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German Covid circumstances rising ‘exponentially’ amid dangerous vaccine pause

A health care worker will take care of a Covid 19 patient in the intensive care unit of the Robert Bosch Hospital in Stuttgart on Tuesday, January 12, 2021.

Bloomberg | Bloomberg | Getty Images

It’s no secret that Germany has seen a sharp rise in coronavirus cases in recent weeks, but a leading health expert in the country is now warning of an “exponential growth” in the number of infections.

It does so at a time when the country has stopped using the AstraZeneca University of Oxford’s coronavirus vaccine.

Epidemiologist Dirk Brockmann, an expert at the Robert Koch Institute for Infectious Diseases, said a recent relaxation of Covid restrictions has allowed a faster spread of a more virulent variant of the virus that was discovered in the UK late last year.

“We are exactly on the flank of the third wave. That can no longer be denied. And at this point in time we relaxed the restrictions and that accelerates the exponential growth,” Brockmann told the German ARD on Tuesday.

“It was completely irrational to relax here. It just powers this exponential growth,” he said.

Germany has been praised for its initial response to the pandemic, which has managed to lower cases through an effective track and tracing regime and keep the death rate lower thanks to its modern hospital infrastructure.

But over the past few months, over the winter, and with new, more virulent variants of the virus, it has seemed difficult to contain infections. The slow adoption of vaccines in the EU has not helped. The block has been criticized for its slower procurement and slower use of vaccines. The introduction of vaccinations in Germany faced several hurdles that frustrated officials and health professionals in the country.

Chancellor Angela Merkel and heads of state agreed earlier this month to gradually ease restrictions and an “emergency brake” that would allow authorities to reverse course if the number of infections rises above 100 per 100,000 for three consecutive days.

According to the government, the emergency brake is intended “in the event of exponential growth” in the cases. Merkel and the regional leaders are expected to review the measures on March 22nd and decide whether or not to proceed with the next step of reopening.

The number of cases per 100,000 reported Tuesday was 83.7 down from 68 a week ago, and the RKI has said the metric could hit 200 by the middle of next month, Reuters said in a report on Tuesday.

The lockdown in Germany is currently expected to last at least until March 28th, but some restrictions have already been relaxed. Schools, daycare centers and hairdressers will reopen at the beginning of the month.

Then a week ago, bookshops and florists were allowed to reopen and some museums too. However, regional rules may vary, with states being given discretion as to how and when to reopen certain case rates.

On March 22nd, Germany’s five-point reopening plan had envisaged that some restaurants, theaters and outdoor cinemas could be reopened. But the rising number of infections could derail that schedule.

Vaccine suspension

The epidemiologist’s key comments come from the fact that Germany and a handful of other European countries have decided to suspend the use of the coronavirus vaccine developed by AstraZeneca and the University of Oxford amid concerns about reports of blood clots in a handful of people who have been vaccinated.

The move has baffled experts around the world as the World Health Organization and the European Medicines Agency (both of which are conducting a safety review of the vaccine) insist that all available evidence shows that the vaccine is safe and effective, rather than asking for a higher one Risk of blood clots, which are common in the general population.

The vaccine manufacturer itself has highlighted that the data shows that the number of blood clots in the vaccinated population was actually lower than expected.

WHO and EMA, due to release the results of their safety review Thursday, say the vaccine’s benefits outweigh the risks and that countries shouldn’t interrupt their vaccination programs. Nevertheless, more than a dozen European countries have stopped using it. According to experts, this could lead to a dangerous increase in infections and deaths.

“Latest figures suggest 40 fatal cases for every 20 million cases vaccinated with Astra-Zeneca shocks. Every single case is always terrible, but that percentage is statistically insignificant. Instead, vaccination delays cost Europe about 2,000 more deaths a day – and tens of billions of euros for closings, closed shops, “said Guido Cozzi, professor of macroeconomics at the University of St. Gallen, in a note on Tuesday.

Even though public health authorities like WHO and EMA reiterated on Thursday that the vaccine is safe, experts fear that more damage has already been done to the vaccine’s reputation.

AstraZeneca’s vaccine has already faced several hurdles ranging from question marks about trial methods and data to false hesitation about the vaccine’s effectiveness in those over 65 and disputes over delays in delivery to the EU. Real-world data shows the vaccine is extremely effective at preventing severe Covid cases, hospitalizations and adult deaths.

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Health

Europe’s suspension of AstraZeneca’s Covid vaccine is damaging

LONDON – The decision of many European countries to stop using the Oxford-AstraZeneca University coronavirus shot could have far-reaching ramifications, analysts say, as vaccine uptake and the wider vaccination program are already lagging behind in the region.

Sweden and Latvia were the last countries to stop using the Oxford-AstraZeneca vaccine on Tuesday over concerns about blood clots. The move follows, among others, Germany, France, Spain, Italy and Ireland to temporarily suspend use of the vaccine as a precautionary measure, while assessing whether there is a connection between the shot and an increased risk of blood clots.

The World Health Organization, drug regulators, and the vaccine maker itself have tried to downplay persistent safety concerns. There is currently no evidence to suggest that there is a link between the shot and an increased risk of developing blood clots, which are common in the general population.

In particular, the WHO has asked the countries not to pause with the shot in their vaccination rollouts. The Advisory Committee on Vaccine Safety has checked the available data and is in close contact with the EU Medicines Agency, the European Medicines Agency.

Additional expert guidance is expected to be announced shortly after the security reviews: the WHO Security Committee will meet on Tuesday, while the EMA will meet on Thursday.

EMA Executive Director Emer Cooke said in a news conference on Tuesday that EU member states’ decision to suspend use of the vaccine could result in lower public confidence in the shot, which affects vaccines confidence, but our job is to make sure that the products we approve are safe. “

It’s not the first time Oxford-AstraZeneca’s vaccine has come under pressure as the drug maker was previously asked about its testing method and data, the effectiveness of the shot in those over 65, and a publicized dispute with the EU Delivery of supplies to the block.

However, health experts and policy analysts are questioning whether much of Europe’s decision to suspend use of the AstraZeneca shot is misplaced and is likely to further damage or even cost lives confidence in the vaccine if a third wave of infections is observed is Paris to Prague, and the introduction of shots by the EU is already slow.

“At this stage, national regulators are likely to act conservatively and out of caution. A risk-averse approach will help reassure the public and limit the impact on future adoption. But the prospect of a longer review or an outright ban cannot be ruled out, “said Federico Santi, Senior Europe Analyst at Eurasia Group, in a statement on Monday.

“Either way, the damage has been done. Willingness to take the AstraZeneca vaccine has already been lower than that of mRNA vaccines available in the EU, as the effectiveness of the headlines and initial confusion about its suitability for those over 65 years of age initially began were confused, “he said.

Some wonder if there was a political element behind the decision to pause the vaccine, as there have been disputes about it in the past.

Several European countries initially decided not to recommend the vaccine for people over 65 as there wasn’t enough evidence that it was effective before reversing that decision as more data became available showing it was the number severe Covid infections and hospital stays were highly effective in reducing deaths.

Such decisions, which were not supported by derogatory remarks from some European heads of state and government (French President Emmanuel Macron once said the vaccine was “virtually ineffective” for those over 65), were viewed by some Europeans only as reluctant to Oxford -AstraZeneca viewed vaccine. The introduction of vaccination in the EU is already much slower than in the UK and US, and the bloc leadership has come under fire for its vaccination strategy.

“We know where this is going, it will lead to a loss of confidence in the vaccine,” Natasha Loder, health policy editor for The Economist, told the BBC’s “Today” program on Tuesday.

When asked whether the suspension had a political dimension, Loder said, “It could be that this vaccine feels bad.” Nevertheless, the decision has “no rational basis” and could be dangerous. “This precautionary principle is nonsense when you are in the middle of a pandemic,” Loder said.

“This is a safe vaccine and when they realize that this is a safe vaccine in Europe they will have to face the aftermath of all this media coverage.”

However, not all EU countries are following the same path. Belgium, Poland and the Czech Republic say they will continue to use the shot, saying the benefits outweigh the risks.

AstraZeneca has vigorously defended its vaccine, stating in a statement Sunday that the number of blood clots recorded after vaccination was fewer than would naturally be expected.

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Politics

As Biden Confronts Covid-19 Vaccine Hesitancy, Republicans Are a Explicit Problem

WASHINGTON – When President Biden urges that as many Americans as possible be vaccinated, many Republicans have deep skepticism about convincing a group that challenges him in particular.

While there has been some resistance to vaccination against the coronavirus from a number of groups, including African Americans and anti-vaccine activists, polls suggest that opinions on the part of the party are severely disrupted.

A third of Republicans in a poll by CBS News said they would not get the vaccine – compared to 10 percent of Democrats – and another 20 percent of Republicans said they weren’t sure. Other surveys have found similar trends.

As the Biden administration prepares television and internet commercials and other efforts to promote vaccination, the challenge for the White House is compounded by the perception of former President Donald J. Trump’s stance on the matter. Although Mr Trump was vaccinated before leaving office and last month urged Conservatives to get vaccinated, many of his supporters appear not to be, and he has not played a prominent role in promoting vaccination.

