsibility for ensuring that the vaccine makers can deliver the hundreds of millions of doses they have promised on tight time frames, avoiding more of the glitches and missed deadlines that slowed the early portions of the rollout.

In his speech, the president practically begged Americans not to be afraid of vaccines that have already been given to millions of people around the country. “Talk to your family, friend, your neighbor,” he implored. “We need everyone to get vaccinated.”

“Because even if we devote every resource we have,” he added, “beating this virus and getting back to normal depends on national unity.”

Finally, Mr. Biden faces a political challenge that could undercut his efforts to make people feel like the economy is working again.

Mr. Biden pushed the American Rescue Plan through Congress with not a single Republican vote. That gives his adversaries little reason to hope for its success and ample motivation to publicize its failures.

The White House has said it will mount an all-out public relations campaign over the next several weeks aimed at making sure that the American public understands what the legislation will do for them: direct payments, unemployment benefits, extra money to care for children and help for schools, businesses and local governments.

The stimulus package encompasses a complex array of programs that will have to be enacted quickly across a host of government agencies. The White House is eager to avoid the kinds of breakdowns that plagued the small business assistance program last year, when crashing computer systems and opaque rules created logjams and inequities that marred the program’s initial stages.

Jen Psaki, the White House press secretary, said Thursday that people could begin seeing deposits in their checking accounts as soon as this weekend.

But administration officials have quietly acknowledged that some of the money in the American Rescue Plan will not be spent for months or even longer. And they have indicated a desire to find someone to oversee the vast effort — a clear sign they recognize the danger if they stumble amid a need to move quickly

The most important question for Mr. Biden may be: Will Americans be patient?

A healthcare worker checking a man's blood pressure in a mountain village in Bulgaria last month before giving him a dose of AstraZeneca’s Covid-19 vaccine. Bulgaria has joined four other countries in halting use of the vaccine while regulators examine reports of blood clots in some recipients. 
Credit…Nikolay Doychinov/Agence France-Presse — Getty Images

Countries continued to shy away from using the AstraZeneca vaccine on Friday, a day after Demark, Norway and Iceland said they would halt its use while European drug regulators examine the possibility of a link to blood-clotting issues. The moves come despite continued support for the vaccine from global health authorities.

Bulgaria joined those countries on Friday, saying it would temporarily suspend inoculations with the AstraZeneca vaccine after the death of a woman a day after she received a shot. And Thailand delayed its rollout of the vaccine, which was to begin Friday.

Both countries said they were acting out of an abundance of caution, and Bulgaria said an autopsy of the woman did not find any traces of blood clots.

Margaret Harris, a W.H.O. spokeswoman, said at a briefing on Friday that AstraZeneca was an “excellent vaccine,” Reuters reported, and that no causal relationship had been shown between the vaccine and reports of blood coagulation. Health officials worry the suspensions will cause more hesitancy about taking vaccines, a crucial tool in combating the pandemic.

Italy and Romania also paused shots on Thursday, but only from a single batch of the vaccine that Italy is investigating. That batch is different from the one that set off alarms in Denmark and several other countries starting last weekend.

Bulgaria — which is experiencing a third wave of the virus — ordered the temporary suspension on Friday after the death of the woman, who was 57, the country’s health minister, Kostadin Angelov, told reporters. There is no indication that the death is related to the vaccination, but the health authorities are investigating.

Mr. Angelov said the woman had several pre-existing conditions, including a history of heart disease.

“I do not expect to find any correlation even in this case” between the death and vaccine, Mr. Angelov said. “However, having the people’s health and well-being in mind, we decided to take action as a precaution.”

The move could further hinder Bulgaria’s efforts in a vaccination campaign that has been marred by a slow rollout and vaccine hesitancy. The country relies heavily on the AstraZeneca vaccine, and has ordered 4.5 million doses.

In an effort to speed up its inoculation campaign, Bulgaria introduced a walk-in vaccination program last month under which anyone wanting to be inoculated would receive an AstraZeneca shot. Since then, those “green corridors” have been switched on and off amid a shortage of doses.

Thailand’s announcement came hours before Prime Minister Prayuth Chan-ocha was scheduled to be the first person in the country to be inoculated with a shot of AstraZeneca, and the move does not affect Thailand’s rollout of the Sinovac vaccine.

