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Wednesday, June 2, 2021

Biden to Tout Free Child Care Through Big Providers For Vaccination Appointments - The New York Times

Nurses prepared doses of the AstraZeneca coronavirus vaccine in Taipei, Taiwan, on Wednesday.
Ann Wang/Reuters

WASHINGTON — The British-Swedish company AstraZeneca is negotiating with the federal government to shift production of its coronavirus vaccine from a troubled plant near Baltimore to a factory owned by the pharmaceutical company Catalent, according to people familiar with the government’s plans.

Catalent already produces AstraZeneca’s vaccine for export at a factory in Harmans, Md., south of Baltimore. It is now in discussions to retrofit a production line there to make the vaccine for the federal government, taking over for Emergent BioSolutions, which was forced to stop manufacturing AstraZeneca’s vaccine more than six weeks ago after a major production mishap.

While it is unclear when the new line could begin operating, any extra doses that Catalent produces for the government are also likely to be exported because the United States has not yet authorized the AstraZeneca vaccine for domestic distribution and has enough of other vaccines to meet demand.

“We can confirm we are working with Catalent but have not disclosed specific details on supply,” said Holly Campbell, a spokeswoman for AstraZeneca. A spokesman for Catalent, which is based in New Jersey, declined to comment.

AstraZeneca has been searching for a new manufacturing partner since the federal authorities decided that Emergent, which has received hundreds of millions of dollars from the federal government to manufacture vaccines, was not capable of producing the AstraZeneca and Johnson & Johnson’s vaccines simultaneously. The decision came after Emergent workers accidentally contaminated a batch of Johnson & Johnson’s vaccine, ruining 15 million doses.

That episode has led to cascading problems for Emergent, Johnson & Johnson and AstraZeneca. Federal regulators asked Emergent to halt all production at its plant while they inspected it. Inspectors returned on Wednesday for another on-site review, according to people familiar with the process.

Regulators are also insisting that Johnson & Johnson and AstraZeneca provide extensive proof that batches of their vaccines produced by Emergent meet regulatory standards before allowing them to be released either for domestic use or for export. While no doses of any vaccine produced by Emergent have been distributed in the United States, the Biden administration had been counting on tens of millions of AstraZeneca doses to fulfill its promise to help other countries in need.

The federal decision to strip Emergent of the responsibility to manufacture AstraZeneca’s vaccine reduced the risks and complexity of the factory’s operations. But it left AstraZeneca temporarily unable to produce its vaccine for the government.

Last May, the Trump administration pledged up to $1.2 billion to AstraZeneca to finance the development and manufacturing of its vaccine, and to supply the United States with 300 million doses if it proved effective. With the country awash in other vaccines, AstraZeneca doses seem mainly bound for export. Federal officials say some might still be useful as booster shots, should those be needed and should AstraZeneca’s vaccine be cleared for distribution in the United States.

Some experts say they worry that producing more AstraZeneca vaccine in the United States will use up valuable materials that might be better directed overseas or to make other vaccines.

One federal official, speaking on the condition of anonymity to discuss continuing talks, said the government was renegotiating AstraZeneca’s contract, at least partly to shift production to Catalent from Emergent. The official estimated that Catalent could produce about 25 million to 35 million doses of AstraZeneca’s vaccine a month on its new line — a rate similar to that expected from Emergent.

Unlike Johnson & Johnson, Pfizer and Moderna, AstraZeneca has not sought authorization from the Food and Drug Administration to distribute its vaccine for emergency use in the United States. Without an obvious or immediate need in this country, AstraZeneca officials are leaning against pursuing authorization here, according to people familiar with their thinking. The company could still pursue licensure, a lengthier and more complicated process.

The AstraZeneca vaccine appears to be linked to a very rare but sometimes fatal blood clotting disorder, similar to the side effects that led to a pause in administering the Johnson & Johnson’s vaccine in the United States. Many European countries temporarily stopped using the AstraZeneca vaccine this year after a small number of clotting episodes, but they have largely restarted, in some cases with restrictions on what age groups should receive it. The vaccine is being used in 173 countries.

President Biden in late April committed to sharing 60 million doses of AstraZeneca’s vaccine. Jeffrey D. Zients, the White House’s Covid-19 response coordinator, said last month that 10 million of those doses could be released to other countries soon, with the rest to be shared in months, pending an F.D.A. review.

Mr. Biden later expanded his pledge, promising to send 20 million doses of other coronavirus vaccine overseas. Samantha Power, the administrator of the United States Agency for International Development, told lawmakers last week that three-fourths of the excess supply in the United States was likely to go to Covax, an international vaccine-sharing initiative, with the rest distributed through bilateral agreements.

