That could make it more difficult for European officials to demand faster shipments. But Belgian courts, like many in continental Europe, consider not only the wording of a contract, but also its genesis, which could work to the advantage of the European Union.

“A European judge looks at the good faith or lack of it that the parties brought into the contract, at the way in which the contract was negotiated, the general atmosphere,” said Professor Van Calster. “I think that the commission probably hopes that the judge will be able to determine that AstraZeneca, in particular, has failed to supply a number of vaccines which they could have reasonably supplied to the European Union.”

He said that the court could rule that AstraZeneca must surrender a certain number of doses, but that the outcome was uncertain.

AstraZeneca said on Monday that it “regrets the European Commission’s decision to take legal action over the supply of Covid-19 vaccines,” describing the lawsuit as “without merit.”

It said that it would deliver almost 50 million doses to the bloc by the end of April, and that it had “fully complied with the advance purchase agreement with the European Commission and will strongly defend itself in court.”

Stefan de Keersmaecker, a spokesman on health issues for the European Commission, said that the bloc had begun legal action because it believed the purchase agreement had been breached.

negotiating a contract with Pfizer for 1.8 billion doses over the next two years.

Ursula von der Leyen, the president of the European Commission, told The New York Times on Sunday that AstraZeneca had squandered the bloc’s trust.

“The noncommunication of AstraZeneca of the problems made it like pulling a chewing gum, because you never knew what was going on,” she said. Ms. von der Leyen added that the delivery shortfalls were too steep to ignore.

“At the moment, the company has a delay in delivering 200 million doses of vaccine by the end of the second quarter,” she said. “The number speaks for itself.”

AstraZeneca’s vaccine is being widely used across Europe, though some countries have curbed its use in younger people because of the risk of very rare blood clots. The European Medicines Agency, the bloc’s drug regulator, said this month that the shot’s benefits still outweighed its risks, but that it should carry a warning.

The vaccine is not yet authorized for use in the United States. American officials have given a few million doses that were manufactured there to Canada and Mexico.

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Covid-19 Live Updates: A Billion Shots, but Global Cases Keep Rising

the devastation in India continues to break daily records and run rampant in much of the world, even as vaccinations steadily ramp up in wealthy countries and more than one billion shots have now been given globally.

On Sunday, the world’s seven-day average of new cases hit 774,404, according to a New York Times database. That is a jump of 15 percent from two weeks earlier, and higher than the peak average of 740,390 during the last global surge in January.

Despite the number of shots given around the world — more than one billion, according to a New York Times tracker — far from enough of the world’s estimated population of nearly eight billion have been vaccinated to slow the virus’s steady spread.

And vaccinations have been highly concentrated in wealthy nations: 82 percent of shots worldwide have been given in high- and upper-middle-income countries, according to data compiled by the Our World in Data project at the University of Oxford. Only 0.2 percent of doses have been administered in low-income countries.

Israel is far ahead of much of the world in vaccinations: More than half of the population is now fully vaccinated. In Britain, where a highly contagious and deadly variant was discovered, nearly two thirds of the population is at least partly vaccinated and the rate of new cases is now among the lowest in Europe.

The United States has also partly vaccinated about 41 percent of its population and has loosened a ban on the export of raw materials for vaccines to help India control the world’s worst outbreak.

India is recording more than a third of all new global cases each day, averaging more than 260,000 new daily cases over the past week. The country’s sudden surge, driven by the spread of a newer variant, is casting increasing doubt on the official death toll of nearly 200,000, with more than 2,000 people dying every day.

Experts say the official numbers, however staggering, represent just a part of the virus’s spread, with hospitals overwhelmed and lacking critical supplies like oxygen.

India is home to the Serum Institute of India, the world’s largest vaccine maker. But only about 8.6 percent of India’s population has received at least one shot of a vaccine. Its surge led to the Indian government’s decision to withhold exports of doses that many low- and middle-income countries were relying on. The vaccine rollout in Africa, which was already slower than it is in any other continent, could soon come to a near halt because of the suspension.

Public health experts say the number of global cases is most likely surging because more contagious virus variants are spreading just as people are starting to let their guards down.

In Thailand, where cases were kept at bay for months with strict quarantines and lockdowns, the virus has spread rapidly, in part by unmasked people partying. Daily cases, still low by global standards, have increased from 26 on April 1 to more than 2,000 three weeks later. And in India, many people stopped taking precautions after officials eased a lockdown that was imposed early last year.

“India let their guard down when the numbers fell and they thought they were over their last peak,” said Barry Bloom, a research professor and former dean of the Harvard T.H. Chan School of Public Health. He added that the United States should “take a lesson from other countries before we become complacent and decide everything’s OK.”

As bad as India’s situation is, the numbers have room to grow worse: Its daily caseloads, adjusted for its huge population, rank well below other countries’.

The rate of new cases in the United States is falling but remains alarmingly high — similar to last summer’s surge.