Dr. Yong Poovorawan, a virologist at Chulalongkorn University in Thailand, told reporters that the country’s delay would probably last a week or two. “We’re not saying the vaccine is bad,” he said of the AstraZeneca vaccine. “We’re postponing it to see if the deaths are related to the vaccine or not.”

Testing of the AstraZeneca vaccine in Oxford, England, in November.
Credit…Andrew Testa for The New York Times

The AstraZeneca Covid-19 vaccine has been authorized for use in more than 70 countries, but the United States is not yet one of them. And as American officials wait for results from the company’s U.S. trial and then emergency clearance, tens of millions of doses sit idly in American manufacturing facilities — even as other countries beg for access.

The doses’ fate is the subject of an intense debate among White House and federal health officials. Some argue that the administration should let them go abroad where they are desperately needed, while others are not ready to relinquish them.

AstraZeneca, a British-Swedish company, is involved in those conversations.

In a prime-time speech to the nation on Thursday, President Biden said the government had made major gains in securing vaccines for the United States. By the end of May, he said, there will be enough for all adults in the country, and promised that by May 1 every adult will be eligible for one.

But other countries are grappling with serious supply issues, and a shortfall in the supply of the AstraZeneca vaccine has fueled tensions with European officials.

AstraZeneca has asked the Biden administration to let it send the American doses to the European Union. The administration, for now, has denied the request, one official said.

The company’s Covid-19 vaccine has meanwhile hit some headwinds this week after health authorities in three European countries suspended its use as a precaution while European drug regulators investigate the possibility that it might increase the risk of blood clots. The countries — Denmark, Iceland and Norway — emphasized that there was no evidence of any causal link. Bulgaria and Thailand suspended use of the vaccine on Friday.

Denmark acted after a 60-year-old woman who received a shot developed a blood clot and died. Several other European countries had stopped using doses from the same vaccine batch after some reports of severe blood clots, and European drug regulators are investigating.

Public health experts expect medical conditions to turn up by chance in some people after receiving any vaccine. In the vast majority of cases, such illnesses have nothing to do with the shots. Most other countries where the AstraZeneca vaccine has been given to many millions of people have not reported similar red flags.

The Biden administration’s hesitation in letting go of the vaccine doses is at least partly related to uncertainties with supply before a benchmark of late May laid down by the president. Vaccine production is notoriously complex and delicate, and problems like mold growth can interrupt a plant’s progress.

The administration’s moves to order more supply of the three vaccines authorized by the F.D.A. has further sidelined AstraZeneca’s candidate. The United States may only briefly, or never, need the AstraZeneca doses.

In Atany, Hungary, administering a coronavirus vaccine produced by Sinopharm, a state-owned Chinese company.
Credit…Peter Komka/EPA, via Shutterstock

Hungary has agreed to pay about $36 a dose for the Covid-19 vaccine made by Sinopharm, a Chinese state-owned company, according to contracts made public by a senior Hungarian official on Thursday. That appears to make the Sinopharm shot among the most expensive in the world.

Hungary has agreed to buy five million doses of the Sinopharm vaccine, priced at 30 euros ($36) each, according to contracts that Prime Minister Viktor Orban’s chief of staff, Gergely Gulyas, uploaded to his Facebook page. The contract is between the Hungarian government and a third-party vendor, and that price far surpasses what the European Union has agreed to pay for vaccines from Western manufacturers.

The European Union has said it would pay 15.50 per dose for the Pfizer-BioNTech vaccine, according to Reuters, which cited an internal E.U. document. For AstraZeneca, it agreed to pay $2.15 per dose, according to Belgium’s budget secretary.

The contracts that Mr. Gulyas published also show that Hungary, which has recorded nearly half a million coronavirus cases and more than 16,000 deaths, has agreed to pay $9.95 per dose for the Russian Sputnik-V vaccine.

The company from which Hungary is buying the vaccine underwent a change in ownership two months before the transaction, was awarded the contract after the government exempted it from having to take part in an open public procurement process, said Miklos Ligeti, legal director for Transparency International Hungary, an anticorruption group. (Because of an editing error, an earlier version of this article misstated which company had changed ownership.)

