Covid-19 Vaccine and Cases News: Live Updates – The New York Times
April 14, 2021
Heres what you need to know:Preparing doses of the Johnson & Johnson coronavirus vaccine in Houston last month.Credit...Go Nakamura for The New York Times
An advisory committee for the Centers for Disease Control and Prevention is discussing the Johnson & Johnson Covid-19 vaccine pause during a meeting on Wednesday afternoon while a possible link to a small number of rare blood clots is investigated.
The emergency meeting follows the Food and Drug Administrations announcement on Tuesday that it was studying six cases of rare and severe blood clots in women aged 18 to 48, one of whom died. All of the women had received the Johnson & Johnson vaccine before developing the clots, though it is unclear whether the vaccine is responsible. As of Tuesday, more than seven million people in the United States have received the shot, and another 10 million doses have been shipped out to the states, according to C.D.C. data.
Following the call from federal health agencies, all 50 states, Washington, D.C., and Puerto Rico on Tuesday quickly paused or recommended that providers pause the administration of the vaccine. The U.S. military, federally run vaccination sites, and a host of private companies, including CVS, Walgreens, Rite Aid, Walmart and Publix also paused the injections.
The Advisory Committee on Immunization Practices, or ACIP, is a panel of independent experts who advise the C.D.C. on its vaccine policies. At the meeting, the experts are reviewing and debating data from the rare cases, and will later hear comments from the public, before a possible vote on how to proceed. They could vote to recommend that the pause continues, for example, or to specify that it should apply only to a certain age or sex.
Federal officials said on Tuesday that the pause might last only a few days, though it depended on what officials learned in the investigation. They said that the pause will give officials more time to alert doctors that patients who have these rare blood clots should not be given the drug heparin, the standard treatment that doctors administer for typical clots, and also provide time to determine whether there are any more cases.
The clotting disorder of concern in the vaccine recipients is different and much rarer than typical blood clots, which develop in hundreds of thousands of people every year. The six women had not only clotting in the brain, but a notably low level of platelets, parts of the blood that help form normal clots.
Right now, we believe these events to be extremely rare, but we are also not yet certain we have heard about all possible cases, as this syndrome may not be easily recognized as one associated with the vaccine, Dr. Rochelle P. Walensky, the C.D.C. director, said at a White House news conference on the pandemic on Wednesday.
The U.S. surgeon general, Dr. Vivek Murthy, reiterated on Wednesday that the pause in Johnson & Johnson vaccinations gives public health officials a chance to investigate the cases and discuss them with health care professionals. He added that pauses are common when new vaccines and drugs are rolled out.
Were just doing the duediligence we need to do to make sureeverything is safe so we cancontinue with our vaccinationefforts, Dr. Murthy said on CBS This Morning.
The committees assessment will be crucial at a time when the nation is racing to vaccinate as many people as possible to curb the steady accumulation of cases, particularly as worrisome variants gain traction. Some public health experts were disappointed in the F.D.A.s recommendation to suspend the Johnson & Johnson vaccine, arguing that preventing these extremely rare side effects was not worth the trade-off of slowing the vaccination campaign and potentially eroding the publics trust of vaccines in general.
At the news conference, Jeffrey D. Zients, the White Houses pandemic coordinator, said that the pause would not generally interrupt the momentum of the countrys vaccination campaign.
In the very short term, we do expect some impact on daily averages as sites and appointments transition from Johnson & Johnson to Moderna and Pfizer vaccines, he said. We have more than enough Pfizer and Moderna vaccine supply to continue or even accelerate the current pace of vaccinations.
Noah Weiland and Madeleine Ngo contributed reporting.
To federal health officials, asking states on Tuesday to suspend use of the Johnson & Johnson coronavirus vaccine until they could investigate six extremely rare but troubling cases of blood clots was an obvious and perhaps unavoidable move.
But where scientists saw prudence, public health officials saw a delicate trade-off: The blood clotting so far appears to affect just one out of every million people injected with the vaccine, and it is not yet clear if the vaccine is the cause. If highlighting the clotting heightens vaccine hesitancy and helps conspiracy theorists, the pause could ultimately sicken and even kill more people than it saves.
Its a messaging nightmare, said Rachael Piltch-Loeb, an expert in health risk communications at the N.Y.U. School of Global Public Health. But officials had no other ethical option, she added. To ignore it would be to seed the growing sentiment that public health officials are lying to the public.