The rates of new coronavirus cases also remain high across much of South America. In Brazil, reported cases are starting to drop but remain high after a more contagious variant tore through the country and overwhelmed hospitals.

In continental Europe, the pace of vaccinations lags that in the United States and Canada, and the number of new coronavirus cases remains particularly high in France, Germany, the Netherlands and Sweden. Turkey, at the crossroads between Europe, the Middle East and Asia, is another hot spot.

Dr. Robert Murphy, the executive director of the Institute for Global Health at Northwestern University, said the United States had a responsibility to send unused vaccine doses to other countries as supplies increase.

“We have to start thinking on a global scale and do what we can to help these other countries,” Dr. Murphy said. “Otherwise we’re never going to put out the whole fire.”

Administering the Astrazeneca vaccine at the Milan military hospital last month.
Credit…Alessandro Grassani for The New York Times

BRUSSELS — The European Union has filed a lawsuit in Belgium against the pharmaceutical company AstraZeneca over what it says is a breach of contract in the company’s delivery of Covid-19 vaccine, the European Commission announced on Monday.

The bloc’s relationship with the company has soured rapidly since AstraZeneca said in January that it would not be able to deliver on its scheduled vaccine doses for the first quarter of the year, setting the region’s vaccination campaign back by weeks.

“The commission has started last Friday a legal action against the company AstraZeneca on the basis of breaches of the advanced purchase agreement,” said Stefan de Keersmaecker, a spokesman on health issues for the commission, the E.U.’s executive branch. “The reason indeed being that the terms of the contract, or some terms of the contract, have not been respected and the company has not been in a position to come up with a reliable strategy to ensure the timely delivery of doses.”

Mr. de Keersmaecker said that all 27 E.U. member countries supported the move.

The company, while acknowledging that production problems have caused delays, has said its failure to deliver is not a breach of contract, because the European Union had placed its order after other clients, most notably Britain. A spokesman for the company did not immediately respond to a request for comment on Monday.

The two parties had been engaged in a dispute arbitration effort, but the European Union decided to move ahead with a legal case. The contract is under Belgian law, and legal proceedings would happen in Belgium.

The European Union’s vaccine contract with AstraZeneca, a British-Swedish company, was the first it signed, in August last year, and covers 400 million doses. So far, the company has delivered just over 30 million.

In an interview with The Times on Sunday, the European Commission president, Ursula von der Leyen, said the company had only supplied a quarter of what it had promised to the bloc, and had to deliver 200 million doses of vaccines by the end of this quarter.

She indicated that the European Union would not open talks over future supply. “At the moment, the company has a delay in delivering 200 million doses of vaccine by the end of the second quarter,” she said. “The number speaks for itself.”

A line at the Louvre in Paris last summer. The European Union is allowing fully vaccinated Americans entry into the bloc this summer.
Credit…Dmitry Kostyukov for The New York Times

BRUSSELS — American tourists who have been fully vaccinated against Covid-19 will be able to visit the European Union over the summer, the head of the bloc’s executive body said in an interview with The New York Times on Sunday, more than a year after shutting down nonessential travel from most countries to limit the spread of the coronavirus.

The fast pace of vaccination in the United States, and advanced talks between the authorities there and the European Union over how to make vaccine certificates acceptable as proof of immunity for visitors, will enable the European Commission, the executive branch of the European Union, to recommend a switch in policy that could see trans-Atlantic leisure travel restored.

“The Americans, as far as I can see, use European Medicines Agency-approved vaccines,” Ursula von der Leyen, president of the European Commission, said Sunday in an interview with The Times in Brussels. “This will enable free movement and the travel to the European Union.

“Because one thing is clear: All 27 member states will accept, unconditionally, all those who are vaccinated with vaccines that are approved by E.M.A.,” she added. The agency, the bloc’s drugs regulator, has approved all three vaccines being used in the United States, namely the Moderna, Pfizer-BioNTech and Johnson & Johnson shots.

Ms. von der Leyen did not offer a timeline for when exactly tourist travel might open up or details on how it would occur. But her comments are a top-level statement that the current travel restrictions are set to change on the basis of vaccination certificates.

Diplomats from Europe’s tourist destination countries, mostly led by Greece, have argued for weeks that the bloc’s criteria for determining whether a country is a “safe” origin purely based on low coronavirus cases are fast becoming irrelevant given the progress of vaccination campaigns in the United States, Britain and some other countries.

Waiting for hospital beds, Covid-19 patients received oxygen provided by a local Sikh house of worship on a sidewalk in New Delhi on Sunday.
Credit…Atul Loke for The New York Times

India’s coronavirus crisis deepened on Monday with the number of new reported cases setting a global record for the fifth consecutive day, as countries, companies and members of the large diaspora pledged to send oxygen and other critical aid.