When asked when asked at the White House on Monday, Mr Biden said Mr Trump’s help in promoting vaccination was less important than bringing trusted community figures on board.

“I have discussed it with my team and they say that what has more impact than anything Trump would say to the MAGA people is what the local doctor, the local preacher, the local people in the church are saying “Biden said, referring to Mr. Trump’s supporters and the campaign slogan” Make America Great Again “. Until everyone is vaccinated, Americans should keep wearing masks, Biden added.

Widespread resistance to vaccination, if not overcome, could prevent the United States from reaching the point where the virus can no longer easily spread and cut back efforts to get the economy going again and the To lead people back to a more normal life. While the problem so far has been access to relatively scarce vaccine supplies, government officials soon anticipate the possibility that supply will exceed demand if many Americans hesitate.

However, many conservative and rural voters continue to point to a variety of concerns. Some conservatives have religious concerns about the Johnson & Johnson vaccine, which uses fetal cell lines derived from abortion.

Republicans often cite suspicion of the government as a reason not to get vaccinated, according to the CBS poll. They fear the vaccines were being made too quickly. And in some communities, so many people have already had the coronavirus that they believe they have developed herd immunity and don’t need the shots.

Other Trump supporters believe the Democrats exaggerated the toll of the pandemic to hurt the former president.

This poses a major challenge to a democratic government, the success of which depends on convincing Americans who did not vote for Mr Biden that the vaccines are safe, effective and necessary.

“We’re not always the best messengers,” said Jen Psaki, White House press secretary, last week.

This meant that a crucial part of the coronavirus response has been outsourced to the administration.

“It’s not an easy endeavor,” said John Bridgeland, founder and executive director of the Covid Collaborative, a non-partisan group of political and scientific leaders who work on vaccine education and meet regularly with the White House on vaccine hesitation.

“The good news is that the White House has been across all of these populations, including realizing that they’re not nicely positioned to reach out to conservatives,” he said. “That’s why they reach us and others.”

The governors have urged the Biden government on the need for clear communication about the vaccines.

White House officials said their research showed that improving access to the vaccines and buying in locally from doctors and pharmacists is the best way to get skeptical conservatives to sign up for a shot. They are planning a flash of commercials on television, radio and the internet to target problem areas: young people, colored people and conservatives, a clerk said.

While working to increase vaccine availability across the country, administrative officials also work with groups like the NTCA – the Rural Broadband Association and the National Farmers Union – to reach out to rural communities on their behalf.

Shirley Bloomfield, the association’s executive director, has worked with the White House to share what she hears from their local members who have deployed broadband lines in rural areas.

Updated

March 16, 2021, 9:07 a.m. ET

“We have worked to have them designated as essential workers at the federal level,” she said. “I didn’t know we had this problem until people came back and said that less than 30 percent of my team would take the shot.”

Ms. Bloomfield said the second gentleman’s office, Doug Emhoff, reached out to her directly to ask about her members and her views on the vaccines.

Mr. Trump got his vaccine secret before leaving office. In particular, he was not featured in a public announcement vaccinating all other former living presidents – Barack Obama, George W. Bush, Bill Clinton, and Jimmy Carter – and encouraging others to follow suit.

Mr Trump was not asked to attend like the others because at the time of filming during Mr Biden’s inauguration, he had not yet revealed that he had been vaccinated.

But behind the scenes there was a quiet effort to convince Mr. Trump to get involved. Joe Grogan, the former director of the White House Home Affairs Council under Mr Trump, has worked with the Covid Collaborative to address conservative reluctance to offer vaccines.

Mr Grogan has made calls about what the best message would be to persuade Mr Trump to get involved – one that inevitably underscores his desire for recognition for the vaccine development as part of Operation Warp Speed.

“As soon as we found out he was vaccinated, I reached out to Joe Grogan,” said Bridgeland, who helped organize the commercial with the former presidents. “We were thrilled to have him vaccinated and would like him to encourage his supporters to get the vaccine.”

A Trump adviser said the former president had not yet been formally approached to speak directly to his supporters.

“It would be very helpful if President Trump made a public announcement,” said Grogan. However, the Biden White House seems divided over how effective Mr Trump’s involvement would really be.

Although Mr Biden denied the need for Mr Trump’s help on Monday, his chief medical advisor, Dr. Anthony S. Fauci, on Sunday on Fox News, said it would “make all the difference in the world” if the former president encouraged his followers to get vaccinated. And Andy Slavitt, a senior White House pandemic advisor, said Sunday, “This is an effort Republicans should know that started before we got here and we are making it.”

Frank Luntz, a Republican strategist, said the best way for the White House to take politics out of the issue.

What you need to know about the vaccine rollout

“That means Joe Biden should acknowledge what Donald Trump did to make the vaccine a reality,” Luntz said. He has worked with the de Beaumont Foundation, an organization focused on improving public health through politics, to encourage conservatives to get vaccinated.

“I don’t think the Trump administration understood the role of communication,” Luntz said, “and I don’t think the Biden administration understands what it means to communicate with Trump voters.”

On Saturday, Mr. Luntz hosted a focus group of about 20 Conservatives to hear from Tom Frieden, former director of the Centers for Disease Control and Prevention. Chris Christie, the former New Jersey governor; and several Republican members of Congress.

Some of the conservatives on the call initially described the vaccines as “rushed” and “experimental” and the coronavirus as “opportunistic” and “government manipulation”. More than half of the callers said their fear of vaccination was greater than their fear of the virus.

But almost all of the participants said they had a more positive opinion about the vaccines after Dr. Frieden had given them five facts about the virus, including: “The more we vaccinate, the faster we can grow the economy and get jobs.”

Mr. Christie emphasized how random the virus can be as it affects different people, including younger adults. Not only did he and Mr. Trump become seriously ill, but he also reminded the group that Hope Hicks, the 32-year-old former Trump adviser, was also very ill.

“She was away for a good 10 days and never had to go to the hospital, but called me and said this was the sickest she had ever been,” said Christie.

Right now, the White House is relying on the work of political opponents like Mr. Christie to sell the message for them. The only substitute within the Biden government that they consider effective among Conservatives is Dr. Francis Collins, the director of the National Institutes of Health, a scientist and Evangelical Christian who stands in both religious and scientific communities.

In the past few weeks, Dr. Collins performed at the Christian Broadcasting Network’s 700 Club, a show popular with evangelical Christians and hosted by Pat Robertson for decades. Dr. Collins also plans to reach out to the National Association of Evangelicals, someone familiar with the planning.

Joshua DuBois, former head of the Office for Faith-Based Partnerships and Neighborhood Partnerships in the Obama White House, was impressed with the efforts of the Biden administration to ease vaccine hesitation.

He said Mr. Biden’s top advisors, such as Marcella Nunez-Smith and Cameron Webb, had asked the religious community to answer questions about the vaccines. The calls included black and Hispanic organizations, as well as white evangelicals.

Mr DuBois acknowledged that hesitation in minority communities was rooted in history. When coronavirus vaccines were launched last year, researchers tracked a surge in social media posts about the infamous Tuskegee study, in which health officials followed and did not treat African American men infected with syphilis.

“There is a history of distrust, but current devastation around us,” said DuBois, “and in response to that devastation, people are choosing to be vaccinated.”

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Moderna Begins Testing Its Covid Vaccine in Infants and Younger Kids.

The pharmaceutical company Moderna has started a study testing its Covid vaccine in children under the age of 12, including babies as young as six months, the company said Tuesday.

The study is expected to enroll 6,750 healthy children in the United States and Canada.

“There is a great demand for information about vaccination in children and how it works,” said Dr. David Wohl, the medical director of the University of North Carolina Vaccination Clinic, who is not involved in the study.

In a separate study, Moderna is testing its vaccine on 3,000 children aged 12 to 17 years.

Many parents want protection for their children, and vaccinating children should help create the herd immunity that is believed to be critical to ending the pandemic. The American Academy of Pediatrics has called for vaccine studies to be expanded to include children.

Every child in Moderna’s study receives two recordings 28 days apart. The study will consist of two parts. In the first case, children aged 2 to under 12 can receive two doses of 50 or 100 micrograms each. People under the age of 2 may receive two exposures of 25, 50, or 100 micrograms.

In each group, the first children to be vaccinated are given the lowest doses and monitored for reactions before later participants are given higher doses.

The researchers then conduct an interim analysis to determine which dose is the safest and most effective for each age group.

Children in the second part of the study receive the doses or placebo shots selected by the analysis, which consist of salt water.

The children will be followed for a year to look for side effects and measure antibody levels, which will allow researchers to determine if the vaccine is effective. Antibody levels will be the main indicator, but researchers will also look for coronavirus infections with or without symptoms.

Dr. Wohl said the study was well designed and likely efficient, but asked why the children should only be observed for one year when adults in Moderna’s study were observed for two years. He also said he was a bit surprised that the vaccine was being tested in children so young so soon.