The one-dose Johnson & Johnson vaccine was just beginning to gain traction among doctors and patients after its reputation took a hit from early clinical trials suggesting its protection against the coronavirus was not as strong as that from the vaccines made by Pfizer-BioNTech and Moderna. Before Tuesdays pause, some patients were asking for it by name.
But amid the blizzard of news and social media attention around the pause, those gains may well be lost, especially if the rare blood clotting feeds politically driven conspiracy theorists and naysayers, who seemed to be losing ground as the rate of vaccinations rose.
The problem is explaining relative risk, said Rupali J. Limaye, who studies public health messaging at the Johns Hopkins Bloomberg School of Public Health. She noted that the potential rate of blood clotting in reaction to the vaccine is much smaller than the blood clotting rate for cigarette smokers or for women who use hormonal contraception, although the types of clots differ.
And officials are not pulling the vaccine. They are simply asking for a timeout, in effect, to figure out how best to use it.
Vaccinators were already fielding questions from worried patients on Tuesday.
Maulik Joshi, the president and chief executive of Meritus Health in Hagerstown, Md., which has given 50,000 doses of all three vaccines without any reported major reactions, said he had a simple message to calm patients fears: Its a great thing that they have paused it, and this is science at work.
Jennifer Steinhauer, Madeleine Ngoand Hailey Fuchs contributed reporting.
The European Union will receive an extra 50 million doses this month of the coronavirus vaccine developed by Pfizer and BioNTech, a lift in its effort to speed up inoculations in the face of difficulties with vaccines developed by AstraZeneca and Johnson & Johnson.
The announcement by Ursula von der Leyen, the president of the European Commission, is part of the European Unions hard pivot to mRNA vaccines such as Pfizers, staking its future coronavirus response on them.
The moves come a day after Johnson & Johnson suspended the rollout of its vaccine in the European Union and as the bloc continued to suffer the fallout from restrictions on the AstraZeneca vaccine, after reports of extremely rare but serious potential side effects from both.
The 27-nation bloc has also entered negotiations with Pfizer over the supply of 1.8 billion new vaccine doses including booster shots to prolong immunity and new vaccines to tackle emerging variants in 2022 and 2023, Ms. von der Leyen said.
In another setback for AstraZeneca, Denmark on Wednesday became the first country to permanently stop the administration of the companys vaccine, saying the potential side effects were significant enough to do so given that it had the pandemic under control and could rely on two other vaccines, from Pfizer and Moderna.
The European Union has not canceled its existing orders of the AstraZeneca and Johnson & Johnson vaccines, but signaled it was not going to be placing more.
The European Medicines Agency, the blocs top drug regulator, continues to say that for most people the benefits of the AstraZeneca vaccine far outweigh the risks of a dangerous, but extremely rare, blood disorder. On Wednesday, the agency said it was expediting its investigation of very rare cases of unusual blood clots in recipients of the Johnson & Johnson vaccine, and expected to issue a recommendation next week.
While the evaluation is ongoing, the agency reiterated its view that the benefits of that vaccine also outweigh the risks.
The European Unions turn away from AstraZeneca follows difficult months in which relations between the company and the bloc deteriorated over delayed shipments and unpredictable supply. And since then, concerns over the possible side effects have exacerbated vaccine skepticism that was already dangerously high in Europe.
Those problems have contributed to Europes falling seriously behind vaccination campaigns in the United States and Britain. The bloc is hoping the new Pfizer shipments will help it begin to catch up and to meet its goal to fully vaccinate 70 percent of its adult population by the end of the summer, some 255 million people.
Pfizers commitment to bring forward the delivery of the 50 million doses, which were originally slated for the end of the year, means the company will deliver a total of 250 million doses to the bloc by the end of June.
We need to focus now on technologies that have proven their worth: mRNA vaccines are a clear case in point, Ms. von der Leyen said.
Monika Pronczuk contributed reporting.
Organizers marked 100 days until the start of the Tokyo Olympics on Wednesday with a subdued ceremony amid tougher restrictions and growing questions over the event as Japan endures another surge of coronavirus infections.
The governor of Tokyo, Yuriko Koike, pledged that officials would do everything to deliver a memorable tournament. Wearing a mask and gloves, she unveiled statues of the Olympic mascots inside Tokyo government headquarters while a video link showed another group of officials unveiling a monument of the Olympic rings atop fog-shrouded Mount Takao, 30 miles west of the capital.
