Johnson & Johnson’s Covid vaccine was supposed to be one of Africa’s most important weapons against the coronavirus.
The New Jersey-based company agreed to sell enough of its inexpensive single-shot vaccine to eventually inoculate a third of the continent’s residents. And the vaccine would be produced in part by a South African manufacturer, raising hopes that those doses would quickly go to Africans.
That has not happened.
South Africa is still waiting to receive the overwhelming majority of the 31 million vaccine doses it ordered from Johnson & Johnson. It has administered only about two million Johnson & Johnson shots. That is a key reason that fewer than 7 percent of South Africans are fully vaccinated — and that the country was devastated by the Delta variant.
At the same time, Johnson & Johnson has been exporting millions of doses that were bottled and packaged in South Africa for distribution in Europe, according to executives at Johnson & Johnson and the South African manufacturer, Aspen Pharmacare, as well as South African government export records reviewed by The New York Times.
donated by the United States. But about four million of the country’s 60 million residents are fully vaccinated.
That left the population vulnerable when a third wave of cases crested over the country. At times in recent months, scores of Covid-19 patients at Helen Joseph Hospital in Johannesburg were waiting in the emergency department for a bed, and the hospital’s infrastructure struggled to sustain the huge volumes of oxygen being piped into patients’ lungs, said Dr. Jeremy Nel, an infectious-disease doctor there.
“The third wave, in terms of the amount of death we saw, was the most heartbreaking, because it was the most avoidable,” Dr. Nel said. “You see people by the dozens dying, all of whom are eligible for a vaccine and would’ve been among the first to get it.”
a United Nations-backed clearinghouse for vaccines that has fallen behind on deliveries. South Africa was slow to enter negotiations with manufacturers for its own doses. In January, a group of vaccine experts warned that the government’s “lack of foresight” could cause “the greatest man-made failure to protect the population since the AIDS pandemic.”
announced in November. Aspen’s facility in Gqeberha, on South Africa’s southern coast, was the first site in Africa to produce Covid vaccines. (Other companies subsequently announced plans to produce vaccines on the continent.)
Understand the State of Vaccine and Mask Mandates in the U.S.
Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
Vaccine rules . . . and businesses.Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.
College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
South African officials hailed Aspen’s involvement as indispensable.
Aspen “belongs to us as South Africans, and it is making lifesaving vaccines,” South Africa’s president, Cyril Ramaphosa, said during a visit to Aspen’s plant in March. He said he had pushed Johnson & Johnson to prioritize the doses made there for Africans.
“I want them now,” Mr. Ramaphosa added. “I’ve come to fetch our vaccines.”
results of a clinical trial suggested that the vaccine from AstraZeneca offered little protection from mild or moderate infections caused by the Beta variant that was circulating in South Africa.
Weeks later, Johnson & Johnson and the government signed a contract for 11 million doses. South Africa ordered another 20 million doses in April. That would be enough to vaccinate about half the country.
South Africa agreed to pay $10 per dose for the 11 million shots, according to the contract. That was the same price that the United Statespaid and slightly more than the $8.50 that the European Commission agreed to pay.The South African contract prohibited the government from banning exports of the vaccine, citing the need for doses to “move freely across national borders.”
introduced export controls this year to conserve scarce supplies. India halted exports produced by the Serum Institute, which was supposed to be a major vaccine supplier to poor countries. In the United States, officials said they didn’t ban exports, but they didn’t need to. The combination of the extensive vaccine production on American soil and the high prices the U.S. government was willing to pay meant that companies made the delivery of shots for Americans a priority.
Other benefits for Johnson & Johnson were embedded in the South African contract.
While such contracts typically protect companies from lawsuits brought by individuals, this one shielded Johnson & Johnson from suits by a wider range of parties, including the government. It also imposed an unusually high burden on potential litigants to show that any injuries caused by the vaccine were the direct result of company representatives engaging in deliberate misconduct or failing to follow manufacturing best practices.
