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Covid Live Updates: U.S. to Send 500 Million Pfizer Shots to 100 Nations Over Next Year

Credit…Tom Brenner for The New York Times

The White House has reached an agreement with Pfizer and BioNTech to provide 500 million doses of coronavirus vaccine to about 100 mostly low-income countries over the next year, a pact that President Biden plans to announce as early as Thursday, according to multiple people familiar with the plan.

Under intense pressure to do more to address the global vaccine shortage and the disparities in vaccination between rich and poor nations, the president hinted at the plan Wednesday morning, when he was asked if he had a vaccination strategy for the world.

“I have one, and I’ll be announcing it,” Mr. Biden said, shortly before he boarded Air Force One for his first trip abroad as president. He was headed first to Cornwall, England, to meet with leaders of the Group of 7 nations.

“We have to end Covid-19, not just at home, which we’re doing, but everywhere,” Mr. Biden said after landing in Britain, in an address to American troops. “There’s no wall high enough to keep us safe from this pandemic or the next biological threat we face, and there will be others. That requires coordinated multilateral action.”

People familiar with the deal said the United States will pay for the doses at a “not-for-profit” price. The first 200 million doses would be distributed this year, and 300 million by the middle of next year, they said.

Pfizer is offering the Biden administration a deal to buy even more doses at cost to be donated overseas. Albert Bourla, chief executive of Pfizer, is expected to appear with the president when Mr. Biden makes his announcement. All the doses are being produced in the United States at Pfizer’s plant in Kalamazoo, Mich.

The United States has already contracted to buy 300 million doses of the Pfizer-BioNTech vaccine, which requires two shots, for distribution in the United States. The new agreement is separate from those contracts, according to people familiar with it.

The White House coronavirus response coordinator, Jeffrey D. Zients, whom Mr. Biden has put in charge of global vaccination, said in a statement on Wednesday that the president would use the “momentum” of the U.S. inoculation campaign “to rally the world’s democracies around solving this crisis globally, with America leading the way to create the arsenal of vaccines that will be critical in our global fight against Covid-19.”

The 500 million doses, still fall far short of the 11 billion doses the World Health Organization estimates are needed to vaccinate the world, but significantly exceed what the United States has committed to share so far. Other nations have been pleading with the United States to give up some of its abundant vaccine supplies.

Last week, Mr. Biden said that the United States would distribute 25 million doses this month to countries in the Caribbean and Latin America; South and Southeast Asia; Africa; and the Palestinian territories, Gaza and the West Bank.

Those doses are the first of 80 million that he pledged to send abroad by the end of June; three quarters of them will be distributed by Covax. The rest will go toward addressing crises in places like India and the West Bank and Gaza, administration officials have said.

But activists, insisting the effort is not nearly enough, are calling on the administration and other developed nations to plan to ramp up manufacturing overseas and push for vaccine makers to transfer their technology to other nations.

Mr. Biden has already committed to supporting a waiver of an international intellectual property agreement that would require vaccine makers to share their technology. But European leaders are still blocking it, and pharmaceutical companies oppose it. The World Trade Organization’s Council for Trade-Related Aspects of Intellectual Property Rights will consider the waiver this week.

“The truth is that world leaders have been kicking the can down the road for months — to the point where they have run out of road,” Edwin Ikhouria, executive director for Africa at the ONE Campaign, a nonprofit aimed at eradicating global poverty, said in a statement on Wednesday.

“This is the moment to do whatever it takes to beat the virus everywhere,” he said, “starting by immediately sharing their surplus doses, fully funding the global initiatives set up to distribute Covid vaccines,” and coming up with an economically viable strategy to distribute them to countries in need.

Mr. Biden’s announcement comes after the United States has at least partly vaccinated 52 percent of its population. But as the pace has dropped sharply since mid-April, the Biden administration has pursued a strategy of greater accessibility and incentives to reach unvaccinated Americans.

In spite of those efforts, there are unused vaccine doses that could go to waste. Once thawed, doses have a limited shelf life and millions could begin expiring within two weeks, according to federal officials.

Dr. Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., warned earlier this week that the world was facing a “two-track pandemic,” in which countries where vaccines are scarce will struggle with virus cases even as better-supplied nations return to normal.

Those lower-income countries will be largely dependent on wealthier ones until vaccines can be distributed and produced on a more equitable basis, he said.

Breakthrough coronavirus infections — meaning those that occur after full vaccination — remain uncommon. And severe Covid among the vaccinated is even more rare. 
Credit…Apu Gomes/Agence France-Presse — Getty Images

Over the last few months, a steady drumbeat of headlines has highlighted the astounding real-world effectiveness of the Covid-19 vaccines, especially the mRNA vaccines made by Pfizer-BioNTech and Moderna. The vaccines, study after study has shown, are more than 90 percent effective at preventing the worst outcomes, including hospitalization and death.