But parts of Tokyo and other municipalities remain under a quasi-state of emergency ordered last week to stem what officials describe as Japans fourth wave of infections. Japan has recorded nearly 3,200 infections a day over the last week, according to a New York Times database few by the standards of the United States and Europe, but a worryingly high number for Asia.
The host nation is also lagging in vaccinations: Shots for those 65 and just began on Monday. So far, Japan has inoculated only frontline medical workers, who make up less than 1 percent of the population, and it will be far from fully vaccinated by July 23, when the Games are scheduled to begin.
Japan is calling these the Recovery Olympics highlighting the nations recovery from the devastating earthquake, tsunami and nuclear disaster in 2011, as well as the worlds recovery from the pandemic. But the Games, originally scheduled for last year, are marching on despite more than 70 percent of the Japanese public saying they should be delayed again or called off entirely.
Organizers announced last month that international spectators would be barred, although thousands of athletes from over 200 nations are expected to compete. The ceremonial torch relay has been making its way across Japan with little fanfare; its two-day leg in Osaka this week was diverted off public roads and took place in an empty park.
Denmark on Wednesday became the first country to plan to permanently stop administering the AstraZeneca vaccine, a month after suspending its use following reports that a small number of recipients had developed a rare but serious blood-clotting disorder.
The director general of the countrys health authority, Soeren Brostroem, said Denmark was able to halt use of the vaccine because it had the pandemic under control and could rely on two other vaccines, from Pfizer and Moderna.
The Danish announcement is another setback for the AstraZeneca shot, which is easy to store and relatively cheap, and was expected to be the foundation of vaccination campaigns around the world.
The country initially suspended the use of the vaccine on March 11, along with Iceland and Norway. Several other European countries, including France, Germany and Italy, followed suit last month.
The European Unions drug regulator, the European Medicines Agency, later recommended that countries keep using the vaccine, saying its benefits far outweighed any potential risks for most people.
Last week, though, the European regulator listed blood clots as a potential very rare side effect of the vaccine.
Several countries that had paused and restarted use of the vaccine have since said they would stop using it in younger people. Britain, which has administered around 20 million AstraZeneca doses, said it would offer alternative vaccines to people under 30.
Based on the scientific findings, our overall assessment is there is a real risk of severe side effects associated with using the Covid-19 vaccine from AstraZeneca, Dr. Brostroem, the Danish health official, said in a statement. We have, therefore, decided to remove the vaccine from our vaccination program.
If Denmark were in a completely different situation and in the midst of a violent third outbreak, for example, and a health care system under pressure, he added, then I would not hesitate to use the vaccine, even if there were rare but severe complications associated with using it.
Danish health officials said that they might reintroduce the AstraZeneca vaccine if the situation changes.
Public health officials have warned that pausing administration of vaccines like AstraZenecas or Johnson & Johnsons could do more harm than good. They note that among seven million people vaccinated with the single-dose Johnson & Johnson vaccine in the United States, six women had developed the rare blood clots fewer than one in one million. It is not yet known whether the vaccine had anything to do with the clots, but even if it did, the risk is smaller than that of getting struck by lightning in a given year (one in 500,000).
Denmark, which has a population of 5.8 million, has managed to contain the pandemic better than its neighbor Sweden or many other European countries. As of Wednesday, Denmark had recorded 2,447 Covid-related deaths.
Almost one million people in the country have received at least a first dose of a vaccine, 77 percent of them the one from Pfizer, according to Denmarks Serum Institute. Around 15 percent received a first dose of the AstraZeneca vaccine before the authorities suspended its use last month, and the remaining 8 percent received the Moderna vaccine.
The countrys health authorities said that people who received a first dose of the AstraZeneca vaccine would be offered a different vaccine for their second dose.
Jasmina Nielsen contributed reporting.
South Africa has faced blow after blow to its pandemic-control efforts: A worrisome variant swept across the country, driving a devastating second wave of coronavirus cases. Then officials had to scramble for an alternative when the vaccine it had bet on, from AstraZeneca, proved ineffective against the variant, which can partially dodge the bodys immune system response.
Now the alternative Johnson & Johnsons single-dose vaccine, the only one now in use in South Africa has run into trouble as well, over concerns of rare blood clots that emerged in a handful of people in the United States who had received the shot. It is unclear whether the vaccine is responsible.