“The upshot is that you have moved almost all of the risk of something being wrong with the vaccine to the government,” said Sam Halabi, a health law expert at Georgetown University who reviewed sections of the South African contract at the request of The Times.
Mr. Halabi said the contract’s terms appeared more favorable to the pharmaceutical company than other Covid vaccine contracts he had seen. South African officials have said Pfizer, too, sought aggressive legal protections.
The contract said Johnson & Johnson would aim to deliver 2.8 million doses to South Africa by the end of June, another 4.1 million doses by the end of September and another 4.1 million doses by the end of December. (The government expects the 20 million additional doses to be delivered by the end of this year, Mr. Maja said.)
The company has so far fallen far short of those goals. As of the end of June, South Africa had received only about 1.5 million of the doses from its order. The small number of doses that have been delivered to the African Union were on schedule.
The difficulties in procuring doses have revealed the limits of fill-and-finish sites, which leave countries dependent on vaccines from places like the European Union or the United States, said Dr. Salim Abdool Karim, who until March was co-chairman of South Africa’s ministerial advisory committee on Covid.
“Ultimately,” he said, “the solution to our problem has to be in making our own vaccines.”
Lynsey Chutel and Choe Sang-Hun contributed reporting.
BERLIN — As concerns grow over the highly contagious Delta variant of the coronavirus, Germany on Monday became the biggest Western country yet to announce that it will offer vaccine booster shots to a wide range of people considered potentially vulnerable, adding to growing momentum in rich nations to give additional shots to fully vaccinated people.
The move by Germany came even as a top European Union official criticized the bloc as falling far short of its promises to donate vaccine doses to Africa and Latin America. And with a limited global vaccine supply, health experts say the top priorities should be distributing doses to poor countries that lag far behind in inoculations, and persuading vaccine-resistant people in wealthy countries to get their first shots.
There is also still no consensus among scientists on the need for booster shots, but as fears rise of more pandemic waves and more costly lockdowns, a growing number of countries are preparing to give their people booster doses — or have already started.
Starting in September, Germany, Europe’s largest economy, wants to administer a booster of the Pfizer-BioNTech or Moderna vaccine to older people, residents of care homes, and people with compromised immune systems — and also to anyone who was already fully vaccinated with the two-dose AstraZeneca or single-dose Johnson & Johnson shots, which clinical trials have shown are not as highly protective.
an early leader in vaccination, began administering boosters to people 60 and older last week. A month ago, Russia made additional shots available to anyone six months after inoculation, and on Sunday, Hungary began offering them four months post-vaccination.
France is offering them only to those with weak immune systems, and plans to give them this fall to those who were the first to be vaccinated early this year — mostly people over 75 and those with serious health problems.
government advisers recommended in late June that everyone over 50 should be eligible but said the priority should be getting the shots to people over 70, health workers, nursing home residents, and younger adults with immune problems or other serious vulnerabilities.
increasingly think that vulnerable populations may need additional shots even as research continues into how long the vaccines remain effective. Some people have already obtained boosters simply by not revealing previous vaccination.
But as governments, terrified of another surge in the virus, increasingly lean toward boosters, the need for them remains unclear.
Studies have indicated that immunity resulting from the Pfizer-BioNTech and Moderna vaccines is long-lasting, and researchers are still working to interpret recent Israeli data suggesting a decline in efficacy of the Pfizer-BioNTech vaccine months after inoculation.
although the vaccine remains powerfully effective against severe disease and death.
Experts were divided on the utility of booster shots so soon after vaccination began. Experience with other diseases indicates that older people and those with weak immune systems might benefit, but there is little hard evidence with the coronavirus.
“The problem here is, we’re just sort of going on immunological priors, rather than really great data to justify things one way or the other,” said Deepta Bhattacharya, an immunologist at the University of Arizona. “I totally understand the decision, but I think we have to acknowledge that there’s a wide range of uncertainty on what it’s going to do.”
Booster doses may help some people with weak immune systems, but others may show little improvement even after a third dose, and still others may not need a booster at all, scientists say.