India’s health ministry reported almost 353,000 new cases and 2,812 deaths on Monday, and enormous funeral pyres continued to burn in the worst-affected cities. Experts say that India’s reported overall toll of more than 195,000 deaths could be a vast undercount.

In New Delhi, where Covid-19 patients have died after hospitals ran out of oxygen, the government extended a lockdown by another week.

India’s Supreme Court last week ordered the government to come up with a “national plan” for distributing oxygen supplies.

The problems in India’s hospitals go beyond oxygen shortages. In the western state of Gujarat, more than a dozen patients were evacuated from a hospital on Sunday night after an air-conditioning unit caught fire, the Press Trust of India reported, the third accident involving virus patients in India in the past seven days.

Last Friday in another western state, Maharashtra, a hospital fire also caused by an air-conditioning unit killed 15 patients. Two days earlier, at least 22 patients died in a hospital in the city of Nashik, also in Maharashtra, after a leak cut off oxygen supplies.

The Biden administration, under pressure to help with the Indian surge as patients and their families make desperate online pleas for aid, said on Sunday that it had partially lifted a ban on the export of raw materials for vaccines and would also supply India with therapeutics, test kits, ventilators and personal protective gear. Other countries, including Britain, have also promised to send medical equipment and raw vaccine materials to India, a key producer of vaccines for lower-income countries.

“Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, we are determined to help India in its time of need,” President Biden said on Twitter on Sunday.

Two Indian-American businessmen — the Microsoft chief executive, Satya Nadella, and the Google chief, Sundar Pichai — have both said that their companies will provide financial assistance to India.

“Devastated to see the worsening Covid crisis in India,” Mr. Pichai wrote on Twitter, pledging $18 million to aid groups working in the country.

A pub in Glasgow, Scotland on Monday.
Credit…Andy Buchanan/Agence France-Presse — Getty Images

Scotland and Wales reopened restaurants, cafes, and nonessential shops on Monday, marking the next phase of a gradual relaxation of coronavirus restrictions that have been in place for months.

In Scotland, restaurants can serve food but not alcohol indoors until 8 p.m., and they can serve food and alcohol outdoors without restrictions. Stores, beauty salons, museums and galleries also reopened, and people are permitted to book travel in the rest of Britain.

The first minister of Scotland, Nicola Sturgeon, said she was hopeful that the country would continue its progress and lift more restrictions by the summer. But she cautioned that the virus was more infectious now than it had been in earlier waves and, therefore, “We must stick to the rules.” Free rapid tests will be available to the public.

In Wales, places of worship and retail stores reopened, and restaurants resumed outdoor service. Outdoor wedding receptions with up to 30 people can take place.

Cases remain low in Britain, with more than 40 percent of the population having received at least one dose of a vaccine. On Sunday, the country reported just over 1,700 new cases and 11 deaths, according to a New York Times database.

Hikers at Lion Rock in Hong Kong in January. 
Credit…Lam Yik Fei for The New York Times

The governments of Singapore and Hong Kong said on Monday that a long-delayed travel bubble between the two Asian financial centers would begin next month, allowing travelers on designated flights to bypass quarantine.

The travel arrangement, which was originally supposed to begin last November, was suspended at the last minute when Hong Kong experienced a sudden surge in cases. With both places now reporting relatively few local infections, officials say the travel corridor will begin on May 26.

“Both sides will need to stay very vigilant in the next one month, so that we can launch the first flights smoothly,” Ong Ye Kung, Singapore’s minister of transport, said in a statement.

The arrangement, which is open to people of any nationality in Singapore and Hong Kong, will begin with one flight per day in each direction for up to 200 passengers. Travelers to both places must test negative for the coronavirus before departure and again upon arrival. They are also required to download and use government contact-tracing apps.

Travelers from Hong Kong must have received their second dose of a vaccine at least 14 days earlier, with some exceptions. Officials in Hong Kong, where the vaccination campaign has struggled to gain momentum, say they hope that this will give residents an incentive to get vaccinated. (There is no vaccination requirement for travelers from Singapore to Hong Kong.)

Officials said that the bubble would be suspended automatically for two weeks if either city recorded a seven-day average of more than five local cases from an unknown source.

The bubble is seen as an important step toward economic recovery in the two cities, both major travel hubs whose flagship carriers, Cathay Pacific and Singapore Airlines, only operate international flights. Similar travel bubbles are already in effect between Australia and New Zealand and between Palau and Taiwan, all places where local transmission of the coronavirus is almost nonexistent.

A small number of guests enjoying the pool at a resort in Phuket, Thailand, this month.
Credit…Adam Dean for The New York Times

Only a few weeks ago, Phuket seemed poised for a comeback. After a year of practically no foreign tourists arriving in Thailand, the national government decided that Phuket would start welcoming vaccinated visitors in July, without requiring them to go through quarantine. The project was called Phuket Sandbox.