“Should we first learn what happens to the older children before we go to the really young children?” Asked Dr. Well. Most young children don’t get very sick from Covid, although some develop severe inflammatory syndrome that can be life-threatening.

Johnson & Johnson has also announced that it will test its coronavirus vaccine in babies and toddlers after first testing it in older children.

Pfizer-BioNTech is testing its vaccine in children ages 12-15 and plans to switch to younger groups. The product is already approved for use in the USA from the age of 16.

Last month, AstraZeneca began testing its vaccine in the UK in children 6 years and older.

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AstraZeneca vaccine halt might gradual Asia’s financial restoration: Moody’s Analytics

SINGAPORE – Asia’s economic recovery could slow as more countries stop using the Covid-19 vaccine developed by AstraZeneca and Oxford University, Moody’s Analytics chief Asia-Pacific economist warned.

“It slightly increases the risk Asia is playing in terms of global economic turnaround,” Steve Cochrane told CNBC’s “Squawk Box Asia” on Tuesday.

Reports of blood clots in some people who received the AstraZeneca Oxford shot resulted in several countries – many of them in Europe – temporarily stopping using the vaccine. The World Health Organization said there was no link between the shot and an increased risk of developing blood clots and is investigating this.

Impact of vaccines on world trade

Cochrane said issues related to the AstraZeneca-Oxford vaccine could affect world trade – and that’s bad news for Asia, where many economies are dependent on trading activities.

The vaccine is of course a risk. One of the critical risks is that vaccines will have to be introduced later this year to get the world economy back on its feet.

Steve Cochrane

Asia Pacific Chief Economist, Moody’s Analytics

“There is a possibility that world trade will be adversely affected if the introduction of vaccines in Europe is delayed. This would result in a more stalled economy in Europe. This could slow the pace of world trade.” ,” he explained.

Asian countries have contained the virus with relative success, and this has helped their economies recover faster than those in Europe and the US

Fortunately, re-locks in some parts of Europe haven’t affected manufacturing, Cochrane said. He added that “almost all” of the effects of these lockdowns have affected the service sector.

“So right now it’s not that big of a problem, and world trade still seems very, very strong,” said the economist. “The vaccine is, of course, a risk. It is one of the critical risks. We have yet to see how vaccines are introduced later this year to get the world economy back on its feet.”

Thailand briefly stops the AstraZeneca vaccine

Thailand temporarily stopped using the AstraZeneca-Oxford vaccine on Friday, but authorities said Monday they would continue to administer the shots.

Thai Prime Minister Prayuth Chan-ocha was the first in the country to receive the AstraZeneca-Oxford shot on Tuesday, Reuters reported.

Elsewhere in Asia, Indonesia on Monday said it would delay the rollout of the AstraZeneca-Oxford vaccine while awaiting review by the WHO, the news agency reported.

– CNBC’s Sam Meredith contributed to this report.

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The AstraZeneca Vaccine: Ought to You Be Involved?

Millionen von Menschen in Dutzenden von Ländern haben den Impfstoff AstraZeneca Covid mit wenigen Berichten über Nebenwirkungen erhalten, und seine vorherigen Tests bei Zehntausenden von Menschen haben festgestellt, dass er sicher ist.

In jüngster Zeit haben Blutgerinnsel und abnormale Blutungen bei einer kleinen Anzahl von Impfstoffempfängern in europäischen Ländern Zweifel an ihrer Sicherheit aufkommen lassen, obwohl kein ursächlicher Zusammenhang zwischen dem Zustand der Patienten und dem Impfstoff festgestellt wurde. Die Berichte haben mehr als ein Dutzend Länder dazu veranlasst, die Verwendung des Impfstoffs während der Untersuchung der Fälle entweder teilweise oder vollständig auszusetzen. Die meisten Nationen gaben an, dies vorsorglich zu tun, bis führende Gesundheitsbehörden die Fälle überprüfen konnten.

Der AstraZeneca-Impfstoff wurde in den USA noch nicht zur Verwendung zugelassen, obwohl eine Überprüfung seiner US-Studie in Kürze erwartet wird.

Die Kaskade von Entscheidungen, die Verwendung des Impfstoffs von AstraZeneca vor allem durch europäische Länder zu unterbrechen, folgte Berichten über vier schwerwiegende Fälle in Norwegen, die unter Gesundheitspersonal unter 50 Jahren beschrieben wurden, die den Impfstoff erhielten. Die meisten entwickelten Gerinnsel oder Blutungsstörungen und hatten niedrige Thrombozytenzahlen, sagten die Gesundheitsbehörden dort. Zwei von ihnen sind an Gehirnblutungen gestorben, die anderen beiden werden ins Krankenhaus eingeliefert. Der Tod einer 60-jährigen Frau in Dänemark und eines 57-jährigen Mannes in Italien führte ebenfalls zu schnellen Entscheidungen, obwohl keiner der Todesfälle vollständig untersucht wurde, um festzustellen, ob ein Zusammenhang mit den erhaltenen Schüssen besteht.

Ein Blutgerinnsel ist ein verdickter, gallertartiger Blutklumpen, der die Durchblutung blockieren kann. Gerinnsel bilden sich als Reaktion auf Verletzungen und können auch durch viele Krankheiten verursacht werden, einschließlich Krebs und genetischen Störungen, bestimmten Medikamenten und längerem Sitzen oder Bettruhe. Gerinnsel, die sich in den Beinen bilden, brechen manchmal ab und wandern in die Lunge oder ins Gehirn, wo sie tödlich sein können.

Es wurde nicht nachgewiesen, dass Impfstoffe Blutgerinnsel verursachen, sagte Daniel Salmon, Direktor des Instituts für Impfsicherheit an der Johns Hopkins University.

Blutgerinnsel sind in der Allgemeinbevölkerung häufig, und die Gesundheitsbehörden vermuten, dass die bei Impfstoffempfängern gemeldeten Fälle höchstwahrscheinlich zufällig sind und nicht mit der Impfung zusammenhängen.

“Es gibt viele Ursachen für die Blutgerinnung, viele prädisponierende Faktoren und viele Menschen mit erhöhtem Risiko – und dies sind oft auch die Menschen, die gerade geimpft werden”, sagte Mark Slifka, ein Impfstoffforscher an der Oregon Health and Science University.

Laut den Centers for Disease Control and Prevention entwickeln in den USA 300.000 bis 600.000 Menschen pro Jahr Blutgerinnsel in ihrer Lunge oder in Venen in den Beinen oder anderen Körperteilen.

Laut diesen Daten treten in der US-Bevölkerung täglich etwa 1.000 bis 2.000 Blutgerinnsel auf, so Dr. Stephan Moll, Hämatologe und Professor für Medizin an der University of North Carolina.

“Die Vereinigten Staaten haben 253 Millionen Erwachsene”, sagte Dr. Moll. “Wenn also jeden Tag 2,3 Millionen Menschen in den USA mit Covid geimpft werden, bedeutet dies, dass täglich etwa 1 Prozent der erwachsenen Bevölkerung geimpft wird.”

Weiter berechnet, sagte er, würde ungefähr 1 Prozent der 1.000 bis 2.000 täglichen Blutgerinnsel – 10 bis 20 pro Tag – bei den geimpften Patienten nur als Teil der normalen Hintergrundraten auftreten, die nicht mit dem Impfstoff zusammenhängen.

“Nur wenn epidemiologische Daten zeigen, dass diese Rate höher ist, würde man sich über einen ursächlichen Zusammenhang wundern”, sagte Dr. Moll.

Dr. David Wohl, Direktor der Impfklinik an der Universität von North Carolina, sagte, er habe in den großen klinischen Studien, die zu ihrer Zulassung führten, keine Beweise dafür gesehen, dass einer der Covid-Impfstoffe Blutgerinnsel, auch Thrombose genannt, verursacht habe.

Dr. Wohl bemerkte aber auch: “Es gibt Unterschiede zwischen Prüfungen und dem wirklichen Leben.”

Die umfangreichsten Sicherheitsergebnisse aus der realen Einführung des Impfstoffs von AstraZeneca stammen aus Großbritannien, wo im letzten Monat 9,7 Millionen Dosen des Impfstoffs verabreicht wurden. Die britischen Daten ergaben, dass zumindest einige Gerinnungszustände, obwohl sie äußerst selten sind, bei Personen, die mit dem Impfstoff von AstraZeneca geimpft wurden, im Vergleich zu Personen, die Pfizers Produkt erhielten, gleich häufig waren. Aber ungewöhnlich niedrige Thrombozytenwerte waren bei Menschen, die den Impfstoff gegen AstraZeneca erhielten, häufiger.

Außerhalb von Studien werden die Impfstoffe einem breiteren Personenkreis verabreicht. Wenn also Sicherheitsfragen auftauchen, sobald ein Impfstoff allgemeiner angewendet wird, sollten die Fragen untersucht werden, sagte Dr. Wohl.

Aktualisiert

15. März 2021, 22:30 Uhr ET

“Wir wollen ein Signal nicht ignorieren, das auf ein größeres Problem hinweisen könnte”, sagte er. “Aber zu diesem Zeitpunkt ist es verfrüht zu glauben, dass AstraZeneca Thrombosen verursacht.”