Secretary of State Antony J. Blinken said this week that the administration would announce an overseas distribution plan within two weeks.

Rebecca Robbins and Benjamin Mueller contributed reporting.

Ethiopian Airlines staff unloading vaccines in Addis Ababa, Ethiopia, in March.
Tiksa Negeri/Reuters

Financial support for Covid-19 vaccination efforts in lower-income nations received a $2.4 billion boost on Wednesday when world leaders met at a virtual summit co-hosted by the Japanese government and Gavi, the Vaccine Alliance.

The funds were pledged by wealthier countries, foundations and private companies. Five countries — Belgium, Denmark, Japan, Spain and Sweden — also announced new plans to share a total of 54 million doses from their domestic supplies with countries in need.

The support is primarily designated for Covax, a year-old initiative promoting equity in the distribution of Covid-19 vaccines. It has shipped more than 77 million doses to 127 countries and is led by Gavi, the World Health Organization and the Coalition for Epidemic Preparedness Innovations.

The funds were sought to purchase additional vaccines for the countries least able to afford them as well as to invest in new vaccine candidates. “Ability to pay should not determine whether someone is protected from this virus,” said Dr. Seth Berkley, the chief of executive of Gavi.

Still, to date only 0.4 percent of all Covid-19 vaccine doses have been administered in low-income countries, according to W.H.O. Director-General Tedros Adhanom Ghebreyesus, who spoke at the meeting. In many countries, even the most vulnerable adults and health care workers have not received vaccinations.

Dr. Berkley said that, on average, wealthy countries had vaccinated more than a third of their populations whereas low income countries had vaccinated less than 1 percent.

How quickly wealthier countries deliver on their promises to share doses remains to be seen; most previously announced gifts have yet to be delivered.

The largest new financial pledge, $800 million, came from Japan, which also said it would eventually share 30 million doses of locally produced vaccines. To date, it has administered only about 14 million shots to its own population.

The U.S. previously announced $2 billion in support for Covax, and Vice President Kamala Harris spoke at the summit meeting but didn’t address ongoing calls for the United States to move more quickly to share its vaccine supply, especially as its vaccination rates increase and cases of Covid-19 fall dramatically. “Our collective future depends on the collective response to the global crisis,” Ms. Harris said. “The challenge before us is to provide equal access.”

She added, “People are still contracting Covid-19. People are still dying every day. And that is why we must work together to get people vaccinated as quickly as possible in every nation throughout the world.”

New pledges came from France, Switzerland, Australia, Kuwait, Mauritius, Mexico and Vietnam, among others. The Bill & Melinda Gates Foundation, Mastercard and the Visa Foundation were among institutions committing funds, and the European Investment Bank announced additional financing to support cost-sharing with African Union countries.

As of Wednesday, $9.6 billion had been raised for Covax’s Advance Market Commitment, a financing mechanism to secure vaccines for low and middle income economies

A vaccination site administering the Pfizer vaccine in Canada last month. AstraZeneca shots are in short supply, so the country will soon begin administering the Pfizer-BioNTech or Moderna vaccines as a second dose. 
Carlos Osorio/Reuters

Facing vaccine shortages, Canada’s immunization advisory body is recommending some Canadians follow up their AstraZeneca shots with a different vaccine on the second dose.

The National Advisory Committee on Immunization said on Tuesday that people who received a first dose of the AstraZeneca vaccine can be given either the Pfizer-BioNTech or Moderna vaccines as their second dose. It also declared that the Pfizer and Moderna vaccines can be used interchangeably, although it recommended sticking with a single brand when possible.

While Canada’s health care system has generally been efficient in dispensing shots, no vaccines are manufactured in the country and larger shipments only began arriving over the past several weeks. To ensure that the maximum number of Canadians have some protection, Canada focused on getting at least one dose to as many people as possible. While 62 percent of Canadian adults have been given at least one shot, only 5.7 percent are fully vaccinated.

The advisory panel’s recommendation came as many provinces are starting to ramp up second doses and it may resolve a potential headache.

Most of the increased shipments of vaccine have come from Pfizer, while supplies of the Moderna and AstraZeneca vaccines have been in much shorter supply. To date, 19.3 million doses of Pfizer’s vaccine have come to Canada compared with 5.7 million doses of Moderna and just 2.8 million Astra Zeneca shots.

The ability to substitute Pfizer’s vaccine for second doses eliminates concerns about limited supplies.