But Thailand is now gripped by its worst Covid-19 outbreak since the pandemic began, spread in part by the well-heeled Thais who partied in Phuket and Bangkok with no social distancing. The confirmed daily caseload — albeit low by global standards — has increased from 26 on April 1 to more than 2,000 three weeks later, in a country that in early December had about 4,000 cases total.

The opening that Phuket had planned for July 1 now appears unlikely, Thailand’s tourism minister acknowledged this month.

“If you ask me how optimistic I am, I cannot say,” said Nanthasiri Ronnasiri, the director of the tourism authority’s Phuket office. “The situation changes all the time.”

The virus’s resurgence after so many months of economic hardship is devastating for the majority of Phuket’s residents, who depend on foreign tourists for their livelihoods.

Dr. Linda Dahl at the Kaufman Astoria Studios in Queens, N.Y.
Credit…Sasha Maslov for The New York Times

Compliance practices at the Academy Awards on Sunday will be closely watched as organizers prepare for the gradual resumption of major events such as the Tonys (to be coordinated with Broadway’s reopening).

Part cop, part coach, Covid compliance officers, or C.C.O.s, have become essential overseers in America’s tentative return to prepandemic life.

“We’re at a tipping point,” said Dr. Blythe Adamson, an infectious disease epidemiologist and economist. “People are going out more, they have pandemic fatigue. They’re vaccinated, but people are still getting Covid with these new strains. It makes the compliance officer role extremely important.”

The budget for Covid compliance on film sets is high: 25 to 30 percent of the total, according to Dr. Linda Dahl, an ear, nose and throat surgeon who has become a C.C.O. Complicating the job, what constitutes Covid compliance can change on a weekly or even daily basis as guidelines from the Centers for Disease Control and Prevention constantly evolve.

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E.U. Sues AstraZeneca Over Missed Vaccine Deliveries

BRUSSELS — The European Union has filed a lawsuit in Belgium against the pharmaceutical company AstraZeneca over what it says is a breach of contract in the company’s delivery of Covid-19 vaccine, the European Commission announced on Monday.

The bloc’s relationship with the company has soured rapidly since AstraZeneca said in January that it would not be able to deliver on its scheduled vaccine doses for the first quarter of the year, setting the region’s vaccination campaign back by weeks.

“The commission has started last Friday a legal action against the company AstraZeneca on the basis of breaches of the advanced purchase agreement,” said Stefan de Keersmaecker, a spokesman on health issues for the commission, the E.U.’s executive branch. “The reason indeed being that the terms of the contract, or some terms of the contract, have not been respected and the company has not been in a position to come up with a reliable strategy to ensure the timely delivery of doses.”

Mr. de Keersmaecker said that all 27 E.U. member countries supported the move.

The company, while acknowledging that production problems have caused delays, has said its failure to deliver is not a breach of contract, because the European Union had placed its order after other clients, most notably Britain. A spokesman for the company did not immediately respond to a request for comment on Monday.

The two parties had been engaged in a dispute arbitration effort, but the European Union decided to move ahead with a legal case. The contract is under Belgian law, and legal proceedings would happen in Belgium.

The European Union’s vaccine contract with AstraZeneca, a British-Swedish company, was the first it signed, in August last year, and covers 400 million doses. So far, the company has delivered just over 30 million.

In an interview with The Times on Sunday, the European Commission president, Ursula von der Leyen, said the company had only supplied a quarter of what it had promised to the bloc, and had to deliver 200 million doses of vaccines by the end of this quarter.

She indicated that the European Union would not open talks over future supply. “At the moment, the company has a delay in delivering 200 million doses of vaccine by the end of the second quarter,” she said. “The number speaks for itself.”

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Post-Merkel Germany May Be Shaded Green

Whatever government fills the vacuum in Germany after Chancellor Angela Merkel will be tinged with green.

After nearly 16 years in office, Ms. Merkel’s conservative party, the Christian Democrats, is slipping and stagnant, critics say — short of ideas on how to keep Germany vibrant and rich in a world where its industrial and export model is outdated; where faith in the United States has been damaged; and where China is more self-sufficient and Russia more aggressive.

The other traditional mainstay, the left-center Social Democrats, currently junior partners with Ms. Merkel, is in even worse shape, both electorally and ideologically.

The German Greens are filling the vacuum. Five months before elections in September, the party is running a close second in the opinion polls to the struggling Christian Democrats, and some think it might even lead the next government.

“They will be part of the next government,’’ said Norbert Röttgen, a prominent Christian Democrat, in a forecast widely shared in Germany. “Either a big part or even the leading part.’’

But these are not the Greens of the Cold War, a radical party appalled by the nuclear standoff between the Soviet Union and the United States over a divided Europe. The Greens are now centrist, eager for power, with a surprisingly gimlet-eyed view of international affairs and of how Germany needs to change without alienating big business.