Such arrangements raise red flags for anticorruption watchdogs, who warn that the involvement of third parties increases the risk of price gouging. “We don’t know how much this company actually paid for this vaccine,” Mr. Ligeti said.

Given publicly available data on this company, Mr. Ligeti pointed to figures that he described as worrying. “The government of Hungary assigned a contract with a net value of 150 million euros” — $179 million — “to a company with registered capital of €9,000” ($10,700), he said.

Hungary is one of the few European countries to sign a deal with Sinopharm, which has promoted itself to developing countries at a time when many richer nations are hoarding doses by Western drugmakers like Pfizer and Moderna. A major selling point has been Sinopharm’s manufacturing capacity: It has said it can make up to three billion doses by the end of this year.

The Sinopharm price is extraordinary in part because the company, unlike the Western vaccine makers, has not published detailed data from Phase 3 trials.

Sinopharm is mass-producing two vaccines. It says that the first, made in conjunction with the Beijing Institute of Biological Products, has an efficacy rate of 79 percent, and that the second, made with the Wuhan Institute of Biological Products, is 72.5 percent effective.

Adam Liptak contributed reporting.

Global roundup

A vaccination center in Mumbai on Wednesday.
Credit…Rajanish Kakade/Associated Press

NEW DELHI — India has recorded one of its worst single-day increases in coronavirus cases since late December, owing largely to a resurgence in the western state of Maharashtra. More than 60 percent of the country’s 23,285 cases on Thursday were reported from the state, according to data from the health ministry.

This month the government of Maharashtra, where the country’s financial capital, Mumbai, is located, imposed a lockdown in some areas after cases surged to over 8,000 in a single day. On Friday, officials announced fresh restrictions in other parts of the state.

A strict lockdown was imposed for a week in the city of Nagpur beginning on Monday, the central and state governments said.

Until last month, India had been experiencing somewhat of a breather in its outbreak. During the peak of its outbreak last fall, the country was registering more than 90,000 cases a day, but cases fell rapidly over the next few months to just about 9,000 a day, according to a New York Times database.

“We are very worried about Maharashtra,” Vinod K. Paul, one of the country’s top health officials, said at a news conference on Thursday. “In all the states where the virus is seemingly on the rise in a significant way, the vaccination eligibility in those areas should be intensified,” he said.

As of Friday morning, India had vaccinated 26 million people against the coronavirus. The government has set a target of 300 million inoculations by July.

In other news from around the world:

  • The health authorities in Germany will remove parts of Spain and Portugal from a list of high-risk areas that the government warns against — but doesn’t forbid — traveling to starting on Sunday. Among the delisted areas in Spain are the Balearic Islands, which include Mallorca, a popular destination for German tourists. Others being taken off the list: the central areas of Castilla-La Mancha, Extremadura, La Rioja, Murcia and Valencia, in addition to the Portuguese regions Alentejo and the Azores. Although travelers coming from Germany no longer have to quarantine before hitting the beaches, they will have to show a negative virus test before departing Germany, which Spain considers a high-risk area.

  • Prime Minister Chung Sye-kyun of South Korea said on Friday that coronavirus restrictions would remain in effect until March 28, the Yonhap news agency reported. The rules, which vary by region but include a nationwide ban on most private gatherings, was set to expire on Sunday. South Korea reported 488 cases on Friday, a three-week high. The government has said it aims to achieve herd immunity by November, but only about 1 percent of the country’s 51 million people have been vaccinated.

  • After months in lockdown, Wales will ease its restrictions starting Saturday, the country’s leader announced. The nation’s stay-at-home order will be replaced by guidance to stay local, and the new rules will permit up to four people from two households to meet together outdoors, and outdoor sport and visits to care homes to restart. “The journey out of lockdown begins in earnest in Wales this weekend,” First Minister Mark Drakeford said on Friday. The gradual approach to reopening will allow haircut appointments from Monday, and shops will be able to welcome customers back on April 12, the same date as they are set to reopen in England.

Anna Schaverien and Christopher F. Schuetze contributed reporting.

Patrons at a bar in Texas on March 10, after Gov. Greg Abbott rescinded Covid restrictions.
Credit…Justin Hamel for The New York Times

One year ago, New Yorkers were told to keep their hands away from their faces — and from people and banisters and elevator buttons. When the hands failed to obey, they were scrubbed to the bone.