South Africas health minister, Dr. Zwelini Mkhize, announced on Tuesday that the country would temporarily halt its vaccine program for medical workers, which has inoculated around 290,000 people so far. Dr. Mkhize said he expected the program a clinical trial to resume in a few days, after the authorities have had a chance to look into the blood clot cases in the United States.
Science must be respected at all times, although this may mean a disruption in our plans, Dr. Mkhize said on Tuesday.
South African health authorities have been gearing up to extend vaccinations to the general public starting in May. That program relies on 30 million doses of the Johnson & Johnson vaccine and 30 million of the two-shot Pfizer-BioNTech vaccine, which South African officials recently secured.
The country halted use of the AstraZeneca vaccine after evidence emerged that it did not protect clinical-trial participants from becoming mildly or moderately ill from the variant, known as B.1.351, that is now dominant in the country. South African authorities then pivoted to the Johnson & Johnson vaccine, which is manufactured in the country under license and has a 64 percent efficacy rate in South Africa, according to an analysis by the U.S. Food and Drug Administration.
Health experts say that the decision on Tuesday to pause vaccinating health care workers is the kind of thing that happens often in clinical trials, and that it probably wont have any major implications for vaccinating the general public.
At the moment, there is nothing to indicate that this will delay the national rollout program, said Dr. Richard Lessells, an infectious diseases specialist at the KwaZulu-Natal Research and Innovation Sequencing Platform.
Even so, if evidence emerges to implicate the Johnson & Johnson vaccine in blood clotting problem, and health officials begin to question its safety, it could be a devastating blow for South Africa, the African country hardest hit by the coronavirus, as it races to inoculate its population before an even more dangerous variant appears.
The U.S. has access to other vaccines to fill a gap, in terms of not using the Johnson & Johnson vaccine, said Shabir Madhi, a virologist at University of the Witwatersrand who ran the AstraZeneca vaccine trial in South Africa. That sort of luxury doesnt exist in other countries, including South Africa.
Global Roundup
Researchers in Britain investigating the effects of using one coronavirus vaccine for a first dose and another for a second have expanded their trial, they said on Wednesday, a day after the pause in the rollout of the Johnson & Johnson vaccine in the United States, the European Union and South Africa fueled uncertainties about vaccination campaigns.
Mixing doses could help countries weather vaccine supply shortages. Some governments have also recommended that some people who have received a first dose of the AstraZeneca vaccine receive a second injection of a different vaccine after a small number of recipients developed a rare blood-clotting disorder.
On Wednesday, German health authorities recommended that anyone under 60 who had received an initial inoculation with the AstraZeneca vaccine be given either the Pfizer/BioNTech or the Moderna vaccine for their second shot.
Some 2.2 million AstraZeneca doses were given to Germans younger than 60 when the authorities first began administering the vaccine, only to reverse that strategy after detecting several dozen cases of clotting.
Public health officials have emphasized that the benefits of the vaccines that have come under scrutiny still far outweigh the potential risks for most people, and some have warned that pausing their rollout could do more harm than good.
The Com-Cov study led by the University of Oxford began in February using AstraZeneca and Pfizer shots, but on Wednesday the researchers announced that they would recruit more volunteers and expand the trial to include doses of the vaccines developed by Novavax and Moderna.
If we can show that these mixed schedules generate an immune response that is as good as the standard schedules, and without a significant increase in the vaccine reactions, this will potentially allow more people to complete their Covid-19 immunization course more rapidly, said Dr. Matthew Snape, the lead investigator of the trial.
Researchers are expecting to publish their first findings by July, although the study will run for a year.
In other news around the world:
Reduced air pollution during the first lockdown in France may have led to non-negligible health benefits, the national public health agency said on Wednesday. A study by the agency estimated that the two-month lockdown last spring had avoided roughly 2,300 deaths from exposure to particulate matter pollution and another 1,200 from exposure to nitrogen dioxide, mainly related to traffic.
India has recorded a record 184,372 new coronavirus cases in 24 hours, officials said on Wednesday, as Maharashtra State, the countrys second most populous, prepared to impose a 15-day lockdown. The authorities in Maharashtra ordered its 120 million residents to remain indoors except for essential reasons beginning Wednesday evening. Hospitals there are running out of beds and essential supplies, and the states top official, Uddhav Thackeray, has asked the central government to mobilize the Indian Air Force to deliver oxygen cylinders. The leader of the state of Uttar Pradesh, Yogi Adityanath, said on Wednesday that he had tested positive for the coronavirus and was self-isolating.