If the Greens surge in Europe’s largest and richest country, it would be a watershed not only for the party but for all of Europe, where it already is part of the governing coalitions in six countries.

It would also potentially herald a shift toward a more assertive foreign policy in Germany, especially toward China and Russia, as global politics is becoming a competition between authoritarian and democratic ideals.

“This is a different party, a different generation, a different setting and a different world,” said Sergey Lagodinsky, a Green member of the European Parliament. “With Covid, climate and common global challenges clearer to many, it’s easier to push for a transformative green agenda in the classic sense.”

“But the confrontation with authoritarianism is now clear,” he added, “and that puts us in a different place.”

Jana Puglierin, the director of the European Council on Foreign Relations in Berlin, said: “The Greens are the only party that can rock the boat a bit, especially on China and Russia. They will strike a better balance between the economy and human rights.’’

Led by two pragmatists, or “realos,” the German Greens honor their “fundis,” the more idealistic among them, without allowing them to marginalize the party, as in the past.

The party’s co-chairs are Robert Habeck, 51, and Annalena Baerbock, 40, who is considered the most likely chancellor candidate. The choice is expected on Monday; she would be the only woman in the race to replace Ms. Merkel.

With the environment central to their program, the Greens represent the current zeitgeist. Its leaders argue that correct economic policies can produce a Germany that is digital, modern and carbon neutral, no longer so dependent on old-fashioned industrial production, however sophisticated.

They oppose Nord Stream 2, the Russian natural-gas pipeline to Germany that circumvents Ukraine and Poland. They also oppose the European Union’s investment deal with China. They are committed to European cooperation, democracy promotion, the defense of human rights, Germany’s membership in NATO and its strong alliance with the United States.

While the Greens consider NATO’s goal of military spending of 2 percent of gross domestic product to be arbitrary, the party favors more spending to ensure that the woefully weak German military is able to meet its NATO responsibilities.

Even Mr. Röttgen, the Christian Democrat who is chairman of the Bundestag foreign policy committee, said that “however embarrassing for me, the Greens have the clearest stance of all the parties on China and Russia.”

They would make “a much more realistic and preferable partner for us on foreign policy,” he said.

Wolfgang Streeck, a leftist German economist, once famously called the Greens “the vegetarian section of the Christian Democrats,” noted Hans Kundnani of Chatham House, a research organization based in London. In the way the party criticizes Russia and China on the grounds of democracy and human rights, Mr. Kundnani said, it is similar to American neoconservatives.

“The German Greens are now a pragmatist centrist party,” said Ulrich Speck of the German Marshall Fund in Berlin. “They want to be part of the government and play a big role, with a focus on greening the economy. They think there are enough in business who understand that this is the future.”

Foreign policy is secondary, Mr. Speck said. “But the democracy agenda matters, and they position themselves in solidarity with opposition democrats in Belarus, Ukraine, Russia and China. And they are very tough on China.”

In Germany, the Greens are already part of governing coalitions with a variety of other parties in 11 of the 16 German states, and were just re-elected to head the government in Baden-Württemberg, where the car industry is important.

In fact, argued Arne Jungjohann, a political analyst with Heinrich Böll Foundation, the Greens are flexible enough to go into coalition with any party, except the far-right Alternative for Germany.

In Britain and Western European countries like France, the Greens are more modest and leftist, committed to the environment. But even there, they are benefiting from the weakness of more established parties.

In six countries, Mr. Jungjohann said, they are already in government. They are part of the governing coalitions in Austria, Belgium, Finland, Ireland, Luxembourg and Sweden.

In Europe’s south and in post-Communist Europe, as in the east of Germany itself, the Greens are not such a big factor, though they are more popular with the urban young.

One of Germany’s main problems is that its successful economic model has become a trap, argued John Kornblum, a former American ambassador to Germany who still lives there.

“They haven’t done very well with digital, but found a market in China for their 19th-century products,” he said. “The Chinese at this point still need them and buy them, but at some point soon China will make all that themselves.”

The other establishment parties “believe that Germany’s existence depends on this 19th-century machine-tool economy,” he said.

Alone among the main parties, the Greens have a vision for a Germany that is digital, climate neutral, deeply committed to the European Union, to democratic values and gender equality. A party that, as Ms. Puglierin said, believes that the future is no longer the diesel Mercedes but the electric Tesla.

Still, the party has had to dance carefully over issues of the military, security and nuclear policy, where idealism confronts the world as it is, and where soft power is not always matched with hard power.

“A test will come, because the reality of foreign policy is not just value-driven, but you need to define your interests,’’ Mr. Lagodinsky said.

True to its roots, the party calls for a Germany without U.S. nuclear weapons. But it has also been careful to hedge its election manifesto.

“They want a world without nuclear weapons, but acknowledge that it will take time to get there — they’ll first have to find other ways to reassure eastern and central European partners,” said Sophia Besch, an analyst with the Center for European Reform in Berlin.