While dozens of mostly wealthy countries, including the United States and most of Europe, have administered more than 100 doses per 100 people, many other nations remain below five per 100 — primarily in Africa, where cases have soared as the Delta variant spreads.
Understand the State of Vaccine Mandates in the U.S.
Doctors Without Borders said recently that it would be “unconscionable” to give booster doses in richer nations before people in poorer ones get their first doses.
“Wealthy governments shouldn’t be prioritizing giving third doses when much of the developing world hasn’t even yet had the chance to get their first Covid-19 shots,” Kate Elder, the senior vaccines policy adviser at Doctors Without Borders’ Access Campaign, said in a statement.
a so-called vector vaccine, like AstraZeneca or Johnson & Johnson.
It is the latest sign that governments are encouraging their citizens to mix and match vaccines in the hope of provoking a more protective immune response against Covid-19. Early results from a British vaccine study showed that volunteers produced high levels of antibodies and immune cells after getting one dose each of the Pfizer-BioNTech and AstraZeneca-Oxford shots.
The new German guidelines announced Monday also went a step further in encouraging parents to vaccinate children between 12 and 17, announcing that doctors and vaccination centers across the country would make the jab available to them before the start of the new school year.
Health ministers stopped short of making a formal recommendation for vaccinating children, but the move made plain their impatience with Germany’s Standing Committee on Vaccinations, which has so far refrained from guiding parents one way or the other, pending more data becoming available.
Vaccinating children “is one building block to allow a safe start into the new school year after the summer vacation,” Mr. Holetschek said.
Apoorva Mandavilli contributed reporting from New York, Benjamin Mueller from London, Aurelien Breeden from Paris, Gaia Pianigiani from Rome, Monika Pronczuk from Brussels, Raphael Minder from Madrid and Thomas Erdbrink from Amsterdam.
LONDON — A new and potentially more contagious variant of the coronavirus has begun to outpace other versions of the virus in Britain, putting pressure on the government to shorten people’s wait for second doses of vaccines and illustrating the risks of a faltering global immunization drive.
The new variant, which has become dominant in India since first being detected there in December, may be responsible in part for a grievous wave of infections across Southeast Asia, including Nepal, where people have been dying in hospital corridors and courtyards. But efforts to understand the variant picked up once it began spreading in Britain, one of at least 49 countries where it is present. Scientists there are sequencing half of all coronavirus cases amid a push to complete the reopening of its economy.
The preliminary results out of Britain, drawn from only a few thousand cases of the variant, contained both good and bad news, scientists said.
The variant, known by evolutionary biologists as B.1.617.2, is “highly likely” to be more transmissible than the variant behind Britain’s devastating wintertime surge, government scientists have said. That earlier variant, known as B.1.1.7, was itself considerably more contagious than the one that first emerged last year in Wuhan, China.
Public Health England report published this weekend provided signs that government scientists said were consistent with a more transmissible virus: The variant first seen in India was roughly 50 percent more likely than B.1.1.7 to be transmitted to the close contacts of an infected person. Government scientists said last week that it could be anywhere from a few percentage points to 50 percent more contagious than B.1.1.7.
Helpfully for Britain and other wealthy nations, the latest worrisome variant has emerged at a less dire moment of the pandemic. More than four out of every five people in England above the age of 65 — among the groups most vulnerable to the virus — have been given both doses of a coronavirus vaccine, driving down hospitalizations and deaths.
And a new study by Public Health England offered reassuring signs that fully vaccinated people were about as well protected from the variant first detected in India as they were from other forms of the coronavirus.
The Pfizer-BioNTech vaccine offered 88 percent protection against the variant first sampled in India, only a slight drop from the 93 percent protection given against the variant from Britain, Public Health England said. The AstraZeneca-Oxford vaccine was 60 percent effective against the variant from India, compared to 66 percent effective against the one first seen in Britain.
Other studies in England have shown little to no difference between the effectiveness of the Pfizer and AstraZeneca vaccines.
wrote on Twitter.