Infections are surging in Thailand, which reported 1,335 new cases on Wednesday, its highest one-day total of the pandemic. Although the country has kept the virus largely under control for more than a year, officials are worried that the latest outbreak, centered in Bangkok, could spread nationwide as people visit relatives during the ongoing Songkran holiday, which marks the Thai New Year. With less than 1 percent of the population vaccinated, most of Thailands provinces have imposed entry restrictions.
Aurelien Breeden contributed reporting.
RIO DE JANIERO Brazils Congress launched an inquiry on Tuesday into the governments handling of the Covid-19 pandemic, raising tensions between President Jair Bolsonaro and local elected officials.
The investigation is expected to give critics of Mr. Bolsonaro a high-profile forum to outline missteps by the government over the past year that turned Brazil into the hardest hit nation at this stage of the pandemic.
Mr. Bolsonaro has spoken dismissively about the severity of the virus, calling it a measly flu, and has opposed restrictive measures to limit its spread, including lockdowns and business shutdowns. Even as the death toll from Covid-19 in Brazil exceeded 4,000 a day for the first time last week, Mr. Bolsonaros government was fighting in court to keep churches open.
Mr. Bolsonaro has also endorsed the use of a cocktail of drugs that leading medical organizations have concluded are ineffectual, and in some cases dangerous, for Covid-19 patients.
For months, the leaders of Brazils Congress showed little interest in investigating the governments failures or holding officials accountable. But a Supreme Court justice ordered the leader of the Senate last week to open a special inquiry, because a sufficient number of senators were in favor.
Mr. Bolsonaro criticized the effort last week, saying that a legislative inquiry would further polarize the country at a time of crisis.
What we need least is more conflict, he said in an interview with CNN Brasil.
Mr. Bolsonaro has pressed his allies in Congress in recent days to broaden the scope of the inquiry to cover the actions of state and municipal governments as well as his own administration.
Health experts say Brazils response to the pandemic has been disastrous. A highly contagious variant of the virus that was first discovered in Brazil last year has overwhelmed hospital systems in several states and driven up contagion in neighboring countries. Brazil is now averaging more than 70,000 new cases a day, rivaling the United States, whose population is half again as large.
Brazilian authorities refusal to adopt evidence-based public health measures has sent far too many to an early grave, Christos Christou, the international president of Doctors Without Borders, said in a statement. This has put Brazil in a permanent state of mourning, and led to the near collapse of Brazils health system.
Last week, Brazil accounted for 26 percent of the worlds Covid deaths and 11 percent of newly reported cases, according to the organization. Brazils population is about 2.7 percent of the worlds population.
transcript
transcript
Lets be blunt. Yesterday, we were thrown a curveball. The news about Johnson & Johnson, which I hope and believe will be a very temporary pause, but yesterday we were thrown a curveball and our job is to hit that ball out of the park anyway, to just keep going, keep moving forward. New Yorkers do that no matter what. The vaccination effort has built and grown, no matter what. And were going to keep building it. The vast majority of New Yorkers who booked appointments for the J&J vaccine will keep the same appointment, and receive Pfizer or Moderna instead. Second, we did have to reschedule about 4,000 people yesterday. Those New Yorkers received messages about new appointments for later this week.
New York City officials said Wednesday that the vast majority of people who were supposed to receive Johnson & Johnsons coronavirus vaccine would keep their scheduled appointments but instead receive either the Pfizer-BioNTech or Moderna vaccine.
The change came after federal health authorities called for a pause in Johnson & Johnson vaccinations on Tuesday as they investigated a rare blood-clotting disorder that emerged in six recipients. States, including New York, followed suit in halting the injections.
About 4,000 people who were supposed to receive Johnson & Johnson shot had to reschedule their appointments on Tuesday, a relatively small number of the tens of thousands of people who are vaccinated daily, city officials said at a news conference.
The city had been relying on the vaccine to inoculate hard-to-reach New Yorkers, including people who are homebound. That homebound program will be suspended through Sunday, though the city is helping to arrange transport to a nearby vaccine site where thats possible, said the city health commissioner, Dr. Dave Chokshi.
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Covid-19 Vaccine and Cases News: Live Updates - The New York Times