They want close cooperation with France on Europe but are less enamored of French ideas for a European army; are ambivalent about a new European air combat system that could carry nuclear bombs and armed drones; and would be strict about exports of arms to customers like Saudi Arabia.

They would also be strict about how and when German forces could engage overseas, even in coalitions of the willing, in the absence of a United Nations Security Council resolution.

But what may be most important for Germany, Ms. Puglierin noted, is that the Greens would at least produce new, needed debates on long-suppressed topics, like the ambivalent German policies toward China and Russia, let alone German dependency on the combustion engine.

“The Greens are the only chance to see real change in German foreign policy,” she said. “We’ve been so status-quo oriented in the Merkel years.”

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Worry Over 2 Covid Vaccines Deals Fresh Blow to Europe’s Inoculation Push

BRUSSELS — First it was AstraZeneca. Now Johnson & Johnson.

Last week, British regulators and the European Union’s medical agency said they had established a possible link between AstraZeneca’s Covid-19 vaccine and very rare, though sometimes fatal, blood clots.

On Tuesday, Johnson & Johnson said it would pause the rollout of its vaccine in Europe and the United States over similar concerns, further compounding the continent’s one-step-forward-two-steps-back efforts to quickly get people immunized against the coronavirus.

European officials had been confident that they had secured enough alternative vaccine doses to take up the slack of the AstraZeneca problems and achieve their goal of fully inoculating 70 percent of the European Union’s adult population — about 255 million people — by the end of the summer.

On Tuesday, European officials did not immediately say whether they believed the milestone would also survive the Johnson & Johnson suspension. But the European commissioner for health, Stella Kyriakides, wrote on Twitter that “Today’s developments with the J&J vaccine in the US are under close monitoring” by the bloc’s medicines regulator.

months of short supplies and logistical problems.

There is mounting evidence that the concerns are eroding Europeans’ willingness to get the AstraZeneca vaccine in particular, and threatening to elevate already high levels of vaccine hesitancy generally.

YouGov poll published last month, 61 percent of the French, 55 percent of Germans and 52 percent of Spaniards consider the AstraZeneca vaccine “unsafe.” That is in stark contrast to the findings of a similar poll from February, when more people in those countries, with the exception of France, believed that the shot was more safe than unsafe.

Regulators have asked vaccine recipients and doctors to be on the lookout for certain symptoms, including severe and persistent headaches and tiny blood spots under the skin. Doctors’ groups have circulated guidance about how to treat the disorder.

In Poland, where the vaccination campaign relies to a large extent on AstraZeneca and where its use has not been restricted, a recent poll showed that given a choice, fewer than 5 percent of Poles would choose the AstraZeneca shot.

Almost everywhere across the European Union, it seems, many are eager for alternatives, as the new types of vaccines that include the Moderna and Pfizer, which utilize science known as “mRNA,” have not been associated with similar side effects.

Data from the 27 E.U. member states by the European Center for Disease Prevention and Control shows that over all, 80 percent of vaccine doses distributed to the bloc have already been administered. That share drops to 65 percent for AstraZeneca, however, suggesting that many of its doses are sitting unused.

Yet it is hard to predict how serious a blow the latest twist in the AstraZeneca saga — and the new Johnson & Johnson concerns — will be to E.U. vaccination efforts, as officials in Brussels have made big if belated efforts to turbocharge the second-quarter supply of doses.

The European Union is poised to receive at least 300 million doses of various vaccines, three times what it got in the first quarter. Two hundred million are slated to come from Pfizer/BioNTech. Moderna is expected to deliver 35 million doses. Another 55 million doses are due of the Johnson & Johnson jab, and 70 million from AstraZeneca.

In the rosiest scenario, the European Union could get up to 360 million doses by June.

On Thursday, after Spain’s government changed the age threshold for the AstraZeneca shot, two-thirds of people called up for vaccination in Madrid did not show up, Antonio Zapatero, the regional health minister, told a news conference on Friday.

He attributed the no-show by 18,200 people to “confusion” generated by Spain’s central government, which said on Wednesday that the AstraZeneca vaccine should be given only to people over 60. Before this change, Mr. Zapatero said, the rate of abstention was 2 percent.

In Belgium, where the use of the AstraZeneca vaccine has also been limited, the authorities said they did not expect major delays in the overall rollout, but they are still concerned about the confusion that the rare blood clotting issue is causing.

Yves Van Laethem, a top epidemiologist who is the country’s Covid task force spokesman, said he expected a two-week delay that would mostly affect younger age groups in late summer. He said the E.U. regulator guidance had only partly helped in clarifying the situation.

The European Medicines Agency’s opinion “wasn’t very clear, and it is also part of the problem,” Dr. Van Laethem said in an interview. “When you say, ‘We don’t apply limitations, but we just say there are serious side effects,’ there is part science and part diplomacy in that.”