Andere Impfstoffe, insbesondere solche, die Kindern gegen Masern, Mumps und Röteln verabreicht wurden, wurden mit vorübergehend verringerten Blutplättchenspiegeln in Verbindung gebracht, einer für die Gerinnung essentiellen Blutkomponente.

Bei einer kleinen Anzahl von Patienten, die die Impfstoffe Moderna, Pfizer-BioNTech und AstraZeneca erhielten, wurde über verringerte Thrombozytenwerte berichtet. Ein Empfänger, ein Arzt in Florida, starb an einer Gehirnblutung, als seine Thrombozytenwerte nicht wiederhergestellt werden konnten, und andere wurden ins Krankenhaus eingeliefert. US-Gesundheitsbehörden haben erklärt, dass die Fälle untersucht werden, sie haben jedoch die Ergebnisse dieser Überprüfungen nicht gemeldet und müssen noch darauf hinweisen, dass ein Zusammenhang mit den Impfstoffen besteht.

Die Europäische Arzneimittel-Agentur gab am Montag bekannt, dass sie mit AstraZeneca und den Gesundheitsbehörden zusammenarbeitet, um “alle verfügbaren Daten und klinischen Umstände in Bezug auf bestimmte Fälle” zu prüfen.

Die Behörden haben nicht detailliert angegeben, wie diese Bewertung aussehen wird. Bei der Beurteilung eines möglichen Zusammenhangs zwischen einem Impfstoff und einer schwerwiegenden Nebenwirkung konzentrieren sich die Ermittler im Allgemeinen darauf, abzuschätzen, wie oft solche medizinischen Probleme in der betreffenden Personengruppe zufällig auftreten dürften.

Das könnte bedeuten, dass man sich Leute in derselben Gruppe ansieht, bevor sie geimpft wurden. Es könnte auch bedeuten, eine ähnliche Gruppe von Menschen zu betrachten. Wenn die Rate dieser Probleme in der geimpften Gruppe höher ist als in einer vergleichbaren Population zu erwarten, ist dies ein Zeichen dafür, dass das Sicherheitsproblem real ist oder zumindest eine genauere Prüfung wert ist.

Solche Untersuchungen hängen typischerweise nicht davon ab, endgültig herauszufinden, ob der Impfstoff die Todesursache oder ein ernstes medizinisches Problem war, da dies in den meisten Fällen nicht endgültig bestimmt werden kann. Die Ermittler berücksichtigen jedoch die Anamnese, z. B. ob eine Person vor der Impfung wegen ähnlicher medizinischer Probleme behandelt wurde.

Die Ermittler berücksichtigen auch Faktoren, die die Wahrscheinlichkeit erhöhen, dass eine Gruppe von Menschen krank wird. Ältere Menschen, die in Impfkampagnen auf der ganzen Welt Vorrang haben, haben ein höheres Risiko, Blutgerinnsel zu entwickeln als jüngere.

Was Sie über den Impfstoff-Rollout wissen müssen

Einzelne Gesundheitsministerien führen ebenfalls Untersuchungen durch, und die Gesundheitsbehörden in diesen Ländern warten auf die Ergebnisse der Autopsien. In Italien haben die Behörden außerdem im Rahmen einer Untersuchung des Todes des Lehrers am Wochenende Dosen des Impfstoffs in der Region Piemont beschlagnahmt.

Ein Beratungsausschuss der Weltgesundheitsorganisation plant, sich am Dienstag zu treffen, um den Impfstoff zu erörtern. Der Sicherheitsausschuss der Europäischen Arzneimittel-Agentur wird am Donnerstag zusammentreten.

Jennifer Nuzzo, Epidemiologin am Center for Health Security der Johns Hopkins University, hoffte, dass die Behörden regelmäßig über den Stand der Untersuchung der Sicherheit des AstraZeneca-Impfstoffs informieren würden – was bei Sicherheitsproblemen häufig nicht der Fall ist geprüft.

“Ich wünschte wirklich, es könnte mehr Kommunikation darüber geben, welche Arten von Analysen sie durchführen, was sie betrachten, auch wenn sie vorübergehend sind – nur um Transparenz in den Prozess zu geben, um das Vertrauen in den Prozess zu verbessern”, sagte Dr. Sagte Nuzzo.

AstraZeneca hat sich vor einer Woche erstmals öffentlich mit den Sicherheitsbedenken befasst, nachdem Österreich die Impfungen gegen eine Charge des Impfstoffs von AstraZeneca eingestellt hatte. Ein Unternehmenssprecher sagte damals, dass keine schwerwiegenden Nebenwirkungen des Impfstoffs bestätigt worden seien.

Am Donnerstag, nachdem Dänemark alle Impfungen mit dem Produkt von AstraZeneca eingestellt hatte, gab das Unternehmen eine Erklärung ab, in der es die Sicherheit seines Impfstoffs deutlicher verteidigte. Die Sicherheitsdaten von AstraZeneca, eine Fundgrube von mehr als 10 Millionen Datensätzen, zeigten keine Hinweise auf ein erhöhtes Risiko für Blutgerinnselprobleme in einer demografischen Gruppe oder einem Land, so das Unternehmen.

Nachdem mehrere weitere Länder Pläne angekündigt hatten, ihre Impfkampagnen auszusetzen, veröffentlichte AstraZeneca am Sonntag eine Pressemitteilung mit genaueren Angaben zur Anzahl der gemeldeten Nebenwirkungen und zu Personen, die in klinischen Studien und Impfkampagnen in Europa geimpft wurden.

Am Montag sagte ein Sprecher von AstraZeneca, das Unternehmen arbeite “mit nationalen Gesundheitsbehörden und europäischen Beamten zusammen und freue sich auf deren Bewertung im Laufe dieser Woche”. (Das Unternehmen weigerte sich, den Sprecher zu benennen.)

Bedenken hinsichtlich der Sicherheit von Impfstoffen in der Vergangenheit wurden in der Regel nicht durch die Beweise bestätigt, obwohl es Ausnahmen gibt. 1999 wurde der erste Impfstoff gegen die Rotavirus-Infektion, die bei Säuglingen Durchfall verursacht, vom Markt genommen, da festgestellt wurde, dass er das Risiko einer Darmobstruktion erhöht.

Aber selbst unbegründete Sicherheitsbedenken haben das Vertrauen der Öffentlichkeit geschwächt.

Nachdem die Food and Drug Administration 1998 einen hochwirksamen Impfstoff gegen Lyme-Borreliose zugelassen hatte, haben Medienberichte und eine Sammelklage Beschwerden von Personen angeheizt, die angaben, nach der Impfung Arthritis entwickelt zu haben. Im Jahr 2001 berief die FDA eine Expertengruppe ein, um die Sicherheitsdaten des Impfstoffs zu überprüfen – klinische Studien hatten keinen Unterschied in der Häufigkeit langfristiger Gelenksymptome zwischen der Impfstoff- und der Placebo-Gruppe ergeben – und kam zu dem Schluss, dass der Impfstoff auf dem Markt bleiben sollte .

Bis dahin war die öffentliche Wahrnehmung des Impfstoffs jedoch zu weit gegangen: Ein starker Umsatzrückgang spornte den Impfstoffhersteller GlaxoSmithKline an, den Impfstoff 2002 vom Markt zu nehmen.

Während mehr als 70 Länder den Impfstoff zugelassen haben, haben die Vereinigten Staaten dies nicht getan. AstraZeneca hat noch keine Genehmigung bei der Food and Drug Administration beantragt und wartet auf die Ergebnisse seiner US-Studie, an der mehr als 32.000 Teilnehmer teilnahmen.

Eine Ankündigung von AstraZeneca zu diesen Ergebnissen könnte in Kürze erfolgen: Die Daten aus dieser Studie werden derzeit von einem unabhängigen Expertengremium geprüft, sagte Dr. Francis Collins, der Direktor der National Institutes of Health, am Montag gegenüber Reuters.

Laut Geoffrey Porges, Analyst bei der Investmentbank SVB Leerink, könnten die Ergebnisse dieser Studie die Sicherheit und Wirksamkeit dieser Studie erheblich verbessern, um die Menschen über den Impfstoff von AstraZeneca zu beruhigen.

“Aber je länger dies da draußen bleibt, ohne eine umfassende Überprüfung und ohne die Ergebnisse der US-Phase 3, desto mehr Menschen werden besorgt sein”, sagte Porges.

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World News

Covid-19 Vaccine Stay Updates: Mississippi Opens Eligibility, Italy Lockdown and Extra

Here’s what you need to know:

Credit…Rory Doyle for The New York Times

Mississippi will become the second state to open Covid-19 vaccinations to all of its adult residents, following a call from President Biden for all states to do so by May 1.

Alaska opened its vaccination doors last week to anybody 16 or older who lives or works in the state. The change in Mississippi takes effect Tuesday.

“Get your shots, friends,” Gov. Tate Reeves announced on Twitter. “And let’s get back to normal!”