In Britain, part of its rapid growth may have to do with the particular places it was first introduced. Bolton, in northwest England, where the new variant is most advanced, is a highly deprived area with tightly packed housing that could be hastening its spread, scientists said.
“We do not know if the increase in transmissibility is the result of specific mixing patterns, or super-spreading events,” a group of researchers led by Robert Challen of the University of Exeter reported on May 11, in a study that was among those presented to an influential government advisory group.
That government advisory body said several days later that it had “high confidence” that the variant first seen in India was indeed more contagious, warning that a “substantial resurgence of hospitalizations” was possible. It said that the variant was gaining a foothold in diverse parts of Britain where “contact patterns or behaviors” alone could not explain its spread.
It is not clear if the variant from India is any deadlier than B.1.1.7.
With cases of B.1.1.7 falling, the variant first seen in India now accounts for roughly half of the sequenced coronavirus cases being monitored by Public Health England. The agency’s scientists have said it was likely to replace B.1.1.7 as England’s dominant virus within a month, a startling turnabout so soon after B.1.1.7 swept much of the world.
“For countries that are starting to struggle with B.1.1.7, they now know they have an even faster one close by,” said Devi Sridhar, a professor of global public health at the University of Edinburgh in Scotland.
experimenting with ways to encourage sick people to isolate.
Some scientists have urged the government to go further by dramatically closing the gap between doses of the Pfizer or Moderna vaccine, for instance, and rerouting those shots to cities hardest hit by the variant from India. Because the AstraZeneca vaccine appears most protective with a 12-week dosing interval, those scientists said, using it meant leaving people only partially vaccinated for a period of time.
At the very least, Professor Sridhar said, people needed to be reminded to remain cautious until they were fully vaccinated.
Prime Minister Boris Johnson’s plan to scrap almost all remaining lockdown restrictions on June 21 rests in large part, scientists said, on how many second doses Britain can administer in the coming weeks.
For many poorer nations, starved for vaccines, there is little choice but to leave long delays between first and second doses. Some of them are uncertain about when shipments of second doses will arrive. Large portions of those countries remain entirely unprotected.
If the variant from India spreads as quickly in other countries as it has in Britain, the burden on unvaccinated nations may grow.
“It’s a warning,” Professor Sridhar said. “What we’re seeing in India is being repeated in Nepal, it’s being repeated in other countries. You need to get ahead of it.”
Japan on Friday approved the Moderna and AstraZeneca coronavirus vaccines for use in adults, giving the country much-needed new options as it tries to speed up an inoculation campaign that has been one of the slowest in the developed world.
Previously, only the Pfizer vaccine had been authorized for use in Japan, where just 4.1 percent of the population has received a first shot. Vaccinations have been held up by strict rules that allow only doctors and nurses to administer shots, and by a requirement that vaccines be tested on people in Japan before they are approved for use.
Japan is in the midst of a fourth wave of Covid-19 infections, just two months before the Summer Olympics in Tokyo are set to begin. Tokyo and eight other prefectures are under a state of emergency that will last at least until the end of this month, and Okinawa is expected to be added to that list. Japan has been reporting about 5,500 cases a day, compared to 1,000 in early March.
A health ministry panel recommended on Thursday night that the government approve the Moderna and AstraZeneca vaccines. The health minister, Norihisa Tamura, said the Moderna shots would be used at mass inoculation sites scheduled to open on Monday in Tokyo and Osaka, which will be staffed mainly by military doctors and nurses.
TAIPEI, Taiwan — Closed schools and restaurants offering takeout only. Lines around the block at testing sites. Politicians on television urging the public to stay calm.
If the scenes around Taiwan this week have a distinctly early pandemic feel, it is because the coronavirus is only now washing up on the island’s shores in force. A crush of new infections has brought a swift end to the Covid-free normality that residents had been enjoying for more than a year.