He said the limited effect that the new AstraZeneca issues would have on Belgian’s rollout was in large part because the country had ordered big shares of other vaccines.

Although all E.U. countries have been offered a chunk of each vaccine approved in the bloc so far — AstraZeneca, Johnson & Johnson, Moderna and Pfizer — many opted to forgo parts of their share of more expensive or cumbersome vaccines like Pfizer and Moderna early on, instead favoring the AstraZeneca jab.

“In Britain or Eastern Europe, a big part of the campaigns are based on AstraZeneca,” Dr. Van Laethem said.

Wealthier bloc members like Denmark, France, Germany and the Netherlands can better compensate for the loss of confidence in AstraZeneca, because they acquired extra doses of other vaccines — especially Pfizer — through a secondary market after poorer E.U. nations gave theirs up.

Those countries — including Bulgaria, Croatia, Latvia and Slovakia — are likely to be less able to quickly offer alternatives.

Dr. Van Laethem, the Belgian immunologist, said that the national and European authorities needed to better communicate the costs and benefits of taking the AstraZeneca dose versus and the other authorized vaccines.

Experts worry that even limited concerns over one vaccine’s unlikely side effects can affect people’s overall willingness to be immunized.

“The main thing is to make people understand that the problem is the virus,” he said. “We have to vaccinate people — the risk linked to the virus is higher than those rare side effects.”

Raphael Minder contributed reporting from Madrid and Constant Méheut from Paris.

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Johnson & Johnson delays its Covid-19 vaccine rollout in Europe.

Johnson & Johnson on Tuesday said it would delay the rollout of its vaccine in Europe amid concerns over rare blood clots, in another blow to the continent’s ambition to ramp up inoculation campaigns that have lagged behind other countries in the West.

Several countries of the bloc were poised to start administering the vaccine later this week, in what would have been a boost to efforts by the European Union to vaccinate 70 percent of adults by September.

“The safety and well-being of the people who use our products is our number one priority,” Johnson & Johnson said in a statement, adding that it had been reviewing the cases of blood clots detected in the United States with European health authorities.

The first signs of concern in Europe came last week. The European Medicines Agency, the bloc’s drug regulator, said it was investigating reports of four cases of blood clots in people who had received a shot of Johnson & Johnson’s Janssen vaccine in the United States, one of them being fatal. The regulator said it wasn’t clear if there was a link between the vaccine and the clots, adding that it treated the reports as “safety signal” that required further assessment.

Johnson & Johnson’s single-dose coronavirus vaccine came to a sudden halt in much of the United States on Tuesday after federal health agencies called for a pause in the vaccine’s use following the emergence of a rare blood clotting in six recipients.

All six were women between the ages of 18 and 48 and all developed symptoms within about two weeks of vaccination. One woman died and a second woman in Nebraska has been hospitalized in critical condition.

Nearly seven million people in the United States have received Johnson & Johnson shots so far, and about nine million more doses have been shipped out to the states, according to data from the Centers for Disease Control and Prevention.

Johnson & Johnson’s announcement comes as Europe has been embroiled in a regulatory back-and-forth over another vaccine, AstraZeneca’s. Several countries have restricted the use of the vaccine in younger people, after the European Medicines Agency said there was “a possible link” between blood clots and the vaccine earlier this month, and said it should be listed as a rare side effect.

Both Johnson & Johnson and AstraZeneca use the same technology, prompting concerns that the blood clots reported in recipients of both vaccines could be the same rare, yet sometimes fatal side effect.

The agency stopped short of advising to curb the use of the vaccine in 27 member countries, saying that it was up to the national authorities to decide who should receive which vaccine, which resulted in a patchwork of different national regulations.

France and Belgium have restricted its use for those older than 55, and Germany, Italy and Spain, for those over 60. Some other countries, such as Poland, which rely heavily on AstraZeneca in their national rollouts, decided to go ahead with AstraZeneca’s vaccine.

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Blood Clots Linked to AZ Vaccine Stem From Rare Antibody Reaction

Two reports published on Friday in a leading medical journal help to explain how AstraZeneca’s Covid vaccine can, in rare cases, cause serious and sometimes fatal blood clots.

Scientific teams from Germany and Norway found that people who developed the clots after vaccination had produced antibodies that activated their platelets, a blood component involved in clotting. The new reports add extensive details to what the researchers have already stated publicly about the blood disorder.

Why the rare reaction occurred is not known. Younger people appear more susceptible than older ones, but researchers say no pre-existing health conditions are known to predispose people to the problem, so there is no way to tell if an individual is at high risk.

Reports of the clots have already led a number of countries to limit AstraZeneca’s vaccine to older people, or to stop using it entirely. The cases have dealt a crushing blow to global efforts to halt the pandemic, because the AstraZeneca shot — easy to store and relatively cheap — has been a mainstay of vaccination programs in more than 100 countries.

statement on its website, AstraZeneca said it was “actively collaborating with the regulators to implement these changes to the product information and is already working to understand the individual cases, epidemiology and possible mechanisms that could explain these extremely rare events.”