The pace of vaccinations in the United States has steadily increased as production has ramped up, from well under one million shots per day on Jan. 20, when Mr. Biden took office, to about 2.4 million doses per day on average, according to a New York Times database.

Mr. Biden’s team has made key decisions that quickened the manufacturing and distribution of vaccines, but now the country faces the challenge of getting all those shots into arms. Mass vaccination sites across the country are opening up or increasing their capacity, in part to respond to the influx of doses from the single-shot Johnson & Johnson vaccine.

But more challenges remain, including improving access in communities of color and convincing Americans wary for a variety of reasons that getting vaccinated is safe and effective.

Although Mississippi lags most states in the share of its population that has been vaccinated, it is doing better than all of its neighbors except Louisiana, according to a New York Times tracker. As of Sunday, about 20 percent of Mississippians have received at least one shot, and 11 percent have been fully vaccinated.

The state had already opened eligibility further than most states, to cover everyone 50 or over. Governor Reeves urged older residents to book appointments as soon as possible.

Gov. Gretchen Whitmer of Michigan has said that her state will drop its restrictions on eligibility by April 5, about a month before Mr. Biden’s deadline. Gov. Ned Lamont of Connecticut said his state would as well, tentatively opening vaccine eligibility to all adults on April 5.

“It’s still going to take some time to get the vaccine to everyone who wants it, and I urge patience to the greatest extent possible,” Mr. Lamont said in a news release.

Officials in Washington, D.C., said on Monday that they would do the same by May 1, allowing anyone 16 or older who lives in the city to be inoculated.

In New York, where the minimum age was recently lowered to 60, the state will open three new mass vaccination sites on Long Island at the end of the week, Gov. Andrew M. Cuomo said on Monday at a news conference. The sites will be on college campuses in Old Westbury, Brentwood and Southampton.

More categories of public-facing workers will become eligible in New York on Wednesday, including government employees, building services workers and employees of nonprofit groups. Mr. Cuomo has yet to announce how or when the state would open eligibility to all adults.

About 92.6 million vaccine doses have been administered since Mr. Biden’s inauguration, according to data released on Monday by the Centers for Disease Control and Prevention. At the current pace, the country will pass 100 million doses under Mr. Biden before the end of the week.

United States › United StatesOn March 14 14-day change
New cases 38,034 –19%
New deaths 572 –31%
World › WorldOn March 14 14-day change
New cases 369,370 +11%
New deaths 5,360 –6%

U.S. vaccinations ›

Where states are reporting vaccines given

Peter Krage, 54, a gerontological nurse, getting his first dose of the AstraZeneca vaccine in Rostock, Germany, last month.Credit…Lena Mucha for The New York Times

As a third wave of the pandemic crashes over Europe, questions about the safety of one of the continent’s most commonly available vaccines led Germany, France, Italy and Spain to temporarily halt its use on Monday. The suspensions created further chaos in inoculation rollouts even as new coronavirus variants continue to spread.

The decisions followed reports that a handful of people who had received the vaccine, made by AstraZeneca, had developed fatal brain hemorrhages and blood clots.

The company has strongly defended its vaccine, saying that there is “no evidence” of increased risk of blood clots or hemorrhages among the more than 17 million people who have received the shot in the European Union and the United Kingdom.

“The safety of all is our first priority,” AstraZeneca said in a statement Monday. “We are working with national health authorities and European officials and look forward to their assessment later this week.”

The timing of the pause in inoculations by some of Europe’s largest countries — which followed a flurry of similar actions by Denmark, Norway and several others — could not have been worse.

Europe’s vaccine rollouts already lag far behind those in Britain and the United States, and there is dawning realization that much of the continent is suffering a third wave of infections. Leading immunologists fretted on Monday that the decision by several of Europe’s leading nations to suspend the use of AstraZeneca would make vaccination efforts even harder by emboldening vaccine skeptics in countries where they are particularly entrenched.

The European Medicines Agency and the World Health Organization warned against an exodus from vaccines that would undermine rollout efforts at a pivotal moment.

VideoVideo player loadingItaly began to enter strict regional lockdowns on Monday, as the government moved to halt an increase in coronavirus infections just one year after the country became the first in Europe to impose a national lockdown.CreditCredit…Alessandro Grassani for The New York Times

A year after Italy became the first European country to impose a national lockdown to contain the spread of the coronavirus, the nation has fallen eerily quiet once again, with new restrictions imposed on Monday in an effort to stop a third wave of infections that is threatening to wash over Europe and overwhelm its halting mass inoculation program.

As he explained the measures on Friday, Prime Minister Mario Draghi warned that Italy was facing a “new wave of contagion,” driven by more infectious variants of the coronavirus.

Just as before, Italy was not alone.

“We have clear signs: The third wave in Germany has already begun,” Lothar Wieler, head of the Robert Koch Institute for Infectious Diseases, said during a news conference on Friday. Prime Minister Viktor Orban of Hungary predicted that this week would be the most difficult since the start of the pandemic in terms of allocating hospital beds and breathing machines, as well as mobilizing nurses and doctors. Hospitalizations in France are at their highest levels since November, prompting the authorities to consider a third national lockdown.

Officials in the United States are watching those developments with wary eyes. At a White House news briefing on Monday, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, pleaded with Americans not to let their guard down as case numbers have dropped from their peak. She pointed to images of young people crowded onto Florida beaches, though generally people are safer outside than inside, and to European nations as a warning.

“Each of these countries has had nadirs like we are having now, and each took an upward trend after they disregarded no mitigation strategies,” she said. “They simply took their eye off the ball. I’m pleading with you for the sake of our nation’s health. These should be warning signs for all of us.”

The U.S. death rate remains at nearly 1,400 people every day. That number still exceeds the summer peak, when patients filled Sun Belt hospitals and outbreaks in states that reopened early drove record numbers of cases, though daily deaths nationwide remained lower than the first surge last spring. The average number of new reported cases per day remains comparable to the figures reported in mid-October.

Across Europe, cases are spiking. Supply shortages and vaccine skepticism, as well as bureaucracy and logistical obstacles, have slowed the pace of inoculations. Governments are putting exhausted populations under lockdown. Street protests are turning violent. A year after the virus began spreading in Europe, things feel unnervingly the same.

In Rome, the empty streets, closed schools, shuttered restaurants and canceled Easter holidays came as a relief to some residents after months of climbing infections, choked hospitals and deaths.

“It’s a liberation to return to lockdown, because for months, after everything that happened, people of every age were going out acting like there was no problem,” said Annarita Santini, 57, as she rode her bike in front of the Trevi Fountain, a popular site that had no visitors except for three police officers. “At least like this,” she added, “the air can be cleared and people will be scared again.”

For months, Italy had relied on a color-coded system of restrictions that, unlike the blanket lockdown of last year, sought to surgically smother emerging outbreaks in order to keep much of the country open and running. It does not seem to have worked.

“History repeats itself,” Massimo Galli, one of Italy’s top virologists, told the daily Corriere della Sera on Monday. “The third wave started, and the variants are running.”

“Unfortunately we all got the illusion that the arrival of the vaccines would reduce the necessity of more drastic closures,” he said. “But the vaccines did not arrive in sufficient quantities.”

Sheryl Gay Stolberg Lauren Leatherby and Mitch Smith contributed reporting.

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Biden: ‘Shots in Arms and Money in Pockets’

President Biden declared on Monday that within 10 days the U.S. would achieve his goal of administering 100 million vaccination shots and delivering 100 million stimulus checks to Americans.

Over the next 10 days, we’ll reach two goals, two giant goals. The first is 100 million shots in people’s arms will have been completed within the next 10 days and 100 million checks in people’s pockets in the next 100 days. Shots in arms and money in pockets. That’s important. The American Rescue Plan is already doing what it was designed to do, make a difference in people’s everyday lives. And we’re just getting started. By the time all the money is distributed, 85 percent of American households will have gotten their $1,400 rescue checks. I’m pleased to announce and introduce another gifted manager to coordinate our implementation of the American Rescue Plan, Gene Sperling. Gene will be on the phone with mayors and governors, red states, blue states, the source of constant communication, a source of guidance and support, and above all, a source of accountability for all of us to get the job done. And together, we’re going to make sure that the benefits of the American Rescue Plan go out quickly and directly to the American people where they belong. Help is here and hope is here in real and tangible ways. We’re just days away from 100 million shots and millions — in the arms of millions of Americans. That’s the way, that’s the way on the way to get every single American access to the vaccine.

Video player loadingPresident Biden declared on Monday that within 10 days the U.S. would achieve his goal of administering 100 million vaccination shots and delivering 100 million stimulus checks to Americans.CreditCredit…Doug Mills/The New York Times

President Biden said Monday that his administration was on pace to achieve two key goals by March 25: the distribution of 100 million shots of Covid-19 vaccines since his inauguration and 100 million checks and electronic deposits of stimulus payments under his economic relief bill.

“Shots in arms and money in pockets. That’s important,” Mr. Biden said in a brief address from the White House.