The advisory panel said that its recommendation follows similar advice from Denmark, Finland, France, Germany, Sweden, Norway and Spain. Several studies have shown that mixing vaccines is safe and effective, the committee said.

Seven of Canada’s 10 provinces, whose health care systems perform the vaccinations, have said they will allow people to change course between doses.

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President Biden announced on Wednesday an accelerated effort to vaccinate Americans by his proposed July 4 deadline.Naima Green for The New York Times

President Biden, facing a self-imposed July 4 deadline to have 70 percent of U.S. adults at least partly vaccinated against the coronavirus, tried Wednesday to rally the nation to meet that goal, announcing an offer of free child care for parents and caregivers while they receive their shots and a national canvassing effort resembling a get-out-the-vote drive.

Declaring June a “National Month of Action,” Mr. Biden appeared at the White House to implore Americans not only to get vaccinated, but also to help persuade their friends and neighbors to do so.

He laid out an aggressive campaign that will include incentives from sports leagues, like free tickets to the Super Bowl and to Major League Baseball games, and from private companies. United Airlines is offering a year of free flights in a sweepstakes open only to vaccinated Americans, and Anheuser-Busch has promised free beer to adults on Independence Day if the nation meets the president’s goal.

“That’s right, get a shot and have a beer,” Mr. Biden declared. “Free beer for everyone 21 years and over to celebrate the independence from the virus.”

Americans will be eligible for a free beer from Anheuser-Busch once the country’s vaccination rate reaches 70 percent.
John Gress/Reuters

The brewing giant Anheuser-Busch said on Wednesday that it would offer Americans another incentive to get vaccinated: free beer.

The company said in a statement that it would “buy America’s next round” of beer, seltzer or nonalcoholic beverage once the country reached President Biden’s goal of having 70 percent of the adult population get at least one coronavirus vaccination by July 4. So far, 63 percent of adult Americans have received at least one dose.

“We pride ourselves on stepping up both in times of need and in times of great celebration, and the past year has been no different,” said Michel Doukeris, the chief executive of Anheuser-Busch, which will offer adults a $5 virtual credit card for beverages if the vaccination goal is met. “As we look ahead to brighter days with renewed optimism, we are proud to work alongside the White House to make a meaningful impact for our country, our communities and our consumers.”

Reaching the vaccination goal by Independence Day may not be easy. The pace of vaccinations in the United States has slowed, with the biggest gains in recent weeks made in vaccinating 12- to 15-year-olds, who are not eligible for the free beer. However, progress has been made in reaching some groups with the highest rates of vaccine hesitancy, including Latinos and people without college degrees, according to the Kaiser Foundation.

Anheuser-Busch’s offer comes as other businesses and states have introduced their own giveaways to encourage vaccinations. Gov. Jim Justice of West Virginia said on Tuesday that the state would give away guns and other prizes, including trucks and lifetime hunting and fishing licenses, to vaccinated residents.

Other states, including California, New Mexico and Ohio, have started lottery drawings to award cash prizes to those who have been vaccinated.

Sterilizing a poultry market in Wuhan, China, in 2013. The Chinese government on Tuesday announced the world’s first human case of the H10N3 strain of bird flu.
Agence France-Presse — Getty Images

A 41-year-old man in China’s eastern Jiangsu Province is the first known human to be infected with a strain of bird flu known as H10N3, China’s National Health Commission said on Tuesday — a development that experts said merited close monitoring because of an underlying continued risk of pandemic flus.

Avian viruses do not typically spread among humans, but they can pose a danger if they mix with a human virus, said Raina MacIntyre, the head of the biosecurity program at the Kirby Institute at the University of New South Wales in Australia.

“If someone has human flu and is infected with bird flu, the two viruses can swap genetic material,” she said. “That’s why you see the concern for pandemic flu arising in countries where humans and livestock have very close contact.”

The Health Commission’s announcement said that there was no evidence of human-to-human transmission in the Jiangsu case. Contact tracing and surveillance have not uncovered any other infections, officials said.

Influenza viruses differ from coronaviruses, and the World Health Organization is working with the Chinese government to monitor the case, according to a statement from the W.H.O. division in Beijing.

The man began feeling feverish at the end of April and was hospitalized on April 28, the Chinese government statement said. On May 28, genome sequencing by the Chinese Center for Disease Control and Prevention determined that he had been infected with H10N3.

The government announcement did not say how the man had been infected, and the W.H.O. said the source of infection was still unknown. The man’s condition has stabilized, and he is ready to be discharged, the government said.