For all of the uncertainty and terror that greeted the arrival of the coronavirus, there was a certain clarity to the early protocols.

Now, after so much tragedy, the city finds itself closer to the point of normalcy. By the end of this week, more than 2.4 million doses of the Covid vaccines will have been administered in New York City, which was once the global epicenter of the pandemic.

This period in the aftermath of lockdown and before a complete reversion to ordinary routines is rife with its own confusion and conflicts.

“It is clear from walking around the city that people are giving in and relaxing rules, probably because of progression in vaccinations and because people are experiencing extreme fatigue,” Emanuela Taioli, the director of Translational Epidemiology at Mount Sinai, told me.

“The reality is that the positivity rates in the city are not going down,” she said. “They are at a plateau and staying there. This has been true for the last two weeks. This means that we have to keep going with the precautions until we are all vaccinated, and that may take another couple of months or more.”

Who wants to hear this? Probably no one.

In Texas, where Gov. Greg Abbott recently lifted a mask mandate, a bar called Shenanigans and Confetti’s Beach Club, in the town of Huntsville, advertised a “Masks Off” party for this past Tuesday night with “100 percent capacity.’’


Tap a state for more detail


Tap a state for more detail

Stay-at-home orders

Tap a state for more detail

On Tuesday, the journal Science reported that the United States, by contracting with multiple pharmaceutical companies out of precaution, had essentially over-ordered vaccine doses. This whiplash notion of scarcity and abundance has led many people to rationalize being vaccinated even if they don’t technically meet eligibility requirements.

It may seem morally reprehensible that a wealthy Brooklynite — claiming asthma or A.D.H.D. as a developmental disability, for example — will travel to a poorer neighborhood to get vaccinated. But epidemiologists turn out to be not in the castigation business when it comes to immunization. They say the point is to get as many people jabbed as possible.

How will we look at this precarious time a year from now? How will we regard the choices we make to jump-start regular life or to wait our turn to hit the piñata? It will depend on the outcome, the worst one being that the powerful go on living as always have, and the vulnerable become even more so.

The semi-deserted Galleria Umberto I in Naples, Italy, on Saturday.
Credit…Cesare Abbate/EPA, via Shutterstock

Italy’s government said Friday that coronavirus restrictions would be severely tightened across much of the country starting Monday and that the entire country would be under lockdown over Easter weekend to beat back surging infections amid a slow vaccine rollout.

The office of Italy’s new prime minister, Mario Draghi, announced the measures, which will force more than half of Italy’s population into lockdown. Starting Monday, health authorities will shut down schools, restaurants and many shops in most northern regions as well as the regions of Rome and Naples. People will also be restricted from leaving their homes except for work, health care visits and emergencies.

For Easter weekend, April 3-5, which is usually celebrated with large family gatherings, a lockdown will limit movement to one trip a day out of the home.

The measures are among the strongest since last March, when Italy became the first Western country to impose a lockdown in an effort to slow the spread of the virus.

“I am aware that today’s measures will have an impact on children’s education, on the economy and also on the psychological state of us all,” Mr. Draghi said during a televised visit Friday to a vaccination hub near Rome. “But they are necessary to avoid a worsening that will make even more stringent measures inevitable.”

“The memory of what happened last spring is still vivid. We will do anything that we can to prevent it from happening again.”

Also Friday, Italy’s Health Ministry applied new criteria to determine when regions are shut down. The restrictions would take effect when the virus caseload surpasses 250 cases per 100,000 residents. Many of the country’s 20 regions are expected to be subjected to the measures.

Italy surpassed 100,000 coronavirus deaths this week, with a current death rate of about 300 per day. The country registered over 25,000 new infections and 373 deaths on Thursday.

Some health officials attribute the rise in contagions and death, especially in central and northern Italy, to the now widespread presence of a more contagious variant first reported in Britain. Italy’s vaccine rollout, as in other European countries, remains slow compared with the United States and Britain. About 7 percent of Italy’s population has been vaccinated.

The country has encountered delays in vaccine deliveries from Pfizer-BioNTech, Moderna and AstraZeneca. And the country’s own difficulties in managing vaccine distribution in the underdeveloped south and in the wealthy, hard-hit region of Lombardy have also slowed things down.

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