By shutting its borders early and requiring two-week quarantines of nearly everyone who arrives from overseas, Taiwan had been managing to keep life on the island mostly unfettered. But all that changed after enough infections slipped past those high walls to cause community outbreaks.
For most of the past week, the government has ordered residents to stay home whenever possible and to wear masks outdoors, though it has not declared a total lockdown. Local authorities are ramping up rapid testing, though some health experts worry that too few tests are being done to stay ahead of the virus’s spread.
1,290 Covid-19 cases and 12 deaths during the entire pandemic.
Adding to the concern: Only around 1 percent of the island’s 23.5 million residents have been vaccinated against the virus so far.
happily shielded from its worst ravages.
Eight months passed last year without a single case of community transmission until an infection in December snapped the streak. Even after that, local infections cropped up only sporadically for months.
Then the tide shifted — gradually, then suddenly.
On April 14, the government began allowing crew members for Taiwanese airlines to quarantine at home for just three days after arriving on long-haul flights, down from the previous requirement of five days.
more pilots and their family members were testing positive, as were employees at a quarantine hotel.
On May 10, a pilot who had been in the United States tested positive after completing his three-day quarantine, but not before he had visited a pub and a restaurant in Taipei.
ordered into rolling 14-day home quarantines. But it was probably too late. A cluster of infections began to emerge among workers and patrons at so-called hostess bars in Taipei’s Wanhua District.
By the end of the week, daily case numbers had soared into the triple digits.
So far, the search for new infections has been concentrated in the populous cities of Taipei and New Taipei, where more than 1,600 people can receive rapid testing each day. Hospitals are also providing slower testing services.
Dr. Chiang Kuan-yu, 37, a physician at Taipei City Hospital, went to Wanhua District on Monday to help run a testing site there. He said there had been big crowds over the weekend, when the case numbers first started to rise. Some people had to wait an extra day to get tested.
“Now there are more resources for testing, so we can keep up better,” Dr. Chiang said.
Chen Shih-chung, Taiwan’s health minister and head of its Central Epidemic Command Center, has urged those with no Covid-19 symptoms and no history of contact to not even come to testing sites, lest they become infected there.
“This only will slow down our search for possible spreaders,” Mr. Chen said in a news briefing. “Don’t go there thinking, ‘Oh, maybe I’m infected, maybe it’s best that I get tested.’ You absolutely must not come.”
early March, and it has since been gradually immunizing health workers and other priority groups. Officials say doses of the Moderna vaccine will arrive soon. Several Taiwanese companies are also developing vaccines.
Taiwanese authorities began working with domestic vaccine producers in January 2020, after the coronavirus’s genetic sequence was made available and before the Chinese city of Wuhan went into lockdown.
“Taiwan got started extremely early,” said Dr. Ho Mei-shang, a research fellow at the Institute of Biomedical Sciences at Academia Sinica in Taipei who was involved with the government’s vaccine efforts. “We said at the time, ‘Whatever the vaccine ends up being, we want make it ourselves as quickly as possible.’”
But Taiwan’s insistence on developing and producing its own immunizations may have made officials less quick to snap up overseas vaccines when those started becoming available, Dr. Ho said.
“And then,” she said, “by the beginning of this year, when the pandemic was so severe in so many countries, we just said we’ll wait a little.”
Even after the AstraZeneca vaccine first became available in Taiwan, the low case count meant many people felt no urgent need to get immunized.
Still, Dr. Ho said she was heartened to see how quickly people in Taiwan were adjusting to the new restrictions on daily life, even after such a carefree past year.
Recently, she went for a run at 10 p.m. and forgot to wear her mask at first. But she noticed that even at that hour, everyone else who was out walking and exercising was masked up.
“This is a state of affairs,” she said, “that really sets Taiwan apart.”
The vaccination woes of some of the world’s poorest nations will continue as the Serum Institute of India, a crucial manufacturing pillar in the plan to supply two billion doses of Covid-19 vaccines to low-income countries, signaled that it would not be able to provide vaccines beyond India before the year’s end.