But alongside this good news have been rare reports of severe Covid in people who had been fully vaccinated.

On June 3, for instance, Napa County announced that a fully vaccinated woman, who was more than a month past her second Moderna shot, had died after being hospitalized with Covid. The woman, who was over 65 and had underlying medical conditions, had tested positive for the Alpha variant, which was first identified in Britain.

Although these cases are tragic, they are uncommon — and not unexpected.

“I’m very sad that she had a sufficiently severe illness that it actually led to her death,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a vaccine expert at Vanderbilt University. But, he noted, “we expected to have the occasional breakthrough infection.”

Such cases should not dissuade people from getting vaccinated, scientists said. “There is not a vaccine in history that has ever been 100 percent effective,” said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “This is your best chance of avoiding severe, critical disease. But as is true of everything in medicine, it’s not perfect.”

Severe Covid is rare in people who have been fully vaccinated. In a paper published last month, the Centers for Disease Control and Prevention said that it had received reports of 10,262 breakthrough infections by April 30. That is just a tiny fraction of the 101 million Americans who had been vaccinated by that date, though the agency noted that it likely represented “a substantial undercount” of breakthrough infections.

Of those breakthrough cases, 10 percent of patients were hospitalized and 2 percent died — and in some of those cases, patients were hospitalized or died from something unrelated to Covid-19. The median age of those who died was 82.

Older adults, who are at greater risk for Covid complications, may also be more likely to develop breakthrough infections because they are known to mount weaker immune responses to vaccines. People who are immunocompromised or have other chronic health conditions may also be at increased risk.

Some of the variants — particularly Beta, which was first identified in South Africa — may be more likely to evade the protection induced by vaccines. But Beta is not currently common in the United States, Dr. Schaffner noted.

The Alpha variant that infected the Napa County woman is highly contagious, but vaccines provide good protection against it — as well as against the original strain of the virus.

“Vaccines provide exceptional protection against death and illness from the virus and all residents should continue to get vaccinated to protect themselves and others,” Dr. Karen Relucio, Napa County’s public health officer, said in a statement.

Breakthrough infections are likely to decrease as more people get vaccinated and community transmission rates fall. “The virus will find fewer and fewer people to infect — it will be harder for the virus to work its way through the population,” Dr. Schaffner said. “These are great vaccines. In order for the vaccines to work optimally — on an individual basis and a community basis — as many people as possible have to be vaccinated.”

A man looked at his phone at a government approved quarantine hotel near Toronto’s main international airport in February.
Credit…Carlos Osorio/Reuters

OTTAWA — Canada will take its first, limited step toward rolling back border restrictions next month, the country’s health minister said on Wednesday.

Fully vaccinated Canadian citizens and permanent residents who fly home will no longer have to quarantine at a government-designated airport hotel until they receive a negative result for a Covid-19 test administered upon arrival, the minister, Patty Hajdu, told a news conference. Instead, those air travelers will be allowed to isolate at home.

Then, assuming that they test negative, they will no longer have to complete the balance of the 14-day quarantine period.

While Ms. Hajdu said that the government hoped to make the change during the first week of July, she said the timing would depend on vaccination and infection rates as well as discussions with provincial governments and the border agency.

When the government announced the mandatory hotel stay in February, it suggested that the bill would come to about 2,000 Canadian dollars for a stay that would generally extend to three nights.

Although most hotels proved to be significantly less expensive than that, and test results generally arrived more quickly than anticipated, the mandatory stay was unpopular with many travelers. Some people have tried to avoid the hotel quarantine program and had to pay a fine of 3,000 Canadian dollars (recently increased to 5,000) as a consequence.

The announcement fell well short of a recommendation from a federal advisory panel to simply shut down the hotel program for everyone.

Under the new plan, foreign visitors and Canadians who are not vaccinated or partly vaccinated will still be required to use the hotel system and quarantine for 14 days. All travelers, regardless of their vaccination status, will also have to produce a recent negative test result before boarding any flight to Canada.

Because Canada has focused on getting at least one shot into every citizen’s arm, relatively few people will be able to take advantage of the new rules when they come into effect. While 68 percent of all Canadian adults have been given at least one shot, only 7 percent are fully vaccinated.

Currently, all nonessential travelers, including tourists who are neither Canadian nor permanent residents, are barred from entry. Canada’s tourism and restaurant industries have been calling for a broad reopening of the border between Canada and the United States. But on Wednesday officials downplayed suggestions that might come soon.

“It is better now to be slow and cautious, to use the best science and evidence, to be careful in our approach, so that we can have a sustained success,” Ms. Hajdu said.