Professor MacIntyre said that usually the people infected by avian viruses are those who are in prolonged close contact with the birds, such as poultry handlers.

The W.H.O. said that H10N3 had “been detected periodically in birds in live bird markets as early as 2002,” but that the virus was unlikely to kill birds or lead to many signs of illness.

“As long as avian influenza viruses circulate in poultry,” the organization said, “sporadic infection of avian influenza in humans is not surprising, which is a vivid reminder that the threat of an influenza pandemic is persistent.”

Family members of a Covid-19 victim praying at a hospital mortuary before their relative’s burial in Kuala Lumpur, Malaysia, in late May.
Lim Huey Teng/Reuters

In Colombia, nearly five hundred people a day have died of the coronavirus over the last three weeks, the nation’s most dramatic daily death rates yet. Argentina is going through the “worst moment since the pandemic began,” according to its president. Scores are dying daily in Paraguay and Uruguay, which now have the highest reported fatality rates per person in the world.

“The vaccines are coming too late,” said María Victoria Castillo, whose 33-year-old husband, Juan David, died in May as he waited for the Colombian government to extend shots to his age group.

Deep into the second year of the pandemic, the world is dividing along a powerful, and painful, line: Those who have vaccines, and those who do not.

As rich nations like the United States prepare for a return to normalcy — at least half of the populations there and in Britain and Israel have received at least one dose of a vaccine, sending cases plummeting — some poorer nations, scrambling for shots and heaving under weary health systems and exhausted economies, are seeing their worst outbreaks since the start of the pandemic.

This is the case in Malaysia, Nepal and other nations in Asia. But in few places is the situation as bleak as South America, which has the highest rate of new infections in the world, according to data from Johns Hopkins University. Uruguay, Argentina, Colombia and Paraguay have all ranked in the top 10 in cases per 100,000 residents over the past week.

Tourists outside the Dehiwala National Zoo in Colombo, Sri Lanka, last year, when it was closed because of the coronavirus.
Dinuka Liyanawatte/Reuters

COLOMBO, Sri Lanka — To prevent the worst of Covid devastation, Sri Lanka imposed lockdowns and stopped flights from abroad for nearly a year, battering the economy and drying up a vital tourism industry.

For animals in the island nation’s zoos, however, it’s been a jolly time.

Amid the absence of visitors, animal births in the zoos rose 25 percent over the past year, according to Ishini Wickremesinghe, the director general of Sri Lanka’s Department of National Zoological Gardens. Particularly striking, she said, is that several animals that do not have a history of breeding in local zoos have given birth.

“Animals are actually having a less-stress and relaxed time with no people around,” she said.

Sri Lanka closed its zoos in March 2020, briefly reopening to visitors earlier this year before closing again as coronavirus infections rose. Among the animals that have bred for the first time are a black swan, a white peacock and a nilgai, the largest antelope in Asia. Others that have produced offspring include an Arabian oryx, a black duck, a scimitar-horned oryx and a zebra.

“We also have three new lion cubs,” Ms. Wickremesinghe said. “After years, the animals really got a good break.”

The cubs are about six months old now. With no visitors around, adult lions are free to roam around their enclosures and consort with potential mates.

At Sri Lanka’s wildlife parks, officials could not confirm whether breeding was on the rise, but animals are “definitely stress-free,” said Manoj Vidyaratne, the warden of Yala National Park on the island’s southeastern coast. “Usually, we see about 400 vehicles in the park daily,” he said, “but this time there is no one.”

Creatures in captivity elsewhere, too, have taken advantage of the pandemic to procreate. Last April, two giant pandas successfully mated at the Hong Kong zoo, which was closed to visitors due to the coronavirus.

Sri Lanka, an early success story in containing the spread of the virus, has experienced a recent surge and is recording nearly 3,000 new daily infections, according to a New York Times database. The pandemic has worsened the economic woes of a country that was already struggling to recover from terrorist attacks in 2019.

Sri Lanka’s zoos, which house about 4,000 species, are among the tourism-dependent country’s major attractions, drawing more than three million visitors a year before the pandemic.

Despite the impact on revenue, Ms. Wickremesinghe said she hoped to keep the zoos closed until cases drop, fearing that primates could catch the virus from an infected visitor. “We don’t know what to do if that happens,” she said.

Global roundup

Students taking supplementary exams in Bhopal, India, in September.
Sanjeev Gupta/EPA, via Shutterstock

The Indian government, still trying to control a devastating second wave of the coronavirus, has canceled national exams for 12th graders, affecting the fates of more than a million students.