The revelation, tucked into a statement by the vaccine manufacturing giant that attempted to deflect mounting criticism, was another setback for Covax, the global vaccine partnership for the poor. It is already more than 140 million doses behind schedule, and the Serum Institute’s announcement suggested it was all but impossible to meet the goal of two billion doses by the end of the year.
The announcement once again underscored the glaring contrast of inequality: As some of the richer nations tout levels of vaccinations that allows them to reopen their society, most of the poorer nations have barely gotten a start.
“We continue to scale up manufacturing and prioritize India,” the Serum institute of India said in the statement on Tuesday. “We also hope to start delivering to Covax and other countries by the end of this year.”
Oxford-AstraZeneca vaccine, licensed to it with the commitment that a large share would go to poor nations.
As part of its plan to have two billion doses by the end of the year, Covax has been counting on hundreds of millions of the Oxford-AstraZeneca vaccine produced by Serum Institute, as well hundreds of millions of as a second vaccine called Novavax that the company is developing.
After India’s devastating second wave of coronavirus infections, the institute diverted all its manufacturing powers to domestic needs, falling behind on commitments to the Covax partnership as well as on bilateral commercial deals with many countries. The institute played down each delay as temporary. But Tuesday’s statement makes clear it is unlikely to meet commitments before the end of the year.
So far, the Covax alliance has supplied only 65 million vaccines, spread across 124 countries, according to the World Health Organization. The W.H.O. said the global alliance was already 140 million doses behind and likely to miss another 50 million doses in June.
“Once the devastating outbreak in India recedes, we also need the Serum Institute of India to get back on track and catch up on its delivery commitments to Covax,” said Dr. Tedros Adhanom Ghebreyesus, the chief of W.H.O.
the government’s mismanagement of the crisis.
India has administered about 180 million doses of vaccines. Only about 5 percent of the country’s adult population. The vaccination rate has fallen to about 1.8 million doses a day, which means it would take the country more than three years to vaccinate 80 percent of its population.
HAMBURG, Germany — When a young woman showed up at Hamburg’s giant Covid vaccination site last week, the city officials who check whether people are eligible were skeptical.
She was in her mid 20s; shots are being given mainly to those 60 and older. But she said she qualified for an exemption because she was caring for her infirm mother and produced a form to make her case. Without a signature from her mother, the form was invalid and the officials turned her away. But she returned quickly, a little too quickly, with the document signed.
This time she claimed to have a sister who was vaccinated for the same reason, but a spot check of inoculation records showed that to be false as well.
“She could not get out of here fast enough,” said Martin Helfrich, a spokesman for the city who witnessed the scene.
Ugur Sahin, the 55-year-old chief executive of BioNTech, the German company that designed the Pfizer vaccine, has said he will also wait his turn.
Germany’s vaccine program is gaining steam, and federal lawmakers have granted new freedoms for the fully vaccinated (as of Wednesday, just under 12 percent of the population), including the right to meet with other inoculated people, shop and travel without testing or quarantining. The move was a clear incentive for Germans who are hoping for a more normal summer (in 2019 Germans took 52 million vacations longer than four days abroad; in 2020 it was only 28 million). But officials say it might also have been a prompt for some to try and get around the priority rules.
AstraZenecaGo, because of its similarity to the popular augmented reality geolocation game Pokemon Go.
Xenia Balzereit, 29, a Berlin journalist, wrote about her lack of shame in taking the initiative to get herself vaccinated with AstraZeneca, the government’s handling of which led to widespread confusion.
“Honestly, my guilty conscience was worse when I cut in line at Berghain in prepandemic times,” she wrote, referring to Berlin’s most famous club.
Family doctors, who started vaccinating in April, have also had much more leeway over whom they choose to vaccinate and why. On Monday both Berlin and the western State of Baden-Württemberg officially dropped vaccine prioritization lists for shots administered by doctors.
But at Hamburg’s vaccine center — the biggest in Germany — priority lists are still in place and enforced.