The president also introduced Gene Sperling, a longtime Democratic policy aide, as his pick to oversee implementation of the $1.9 trillion economic relief package that he signed into law late last week.

“The American Rescue Plan is already doing what it was designed to do,” Mr. Biden said. “Make a difference in people’s everyday lives.”

The United States has administered 92.6 million vaccine doses since Jan. 20, when Mr. Biden took office, according to data released on Monday by the Centers for Disease Control and Prevention. At the current pace of vaccinations, the country will pass 100 million doses under Mr. Biden before the end of the week.

Answering a question from a reporter after the speech, Mr. Biden brushed aside calls for his administration to enlist former President Donald J. Trump’s help in appealing to Republicans who have resisted getting vaccinated.

“I discussed it with my team,” Mr. Biden said, “And they say the thing that has more impact than anything Trump would say to the MAGA folks is what the local doctor, what the local preachers, the local people in the community would say. So I urge, I urge all local docs, and ministers, and priests, to talk about why — why it’s important to get that vaccine.”

Mr. Biden’s remarks came as his team launched a week of sales pitches for the relief bill. The president and several members of his administration will travel the country to promote the plan that contains direct $1,400-per-person payments to low- and middle-income Americans, new monthly checks for parents and additional relief for the unemployed, among other particulars.

Mr. Biden will visit Delaware County, Pa., on Tuesday and will appear with Vice President Kamala Harris on Friday in Atlanta, which helped deliver Democrats the Senate majority that made the stimulus law possible.

A group of other administration representatives and officials, including the first lady, Jill Biden, and Ms. Harris’s husband, Doug Emhoff, will also make trips. Ms. Harris and her husband landed in Las Vegas for an event on Monday afternoon, while Dr. Biden finished an event in New Jersey.

The road show is an effort to avoid the messaging mistakes of President Barack Obama’s administration, which Democrats now believe failed to continue vocally building support for his $780 billion stimulus act after it passed in 2009. The challenge will be to highlight less obvious provisions, including the largest federal infusion of aid to the poor in generations, a substantial expansion of the child tax credit and increased subsidies for health insurance.

Mr. Sperling’s challenge with the rescue plan will be different than the one Mr. Biden faced in 2009, because the relief bill differs starkly from Mr. Obama’s signature stimulus plan. The Biden plan is more than twice as large as Mr. Obama’s. It includes money meant to hasten the end of the pandemic, including billions for vaccine deployment and coronavirus testing.

Oversight of the $1.9 trillion relief legislation is currently expected to rely on the Government Accountability Office and the Pandemic Response Accountability Committee, a panel of inspectors general from across the federal government. A Treasury official said that the department would set up a process to monitor the use of funds that are being sent to states to ensure that they are used according to the eligibility requirements in the law.

A rally in San Francisco on Saturday in support of a five-day in-person learning schedule at the city’s public schools.Credit…John G Mabanglo/EPA, via Shutterstock

Parents of schoolchildren protested in several cities around the United States over the weekend, frustrated by the off-again-on-again reopening policies in some school districts and blanket closures in others a full year after the pandemic began, despite growing scientific evidence that schools can reopen safely if they follow basic procedures.

Several hundred people rallied in downtown Naperville, Ill., on Sunday to urge officials to give students the option of returning to the classroom five days a week. Wielding signs with messages like “Get our kids back in school” and “Flip the school board,” demonstrators chanted, “Five days a week,” The Naperville Sun reported.

In San Francisco, hundreds of parents and children marched on Saturday in support of a five-day in-person learning schedule, arguing that a partial reopening falls short, The San Francisco Chronicle reported. Similarly, parents demonstrated at Pan Pacific Park in Los Angeles on Saturday, according to a local news station, saying a tentative agreement with teachers for a partial reopening in April was not enough.

Parents pressing for in-person classes say that remote learning leaves students feeling emotionally and socially drained at home.

They have the Biden administration on their side. Jill Biden and members of her husband’s administration have been traveling the country in a campaign aimed at reopening schools. And the Centers for Disease Control and Prevention released guidelines last month saying it was safe for schools to reopen if they could ensure measures like proper masking, physical distancing and hygiene were taken. The recommendations called for every elementary school to open in some fashion.

In early February, The New York Times surveyed 175 experts — mostly pediatricians focused on public health — who largely agreed that it was safe enough for schools to be open to elementary students for full-time, in-person instruction. Some said that was true even in communities where coronavirus cases were widespread, with proper safety precautions, including adequate ventilation and avoidance of large group activities.

Heather Kilpatrick used to work in hospitality before the pandemic, but she now stays home with her 3-year-old daughter, Vivienne. Credit…Tony Luong for The New York Times

In the year since the pandemic upended the U.S. economy, more than four million people have quit the labor force, leaving a gaping hole in the job market that cuts across age and circumstances.

An exceptionally high number have been sidelined because of child care and other family responsibilities or health concerns. Others gave up looking because they were discouraged by the lack of opportunities. And some older workers have called it quits earlier than they had planned.

These labor-force dropouts are not counted in the most commonly cited unemployment rate, which was 6.2 percent in February, making the group something of a hidden casualty of the pandemic.

Now, as the labor market begins to emerge from the pandemic’s vise, whether those who have left the labor force return to work — and if so, how quickly — is one of the big questions about the shape of the recovery.

There is some reason for optimism. Economists expect that many who have left the labor force in the past year will return to work once health concerns and child care issues are alleviated. And they are optimistic that as the labor market heats up, it will draw in workers who grew disenchanted with the job search.

Moreover, after the last recession, many economists said those who left the labor force were unlikely to come back, whether because of disabilities, the opioid crisis, a loss of skills or other reasons. Yet labor force participation, adjusted for demographic shifts, eventually returned to its previous level.

But the speed with which the pandemic has driven workers from the labor force could leave lasting damage.

Many Facebook and Instagram users are already using the apps to share their vaccination status.Credit…Marcio Jose Sanchez/Associated Press

Facebook said on Monday that it planned to expand its efforts to help get people vaccinated against the coronavirus.

The social network said it would roll out a new location-based tool to direct people to the clinics nearest to them that offer vaccinations, which users can find inside Facebook’s main app.

The company will also have an information center for Covid-19-related questions and data inside its Instagram photo-sharing app, building on a similar effort that Facebook introduced last year. And it will keep adding automated chat bots to WhatsApp, which can text users information on where to get vaccinated.

“By working closely with national and global health authorities and using our scale to reach people quickly, we’re doing our part to help people get credible information, get vaccinated and come back together safely,” Mark Zuckerberg, the chief executive of Facebook, said in a company blog post.

While Facebook previously allowed anti-vaccination groups on its platform to flourish, last year it pledged to remove Covid-related misinformation from its site. It also labeled posts related to the coronavirus with links to its official information center so it could direct people to sources like the World Health Organization.

But critics have said that false or misleading data about vaccines and the virus continues to be visible in private groups and pages on Facebook.

At North Dakota State University in October. Several studies have shown that the pandemic has disproportionately affected the mental health of young people.Credit…Bing Guan/Reuters

Young people’s reports of poor well-being during the pandemic have fueled a global crisis that needs immediate attention, according to a nonprofit organization that surveyed nearly 50,000 people in eight countries, providing a comprehensive overview of the pandemic’s impact on mental health.

More than one in four respondents reported facing or being at risk of clinical disorders, a number that rose to nearly one in two for those ages 18 to 24, according to the report, which was released by group, Sapien Labs, a U.S. nonprofit group dedicated to understanding the human mind.

The report, based on data collected from an online, anonymous survey whose findings were published on Monday, focused on Australia, Britain, Canada, India, New Zealand, Singapore, South Africa and the United States. It found that 40 percent of respondents ages 18 to 24 reported feeling sadness, distress or hopelessness, as well as unwanted, strange and obsessive thoughts.

“The coronavirus pandemic has exacerbated trends that were already there, and made them worse,” said Dr. Tara Thiagarajan, the founder and chief scientist of Sapien Labs. “Particularly, social isolation has had a larger impact on young people, and it’s pushed many of them over the edge.”

Other studies have shown that the pandemic has disproportionately affected the mental health of young people, women and people of color.

Mental health experts have also warned against the long-term effects of the pandemic, which are likely to include an economic recession and the psychological fallout of long-term social isolation.

The report’s authors, Dr. Thiagarajan and Jennifer Newson, urged governments to focus on population-wide policies targeting mental health, instead of individual approaches that are often favored.

“While much of the focus in the mental health arena has been on self-care through apps, therapy and other programs, social and economic policy and institutional culture may have a large role to play in the mitigation of our present mental health crisis and prevention of future crises,” they wrote.

Anallely Falcon receiving her second dose on in Central Falls, R.I., last month.Credit…David Degner for The New York Times

Nearly nine in 10 Americans who received the first dose of a two-dose Covid-19 vaccine went on to complete the regimen, and most people who received two doses got them within the recommended time frames, federal health officials reported on Monday.

The analyses, by investigators with the Centers for Disease Control and Prevention, included data on tens of millions of Americans who received the Moderna or Pfizer-BioNTech vaccines between mid-December and mid-February.