The decision to call off the exams, which had been postponed from the spring, came late on Tuesday at a meeting of senior officials chaired by Prime Minister Narendra Modi. It showed that concerns around the spread of infections remain serious even as India’s official case count has dropped significantly from its peak a month ago.

“Students, parents and teachers are naturally worried about the health of the students in such a situation,” Mr. Modi said in a statement. “Students should not be forced to appear for exams in such a stressful situation.”

After India recorded more than 400,000 cases a day a month ago, the most in any country since the pandemic began, new infections there have dropped by more than half. Yet India is still averaging more than 3,000 deaths per day, a number that experts believe is a significant undercount. On Wednesday, the government reported 132,788 new cases and 3,207 deaths from the virus.

Most states remain under some form of lockdown, and hardly any of India’s young people have been fully vaccinated against Covid-19. The Indian government only last month opened vaccinations to people under 45, and a shortage of doses has meant that most states have made little progress in inoculating the young. About 12 percent of people in the country have received at least one dose of a vaccine, according to a New York Times database.

“This is the right step,” said Renu Singh, the principal of Amity International School in Noida, a suburb of New Delhi. “Most important is the safety, security and health of the child. Children are not vaccinated. If they come to school, they will be exposed.”

Antra Rajpoot, a 12th grader at the school, said that the idea of sitting for an exam with large numbers of students felt “really unsafe.” The government’s decision “definitely brought about a sense of certainty, safety, and it’s a very happy decision.”

Without the exams, which help determine placement in colleges and professional schools, Mr. Modi’s office said that the Central Board of Secondary Education, which administers the tests, would come up with an alternate method of assessing student performance.

In other news around the world:

  • President Emmanuel Macron of France announced on Wednesday that all 12- to 17-year-olds would be eligible for vaccination starting in mid-June. Speaking on a visit in the southwest part of the country, Mr. Macron noted that half of all French adults had already received at least one shot of a Covid-19 vaccine, but he asked the country to remain “extremely cautious and vigilant” and said a nationwide mandate on outside mask wearing would be lifted only gradually over the coming weeks and months.

  • Australia’s second largest city, Melbourne, extended a lockdown for one more week as authorities try to contain an outbreak of the coronavirus variant first detected in India. Six new coronavirus cases were recorded on Wednesday in the state of Victoria, bringing the total in the outbreak to 60 cases. Melbourne’s five million residents are only allowed to leave home for essential purposes. The lockdown will remain in effect until at least June 10.

Carleen Hartman, the owner of Hartman Jerk Chicken in Wilkes-Barre, Pa. Originally from Jamaica, she moved to the city from New York a decade ago.
Jonno Rattman for The New York Times

Main Street in Wilkes-Barre, a city of 41,400 people in northeastern Pennsylvania, is not a place dominated by chic restaurants or perfectly manicured sidewalks. On many blocks sit empty storefronts and businesses that seem suited to a bygone era.

Even before the pandemic, the city had to work hard to keep its downtown vibrant and compete with strip malls and big-box stores.

But it faced its biggest test starting last March.

“The pandemic was like an asteroid heading toward Earth,” said Larry Newman, the executive director of the Diamond City Partnership, a nonprofit involved in revitalizing downtown Wilkes-Barre.

Main Street businesses across the United States rely almost entirely on foot traffic. Rescuing small businesses, which make up more than 40 percent of the country’s economy, was seen as imperative for leaders in Washington and small cities like Wilkes-Barre.

At a Kroger supermarket in Yorktown, Va. Some customers stopped wearing masks after employers removed requirements to do so.
Carlos Bernate for The New York Times

The Kroger supermarket in Yorktown, Va., is in a county where mask wearing can be casual at best. Yet for months the store urged patrons to cover their noses and mouths, and almost everyone complied.

That changed in mid-May after the Centers for Disease Control and Prevention advised vaccinated people in the United States that they could go maskless in most indoor settings. The next week, the store told employees that they could no longer ask customers to cover their faces. So mask use plummeted, and the workers’ anxiety shot up.

“We just feel like we’re sitting ducks,” said Janet Wainwright, a meat cutter at the store.

More than a dozen retail, hospitality and fast-food workers across the country interviewed by The New York Times expressed alarm that their employers had used the C.D.C. guidance to make masks optional for vaccinated customers.

The effect of the change appears to be most acute in politically mixed or conservative areas, where, workers said, employer policies were often the only thing standing between them and customers who were neither masked nor vaccinated. As a result, they feel far more exposed now.

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Biden to Tout Free Child Care Through Big Providers For Vaccination Appointments - The New York Times
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