Kai Pawlik, 43, a coordinator at the vaccine center, says cheats are often easily found out.
Mr. Pawlik, who often has to deal with the less clear-cut cases, says he understands that some people are so desperate to get the shot that they might misrepresent or pretend to misunderstand the rules.
“And on the other hand, of course, there are people who quite brazenly try to take advantage of a system and get ahead,” he said. “And then my sympathy is quite limited.”
Björn Eggers, a 43-year old police officer, who like many other frontline workers is already eligible, came for his second shot on Friday. He was not impressed with the idea of line jumpers.
“If everyone tried to do it,” he said, “we’d have absolute chaos.”
WASHINGTON — President Biden, heeding widespread calls to step up his response to the pandemic’s surge abroad, said on Monday that his administration would send 20 million doses of federally authorized coronavirus vaccine overseas in June — the first time he has pledged to give away doses that could be used in the United States.
The donation is another step toward what Mr. Biden promised would be an “entirely new effort” to increase vaccine supplies and vastly expand manufacturing capacity, most of it in the United States. He also put Jeffrey Zients, the White House coronavirus response coordinator, in charge of developing a global strategy.
“We know America will never be fully safe until the pandemic that’s raging globally is under control,” Mr. Biden said in a brief appearance at the White House. “No ocean’s wide enough, no wall’s high enough, to keep us safe.”
With new cases and deaths plummeting as vaccination rates rise in the United States, the epicenter of the crisis has moved to India and other nations. A growing and bipartisan chorus of diplomats, health experts and business leaders has been pushing the president to do more to end what the AIDS activist Asia Russell calls “vaccine apartheid.”
There is a huge disconnect growing where, in some countries with the highest vaccination rates, there appears to be a mind-set that the pandemic is over, while others are experiencing huge waves of infection,” Dr. Tedros said.
Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.
Dr. Tedros called for well-supplied nations to send more of their vaccine allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.
Mr. Biden took office vowing to restore the United States as a leader in global public health, and he has taken certain steps to do so: rejoining the World Health Organization, pledging $4 billion to an international vaccine effort and providing financial support to help Biological E, a vaccine manufacturer in India, produce at least one billion doses of coronavirus vaccines by the end of 2022.
To broaden supply further, Mr. Biden recently announced he would support waiving intellectual property protections for coronavirus vaccines. But activists say simply supporting the waiver is not enough; Mr. Biden must create the conditions for pharmaceutical companies to transfer their intellectual property to vaccine makers overseas, they argue. They view his efforts as piecemeal.
“We’re after 100 days into the administration, and what Biden should be delivering is a global battle plan against vaccine apartheid, and the announcement today is lines on a Post-it note,” Ms. Russell said, adding, “There must be a global strategy led by the U.S. that’s based on technology transfer, on forcing pharma to come to the table to share the recipe.”
assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses.
An open letter to the president, made public last week by a bipartisan group including business leaders, diplomats and a former defense secretary, argued that such a waiver “would make little difference and could do harm.”
While global health activists are strongly in favor of the waiver, some said they welcomed the views of the business community. They see clear parallels to their work fighting the global AIDS epidemic.
“It shows an unprecedented willingness of pharma and its allies in the private sector to admit what all of us having been saying for months — the private sector alone cannot and will not ensure global vaccine access,” James Krellenstein, a founder of PrEP4All, a nonprofit aimed at ensuring universal access to H.I.V. prevention and treatment, wrote in an email on Sunday. “It really shifts the burden to the Biden administration,” he added.
The organizer of the open letter, Hank Greenberg, the chairman of Starr Companies and former chairman of American International Group, the insurance industry giant, said in an interview on Monday that Mr. Biden’s announcement did not go far enough.
Mr. Greenberg, 96, a veteran of World War II, said he was inspired to write after a former chief executive of an A.I.G. subsidiary who later became the ambassador from the Philippines to the United States told him he was not able to get vaccinated. Like Mr. Biden, he used language that evoked the war effort.