The percentage of people completing the regimens varied markedly by jurisdiction and between demographic groups, however. Federal health officials urged local vaccinators to take steps to ensure that everyone comes back, including scheduling a return appointment when giving the first shot, sending reminders, and rescheduling missed or canceled appointments.

While the data were “reassuring” over all, C.D.C. researchers said, the first groups receiving the vaccine in the United States — health care workers and long-term care facility residents — had easy access to the second dose, since they were likely to have been vaccinated at their workplace or place of residence.

As vaccines are offered to broader groups of people, the scientists warned, the percentage getting fully vaccinated may drop.

People are not considered fully vaccinated against the coronavirus until two weeks after they receive the second shot of the two-dose regimen (or two weeks after receiving the single-dose vaccine made by Johnson & Johnson).

C.D.C. researchers looked at some 40.5 million Americans who were vaccinated between Dec. 14, 2020 and Feb. 14, 2021.

In one analysis, they reviewed the records of 12.4 million people who had received the first dose of a two-dose vaccine regimen and had enough time to get the second dose. Some 88 percent had completed the series, while 8.6 percent were still within the allowable interval — 42 days — to receive the second dose. But 3.4 percent had missed that window. (The recommended interval between doses is 21 days for the Pfizer-BioNTech vaccine and 28 days for Moderna).

Americans most likely to have missed the second dose varied by locality. Among vaccine recipients for whom information on race and ethnicity were known, the lowest completion rates were among Native American or Alaska Native individuals.

A second analysis of 14.2 million people who completed the full regimen found that 95.6 percent received the second dose within the recommended period, though again the figures varied by community.

The authors of the study urged providers and public health workers to encourage Americans to come back for second doses and to emphasize the importance of full vaccination. C.D.C. officials also asked that vaccinators work to understand what keeps people from completing the series, and whether access or lack of confidence in the vaccines are playing a role.

GLOBAL ROUNDUP

With the borders closed, Russian tourists are discovering domestic destinations, like Lake Baikal.Credit…Sergey Ponomarev for The New York Times

Usually, it is foreigners who flock to Lake Baikal in Siberia this time of year to skate, bike, hike, run, drive, hover and ski over a stark expanse of ice and snow, while Russians escape the cold to Turkey or Thailand.

But Russia’s borders are still closed because of the pandemic, and to the surprise of locals, crowds of Russian tourists have traded tropical beaches for the icicle-draped shores of Baikal, the world’s deepest lake. The tour guides are calling it Russian Season.

If you catch a moment of stillness on the crescent-shaped, 400-mile-long, mile-deep lake, the assault on the senses is otherworldly. You stand on three feet of ice so solid it is crossed safely by heavy trucks, but you feel fragile, fleeting and small.

Yet stillness is hard to come by.

Western governments have been discouraging travel during the pandemic, but in Russia, as is so often the case, things are different. The Kremlin has turned coronavirus-related border closures into an opportunity to get Russians — who have spent the last 30 years exploring the world beyond the former Iron Curtain — hooked on vacationing at home.

A state-funded program that began last August offers $270 refunds on domestic leisure trips, including flights and hotel stays. It is one example of how Russia, which had one of the world’s highest coronavirus death tolls last year, has often prioritized the economy over public health during the pandemic.

“Our people are used to traveling abroad to a significant degree,” President Vladimir V. Putin said in December. “Developing domestic tourism is no less important.”

In other news from around the world:

  • The government of Hong Kong said on Monday that vaccine eligibility would be expanded to include everyone age 30 and older regardless of occupation, as the Chinese territory tries to increase vaccine uptake. About 200,000 of Hong Kong’s 7.5 million residents have received a first dose of either the BioNTech or Sinovac vaccines since the inoculation drive began late last month. But the proportion of people who show up for their appointments has fallen amid reports that six people have died after receiving the vaccine developed by Sinovac, a private Chinese company. Officials say that two of the deaths are not directly related to the vaccine and that the others are under investigation. The vaccine announcement came as Hong Kong is trying to contain a cluster of cases that began at a gym and has grown to 122 people, with more than 850 close contacts sent to government quarantine facilities and multiple residential buildings locked down overnight for mandatory testing. Also on Monday, the U.S. Consulate in Hong Kong said it was closing for deep cleaning after two employees tested positive for the virus.

The pandemic became real for Clary Montgomery when she introduced her daughter, Paloma, who was born March 11, 2020, to family members via video.

“When my toddler grandson tried to feed me a blueberry through the cellphone screen.”

That was the answer from Alice Gilgoff, 74, of Rosendale, N.Y., when The New York Times asked readers: When did the coronavirus pandemic become real for you? Nearly 2,000 people responded, and we have compiled many of their thoughts.

Across the United States and around the globe, nearly everyone experienced a moment when the pandemic truly hit home. And one year later, as the pandemic carries on, having claimed more than 2.6 million lives worldwide, it has been with us long enough to have its own history.

The answers from readers to that question are a journey through time. It has been a year of trauma and resilience. No one has been spared, yet some have borne burdens far more profound than others.

Still, our stories connect us: each of us human, each of us just trying to survive a pandemic that changed us and the world.

Denise Saylor photographed herself as Lara Comstack injected her with  vaccine in January at the Callen-Lorde Community Health Center in Manhattan.Credit…James Estrin/The New York Times

Most people aren’t particularly fond of needles.

For a significant number of people, though, fear of needles goes beyond anxiety into a more dangerous area, and prevents them from seeking out needed medical care.

As the world’s hopes of returning to a post-pandemic normal rest largely on people’s willingness to take a Covid-19 vaccine, experts and health care professionals are assuring those people that there are ways to overcome this problem.

“It would be heartbreaking to me if a fear of needles held someone back from getting this vaccine, because there are things we can do to alleviate that,” said Dr. Nipunie S. Rajapakse, an infectious diseases expert at the Mayo Clinic in Minnesota.

A study from the University of Michigan found that 16 percent of adults in several countries avoided annual flu vaccinations because of a fear of needles, and 20 percent avoided tetanus shots.

Whether fear is keeping you from being vaccinated at all or is causing you distress about doing so, there are some steps that the experts suggest:

  • Seek professional help. A therapist can help people with the most severe fear, especially if the fear is interfering with getting appropriate medical care.

  • Tell the nurse about your fear before getting the shot. There may be techniques the nurse can use, or products may be available, to reduce the pain of the injection or to put you at ease.

  • Distract yourself. It could be a YouTube video or your favorite song playing on your phone. You could practice deep-breathing or meditation techniques, or wiggle your toes, or look around and count all of the blue items you can see in the room.

  • Focus on the benefits. Think about the summer barbecues, family gatherings and economic recovery the vaccines will help usher in, and you might be feeling more optimistic and excited than nervous.

The apparent assault on an Uber driver, Subhakar Khadka, is the latest incident involving confrontations around coronavirus protections.Credit…Jason Henry for The New York Times

Two arrests have been made after scenes from a viral video that circulated showed passengers taunting and deliberately coughing on an Uber driver.

In the dashcam video, the driver, who had a hand on his head, looked exasperated. A woman in the passenger’s seat uttered an expletive about a mask and then coughed on the driver, while using racial slurs. Another passenger joined in, pulling down her mask and laughing. “And I got corona,” she said.

The driver refused to continue the ride, and the situation escalated. The passenger who had initially coughed on the driver grabbed his phone and tore off his mask, breaking the strap. The women continued screaming profanities.

The San Francisco Police Department said in a statement last Thursday that the driver, identified by KGO-TV as Subhakar Khadka, had picked up three passengers in the early afternoon on March 7, but when he saw that one of the women was not wearing a mask, he told them he would not continue unless they all wore masks.

In a video that was posted on Instagram and has since been removed, one passenger said that the driver was trying to make them exit the car in the middle of the freeway.

Soon, “an altercation ensued,” the police said.

One woman grabbed the driver’s cellphone, which Mr. Khadka eventually retrieved, and another passenger sprayed “what is believed to be pepper spray” into the car through an open window after they exited the vehicle, according to the police.

The flare-up is the latest high-profile example of mask conflicts, which have sometimes taken violent turns. Last year, prosecutors in Chicago said two sisters attacked a store security guard with a garbage can. One of the women stabbed the guard repeatedly with a small knife after he tried to insist that they wear masks and use the store’s hand sanitizer on entry.

In another case last year, an 80-year-old man in upstate New York was killed after he asked a bar patron to wear a mask; the patron shoved the man to the ground, causing him to hit his head.

Mr. Khadka, an Uber driver from Nepal who came to the United States eight years ago, said in an interview with KPIX that he never said anything “bad” to the women, and that they had refused to leave his car. Mr. Khadka said he believed he was singled out for their ire because he is South Asian. “If I was of another complexion, I would have not gotten that treatment from them,” he said. “The moment I opened my mouth to speak, they realized I’m not among one of them. It’s easy for them to intimidate me.”