A Covid vaccine clinic in Bernalillo, N.M. The vaccine is free, but polls show that about a third of unvaccinated adults were unsure whether insurance covered it.
Credit…Paul Ratje for The New York Times

The Biden administration is reminding doctors, hospitals, pharmacies and insurers that it is illegal to bill patients for coronavirus vaccines, a letter obtained by The Times shows.

The new warning responds to concerns among unvaccinated Americans that they could receive a bill with their shot. A recent Kaiser Family Foundation poll found that about a third of unvaccinated adults were unsure whether insurance covered the vaccine.

“We recognize that there are costs associated with administering vaccines — from staff trainings to vaccine storage,” Xavier Becerra, the health and human services secretary, wrote in a letter to vaccinators and insurers. “For these expenses, providers may not bill patients but can seek reimbursement through Medicare, Medicaid, private insurance or other applicable coverage.”

The letter warns that billing patients could lead to state or federal “enforcement actions,” but does not specify what the penalty would be.

The federal government wrote strong consumer protections to ensure that patients do not have to pay for coronavirus vaccines.

In stimulus legislation last spring, it barred insurers from charging patients co-payments or deductibles for the vaccines. The same law also created a fund that would cover the costs of vaccinating uninsured Americans.

Layered on top of those legislative protections are the contracts that doctors and hospitals signed to receive vaccines. Those documents specify that vaccinators cannot bill patients for the service.

Receiving the Oxford-AstraZeneca vaccine in Currie, Scotland, in January.
Credit…Photo photo by Russell Cheyne/Agence France-Presse

People receiving the Covid vaccine made by Oxford-AstraZeneca had a slightly increased risk of a bleeding disorder, and possibly other rare blood problems, researchers reported on Wednesday.

The findings, from a study of 2.53 million adults in Scotland who received their first doses of either the AstraZeneca vaccine or the one made by Pfizer-BioNTech, were published in the journal Nature Medicine.

The study found no increased risk of the blood disorders with the Pfizer-BioNTech vaccine.

The AstraZeneca vaccine is not authorized for use in the United States, but has been authorized by the European Medicines Agency, the European Union’s top drug regulator, as well as by many countries outside the bloc. But reports of rare clotting and bleeding disorders in younger adults, some fatal, led some countries to limit the vaccines’s use to older people, and a few to drop it altogether.

The new study found that the AstraZeneca vaccine was linked to a slight increase in the risk of a disorder called “immune thrombocytopenic purpura,” which can cause bruising in some cases but also serious bleeding in others. The risk was estimated at 1.13 cases per 100,000 people receiving their first dose, up to 27 days after vaccination.

Workers near a wholesale market in Wuhan, China, in March 2020.
Credit…Hector Retamal/Agence France-Presse — Getty Images

In the two years before the pandemic began, markets in the Chinese city of Wuhan were selling nearly three dozen animal species that can harbor pathogens that jump to humans, researchers have found, shedding new light on the possible role of the wildlife trade in the coronavirus’s origins.

The researchers found sales in Wuhan of mink, palm civets and raccoon dogs, but they did not find sales of pangolins or bats, which have been suspected as possible sources of the coronavirus.

In all, the researchers documented sales of more than 47,000 animals across 38 species in Wuhan markets between May 2017 and November 2019. Thirty-three of the species have previously been infected with diseases or disease-bearing parasites that can affect humans, the researchers said.

China suspended the sale and consumption of wild animals as the coronavirus began spreading rapidly early last year. The country’s wildlife trade played a key role in the SARS outbreak in the early 2000s.

A team of experts who led a World Health Organization mission to Wuhan this year examined vendor records and other evidence from the city’s animal markets. But the team reached no firm conclusions about the markets’ role in the outbreak, or about the specific species through which the coronavirus might have spread to humans.

More than a year into the pandemic, the question of the virus’s origins remains largely unresolved. The Biden administration last month announced a new push to investigate whether it could have accidentally leaked from a laboratory in Wuhan.

President Biden’s action came as top health officials renewed their appeals this week for a more rigorous inquiry. And it followed mounting criticism of a report from a team of international experts convened by the World Health Organization that largely dismissed the possibility that the virus had accidentally escaped from a Chinese laboratory called the Wuhan Institute of Virology.

Many scientists support investigating all possibilities, including the laboratory origin, even though they think the virus was probably transmitted from animals to humans outside of a laboratory. Angela Rasmussen, a virologist at University of Saskatchewan’s Vaccine and Infectious Disease Organization, said of the new study, “I think this puts a big point in the column of natural origin through intermediate species.” She said that while the paper “doesn’t prove anything” it “provides clear evidence that the wildlife markets really haven’t been investigated enough.”