CAPE TOWN — Facing a resurgence of Covid-19 infections and plagued by delays with vaccine supply, South Africa began the second phase of its public vaccination campaign on Monday, opening appointments for people aged 60 or older.
Only about 500,000 people in the country have been vaccinated to date, and most doses have gone to health care workers in a trial involving the Johnson & Johnson vaccine. South Africa is aiming to open vaccinations for people aged 40 or older in July, followed by the rest of the adult population in November.
South Africa has obtained nearly a million doses of the Pfizer-BioNTech vaccine and anticipates receiving around 4.5 million doses by the end of June.
The country has also ordered 3 million doses of the Johnson & Johnson vaccine, but only plans to begin using these in the public rollout following a verification process by international regulatory agencies, including the U.S. Food and Drug Administration.
some 1.6 million confirmed cases, South Africa has been hit harder by the pandemic than any other nation in Africa. Its most recent wave of infections, in December and January, was driven by a more contagious variant of the coronavirus, known as B.1.351, that was first detected in South Africa.
The government has set a goal to vaccinate 5 million people by the end of June, South Africa’s health minister, Zweli Mkhize, said Sunday. Just over 4,000 people were scheduled to receive vaccines on Monday.
The expanded eligibility comes at a critical phase: South Africa is experiencing a sustained rise in cases, and officials have warned of a third wave in the coming weeks, as the southern hemisphere heads into winter.
The slow rollout has underscored global problems of vaccine inequality, especially in Africa, where fewer than 23 million vaccines have been administered, according to the Africa C.D.C. Even vaccines manufactured in South Africa have been disproportionately exported to wealthier nations.
suspended use of the AstraZeneca-Oxford vaccine after ordering more than one million doses, and again in April, following safety concerns surrounding the Johnson & Johnson vaccine.
“For now, we can go on and protect the most vulnerable,” said Dr. Keith Cloete, the head of the health department in the Western Cape province, where more than 11,000 people have died from Covid-19.
The United States will send at least 20 million coronavirus vaccine doses in June to countries struggling against the pandemic, answering calls that the Biden administration isn’t doing enough to help countries that face dire shortages of vaccines and other treatments.
President Biden said on Monday that those 20 million doses, of Pfizer-BioNTech, Moderna and Johnson and Johnson vaccines, would be in addition to 60 million doses of AstraZeneca’s vaccine, which the U.S. plans to donate once the vaccine is cleared for use by the Food and Drug Administration. It is not clear exactly how long it will take the F.D.A. to authorize AstraZeneca’s vaccine.
“We know America will never be fully safe until the pandemic that’s raging globally is under control,” Mr. Biden said during a news conference at the White House. “No ocean’s wide enough, no wall is high enough, to keep us safe.”
Mr. Biden’s announcement on Monday afternoon came not long after a World Health Organization news conference at which the director general, Dr. Tedros Adhanom Ghebreyesus, said that countries with high vaccination rates had to do more to help countries that were being hit hard by the coronavirus, or the entire world would be imperiled.
Britain, which have seen a decline in cases and deaths in recent weeks, relaxed restrictions as the virus battered India and other Asian countries.
Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.
Dr. Tedros called for well-supplied nations to send more of their vaccine supplies and allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.
Ms. Fore released a statement on Monday saying that Covax would soon complete delivering 65 million doses, but that it should have delivered at least 170 million and that the effort could be short by as much as 190 million doses by the time Group of 7 leaders gather in England in June.
convincing the remaining unvaccinated people to get the shot.
Last week the Centers for Disease Control and Prevention changed its guidance to allow people who have been vaccinated to forgo their masks indoors and outdoors in many situations. The decision caused confusion in states and individuals, some who were eager to return to a semblance of normalcy and others who said they planned to stay masked indefinitely.
Dr. Rochelle Walensky, the director of C.D.C., said on “Meet the Press” on Sunday that the agency’s suggestions were “not permission to shed masks for everybody, everywhere.”
On Monday, Dr. Tedros’s message was more straightforward.