One of the passengers was arrested in Las Vegas on Thursday, the Las Vegas Police Department said. The passenger, Malaysia King, 24, was taken into custody on a warrant for assault with a caustic chemical, assault and battery, conspiracy and violation of a health and safety code, the police said.

A second passenger, Arna Kimiai, 24, turned herself in on Sunday, the San Francisco Police Department announced. Ms. Kimiai was booked on charges of robbery, assault and battery, conspiracy, and violation of a health and safety code.

“The behavior captured on video in this incident showed a callous disregard for the safety and well-being of an essential service worker in the midst of a deadly pandemic,” said Lt. Tracy McCray, who heads the San Francisco Police Department’s robbery detail.

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Eire, Netherlands droop AstraZeneca vaccine amid blood clot fears

A medical worker fills a syringe with AstraZeneca vaccine at Santa Caterina da Siena – Amendola secondary school in Salerno on March 13, 2021 in Salerno, Italy.

Francesco Pecoraro | Getty Images News | Getty Images

LONDON – Ireland and the Netherlands have joined the growing list of countries that have stopped using the coronavirus vaccine developed by AstraZeneca and Oxford University because of blood clot concerns.

The Dutch government said Sunday that the Oxford-AstraZeneca vaccine would not be used until March 29, while Ireland said earlier in the day it had temporarily suspended the shot as a precautionary measure.

The World Health Organization tried to downplay the ongoing safety concerns and stated last week that there was no link between the shot and an increased risk of developing blood clots. The United Nations Health Department has urged countries to continue using the Oxford-AstraZeneca vaccine.

Even so, some European countries have already stopped using the Oxford-AstraZeneca vaccine. It added to the worries of the battered vaccination campaign in the region when the German health department warned that a third wave of coronavirus infections had already begun.

Thailand has also stopped the planned use of the vaccine.

The move to suspend use by Dutch and Irish officials came shortly after the Norwegian Medicines Agency announced that three health workers were hospitalized for bleeding, blood clots and low platelet counts after receiving the Oxford-AstraZeneca vaccine. Norway has suspended its vaccination program against Oxford-AstraZeneca.

Geir Bukholm, director of the Infection Control and Environmental Health Department at the Norwegian Public Health Institute, said the Norwegian Medicines Agency will “follow up on these suspected side effects and take the necessary action in this serious situation”.

The picture taken on November 27, 2020 shows “Nikki” Anniken Hars treating a Covid-19 patient in the intensive care unit of Oslo University Hospital Rikshospitalet in Oslo, Norway.

JIL YNGLAND | AFP | Getty Images

The European Medicines Agency, the European Medicines Agency, also said there is no evidence that Oxford-AstraZeneca’s vaccine causes blood clots and that the vaccine’s benefits “continue to outweigh the risks”.

The EMA admitted that some European countries had stopped using the Oxford-AstraZeneca shot, but said vaccinations may continue to be given while a clot investigation is ongoing.

How did AstraZeneca react?

“A careful review of all available safety data from more than 17 million people vaccinated with the AstraZeneca COVID-19 vaccine in the European Union (EU) and the UK found no evidence of an increased risk of pulmonary embolism, deep vein thrombosis ( DVT) or thrombocytopenia in a certain age group, gender, group or country, “AstraZeneca said in a statement on Sunday.

The most common side effects of the Oxford AstraZeneca vaccine, which does not contain the virus and cannot cause Covid, are usually mild or moderate and improve within a few days after vaccination.

A health worker holds a box of the AstraZeneneca vaccine at the Bamrasnaradura Institute for Infectious Diseases in Nonthaburi Province on the outskirts of Bangkok.

Chaiwat subprasome | SOPA pictures | LightRocket via Getty Images

The pharmaceutical company said that 15 events involving deep vein thrombosis and 22 events involving pulmonary embolism were reported among those vaccinated in the EU and the United Kingdom.

“This is much less than expected to occur naturally in a general population of this size, and it is similar to other approved COVID-19 vaccines,” said AstraZeneca.

What do the experts say?

“Covid definitely causes bleeding disorders and each of the vaccines prevents Covid disease, including more severe cases,” said Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine.

“Therefore, it is highly likely that the vaccine’s benefits will significantly outweigh the risk of clotting disorders, and the vaccine will prevent other consequences of Covid, including deaths from other causes.”

Evans said it was “perfectly reasonable” to conduct studies on vaccines and coagulation disorders, but added, “It seems a step too far to take precautionary measures that would prevent people from receiving vaccines that prevent disease.”

Many high-income countries – such as the UK, France, Australia and Canada – have decided to continue rolling out the Oxford-AstraZeneca vaccine.

“When there is clear evidence of serious or life-threatening side effects that have important consequences,” Adam Finn, professor of pediatrics at Bristol University, said in a statement.

“So far, however, this has not been the case, and it is highly undesirable to disrupt a complex and urgent program every time people, after receiving a vaccine, develop illnesses that are random and not causal. In situations like this, it is not easy to Making the right call, but a steady hand on the tiller is probably what is needed most, “said Finn.

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EU says AstraZeneca not doing sufficient to satisfy vaccine supply goal

A healthcare professional will prepare a dose of the Oxford / AstraZeneca Covid-19 vaccine at the vaccine center at the Brighton Center in Brighton, southern England on January 26, 2021.

Ben Stensall | AFP | Getty Images

LONDON – The European Union has asked AstraZeneca to do more to meet its contract with the bloc as concerns grow that the pharmaceutical company will again miss delivery targets.

It is not the first time that the EU and the drug giant have been at odds with each other. AstraZeneca initially offered to sell around 100 million Doses of his Covid-19 burst before the end of March. However, the company had to renegotiate that amount to just 40 million due to manufacturing issues.

The European Commission, the body that negotiates vaccination contracts on behalf of the 27 member states, is now concerned that this reduced amount will not be respected either.

“AstraZeneca vaccine supply: I see efforts but not ‘best efforts’. This is not yet good enough for AstraZeneca to meet its Q1 commitments,” said Thierry Breton, Internal Market Officer, Thursday evening on Twitter .

Data from the European Center for Disease Prevention and Control shows that 11.76 million doses of the AstraZeneca vaccine had been delivered as of Thursday.

“It is time for AstraZeneca’s board of directors to take on their fiduciary responsibility and do everything possible now to meet AZ’s commitments,” said Breton.

AstraZeneca wasn’t immediately available for comment when CNBC reached out on Friday.

The firm’s CEO, Pascal Soriot, told European lawmakers last month that the reason for the delays was the low return on EU plants. He also said his company was working around the clock to increase production and that it only had six months to prepare the sting, compared to other previous work that took years to develop a new vaccine.

EU “a watchful eye”

At a press conference last month, the President of the European Commission, Ursula von der Leyen, said the EU was “closely monitoring” AstraZeneca’s deliveries.

The supply problem has caused Italy to stop shipping AstraZeneca vaccines destined for Australia last week.

European countries can ban the export of Covid-19 vaccines if a pharmaceutical company fails to perform its contract and the vaccines are supposed to go to a country that is not classified as vulnerable. Low- and middle-income countries and neighboring countries are exempt from these restrictions.

Realizing that there may be further problems with AstraZeneca’s deliveries could lead Member States to stop further deliveries of this vaccine.

The introduction of vaccination is fundamental to the region’s economic recovery, and new problems with bumps could ruin the exit from the crisis.

European Central Bank President Christine Lagarde said on Thursday: “The ongoing vaccination campaigns and the gradual easing of containment measures – apart from other adverse developments related to the pandemic – support expectations of a significant recovery in economic activity over the course of 2021.” “

The EU vaccination program has so far been criticized several times. Some countries have complained that regulators are too slow to approve the bumps compared to other parts of the world. There were production and delivery problems. Bureaucracy at the national level has also hampered the process.

The EU has committed to vaccinating 70% of the adult population before the end of summer.

Earlier this week, the commission agreed with Pfizer and BioNTech to receive 4 million additional doses of their vaccine over the next two weeks.

On Thursday, the block also approved its fourth Covid-19 vaccine with the Johnson & Johnson candidate.

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New York vaccine czar referred to as county executives to find out Cuomo help: report

New York Governor Andrew Cuomo listens to speakers at a vaccination site in New York on March 8, 2021.

SETH LITTLE | AFP | Getty Images

Larry Schwartz, director of New York vaccine rollout and longtime advisor to Governor Andrew Cuomo, has called some district officials over the past few weeks to rally their support for the governor while he grapples with an ongoing sexual harassment investigation, the reported Washington Post on Sunday, citing several officials.

A district chief, speaking on condition of anonymity fearing retaliation by the Cuomo administration, told the Post that it filed a notice on Friday with the Public Integrity Department of the Attorney General’s office of a possible ethics violation by Cuomo’s office would have.

Schwartz, a former top advisor to the governor who came back as an unpaid advisor to direct the state’s vaccine distribution, is in frequent contact with local officials to discuss vaccine planning and distribution.

However, his appeals to officials over the past few weeks regarding their loyalty to the governor raised concerns that the governor’s political situation and response to it could affect the state’s vaccination operation or result in preferential vaccination decisions.