The study of the animal markets, published this week in the journal Scientific Reports, was written by authors affiliated with China West Normal University, Oxford University and the University of British Columbia.

Between 2017 and 2019, one of the researchers conducted monthly surveys of all 17 shops in Wuhan markets that sold live wild animals for food and pets. Seven of these shops were at the city’s Huanan seafood market. Several early Covid cases in Wuhan were discovered in people with connections to that market.

The researchers originally carried out the surveys to investigate a tick-borne virus. But their results became “serendipitously” relevant to the Covid-19 pandemic, the researchers wrote.

Among the other species on sale in Wuhan, according to the researchers, were badgers, hedgehogs, weasels, porcupines, marmots, red foxes, flying squirrels, crested myna birds, snakes, vipers, cobras and Siamese crocodiles. Almost all of the animals were “sold alive, caged, stacked and in poor condition,” the researchers wrote, and were often butchered on site.

A mass vaccination program for older people at a clinic outside Johannesburg, South Africa, last month.
Credit…Themba Hadebe/Associated Press

Mastercard’s charitable arm has promised to donate $1.3 billion for vaccines in Africa, one of the largest corporate donations of the pandemic, as the continent struggles to contain a surge of infections.

The Mastercard Foundation said on Tuesday that its donation would be deployed over three years “in partnership” with the Africa Centers for Disease Control and Prevention. It said the goals were to strengthen the agency’s capacity, “lay the groundwork” for local vaccine manufacturing, acquire vaccines for at least 50 million people and help deliver shots to millions more.

“Ensuring inclusivity in vaccine access, and building Africa’s capacity to manufacture its own vaccines, is not just good for the continent, it’s the only sustainable path out of the pandemic and into a health-secure future,” John N. Nkengasong, the director of the Africa Centers for Disease Control and Prevention, said in the statement announcing the donation.

Africa is battling a sharp, sudden rise in coronavirus infections and deaths that experts believe is linked to the rise of new variants. The latest hot spots include Botswana, Namibia and Tunisia, according to a New York Times database.

But as of Wednesday only about 38 million, or slightly more than 2 percent, of the continent’s 1.3 billion people had received at least one dose of a coronavirus vaccine, according to the Our World in Data project. That was roughly the number of first doses given so far in Italy, which has a population of about 60 million.

Mastercard’s donation is the latest effort to address the glaring vaccination gap between rich and poor countries.

Last week a group of wealthy countries, foundations and private companies pledged $2.4 billion for global vaccination efforts and announced plans to share a total of 54 million doses from their domestic supplies with countries in need, for example.

The World Health Organization said last week that only 0.4 percent of all Covid-19 vaccine doses had been administered in low-income countries. And pharmaceutical companies have only manufactured a fraction of the 11 billion shots that researchers at Duke University estimate will be needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity.

Mandy Lin, 43, left, and her 9-year-old son returning to their apartment in Philadelphia last week. Ms. Lin stays close to home because she is fearful of anti-Asian attacks.
Credit…Hannah Yoon for The New York Times

Millions of Americans may be leaping into a summer of newly unmasked normalcy, but a surge in anti-Asian attacks during the pandemic is now holding back many Asian American families from joining them.

As schools phase out remote learning, companies summon employees back to work and masks fly off people’s faces, Asian Americans say that America’s race to reopen is creating a new wave of worries — not about getting sick, but about whether they will be attacked if they venture back onto a bus or accosted if they return to a favorite cafe or bookstore.

In more than a dozen interviews across the country, Asian Americans detailed fears about their safety and a litany of precautions that have endured even as the country has reopened.

Stop AAPI Hate, a coalition of community and academic organizations, tracked more than 6,600 attacks and other incidents targeting Asian Americans and Pacific Islanders from March 2020 to March 2021. A survey this spring found that one in three Asian Americans worried about becoming victims of hate crimes.

Asian Americans said they hoped the threats would ebb as more people got vaccinated and the pandemic faded. But person after person echoed the same worry: There is no vaccine against bigotry.

A mobile vaccination clinic in Foley, Minn. last month.
Credit…Liam James Doyle for The New York Times

As many Americans prepare to head back to the office, companies are hammering out policies on the extent to which they will require, or strongly encourage, employees there to be vaccinated against the coronavirus.

The bottom line is that companies are legally permitted to make employees get vaccinated, according to recent guidance from the federal agency that enforces workplace discrimination laws, the U.S. Equal Employment Opportunity Commission.

The agency said that employees who will not get vaccinated because of a disability or sincerely held religious belief may be entitled to an accommodation. Many companies are still reluctant to require inoculations for their employees, for a variety of reasons.

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