The two new reports were published by The New England Journal of Medicine. One from Germany describes 11 patients, including nine women ages 22 to 49. Five to 16 days after vaccination, they were found to have one or more clots. Nine had cerebral venous thrombosis, a clot blocking a vein that drains blood from the brain. Some had clots in their lungs, abdomen or other areas. Six of the 11 died, one from a brain hemorrhage.

One patient had pre-existing conditions that affected clotting, but during a news briefing on Friday, Dr. Andreas Greinacher, an author of the report, said those conditions most likely played only a minor role in the disorder that occurred after vaccination.

second report, from Norway, described five patients, one male and four female health care workers ages 32 to 54, who had clots and bleeding from seven to 10 days after receiving the AstraZeneca vaccine. Four had severe clots in the brain, and three died. Severe headaches were among their early symptoms. Like the German patients, all had high levels of antibodies that could activate platelets.

The team from Norway also recommended treatment with intravenous immune globulin. The researchers said the disorder was rare, but “a new phenomenon with devastating effects for otherwise healthy young adults,” and they suggested that it may be more common than previous studies of the AstraZeneca vaccine had indicated.

On Friday, European regulators also said they were reviewing reports of a few blood clot cases that occurred in people who had received the Johnson and Johnson vaccine. In the United States, federal agencies are investigating reports of a different type of unusual blood disorder involving a precipitous drop in platelets that emerged in a few people who had received either the Pfizer-BioNTech or Moderna vaccines.

Benjamin Mueller and Melissa Eddy contributed.

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Crowds Lured by a Hoax Concert Clash With Belgian Police

BRUSSELS — In an April Fool’s Day joke that went wrong, a fake announcement of a music festival contributed to thousands gathering in a major park in Brussels on Thursday in defiance of Covid-19 restrictions. As the police confronted the crowd, several officers and participants were wounded, and four people were arrested.

The unusually warm weather in the city would most likely have drawn people to the park in higher numbers, but the prank added to the density. The level of frustration, particularly among younger people, is high in Belgium, as new Covid-19 cases are increasing and hospitals become saturated despite months of restrictions.

The hoax festival, announced on Facebook and called “La Boum,” a slang word in French for a party, promised the appearance of famous DJs, including David Guetta, and claimed that no coronavirus rules would be followed.

The organizers noted that the festival was a hoax, but, according to the police, 1,500 to 2,000 people still gathered in the park, Bois de la Cambre, on Thursday afternoon, after tens of thousands registered on Facebook their interest in the event. Despite several warnings, the police said, the attendees refused to leave, and some chanted “Freedom!” and threw bottles. The police used water cannons and sent in mounted officers to disperse the crowd.

Belgium has been in a semi-lockdown since October, with restaurants and bars closed, and rules requiring residents to work from home and limiting social contacts to one person per household. Up to four people are allowed to meet outside, as long as they wear face masks and respect social-distancing rules. Last week, in response to an increasing number of new cases and a rise in the number of hospitalized patients, the Belgian authorities tightened the rules, ordering hairdressers and beauty salons to close and allowing nonessential stores to serve customers by appointment only.

Prime Minister Alexander De Croo posted on Twitter that the gathering in Brussels was “totally unacceptable.”

“All support to the injured police officers,” he added. “I understand everyone is tired of corona. But the rules are there for a reason, and they are binding for everyone. Hospitals are filling up. Solidarity now is the key to freedom tomorrow.”

Annelies Verlinden, the Belgian interior minister, acknowledged that “for many people, especially the young ones, the Covid crisis is now lasting a very long time.” But she said that the gathering in Brussels was “a slap in the face for all those who are doing their best to respect the coronavirus measures.”

On Wednesday, a Brussels court ordered the Belgian government to lift all Covid-19 restrictions, ruling that the measures did not have a legal basis because they had been instituted by ministerial decrees. But the court gave the government 30 days to remedy the situation, and a special pandemic law is currently being debated in Parliament.

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Can U.S. Travelers Go To Europe? Here’s What to Know

With the number of people in the United States vaccinated against the coronavirus climbing, Americans are starting to explore their prospects for international travel this summer, a season when Europe is traditionally a big draw.

Most of Europe has been off-limits to most U.S. citizens for over a year, and the continent is currently grappling with a third wave of coronavirus infections and a surge in new, more contagious variants, making it unclear when its borders will reopen. But some European countries have started to welcome vaccinated travelers, including American tourists, and others are making preparations to ease restrictions in time for the summer season.

Vaccine and health certificates that would help speed travel are under development, which could make it easier for tourism to restart. The 27 member countries of the European Union have endorsed the idea of a vaccine certificate. While individual European countries will still set their own rules, the initiative is expected to establish a coordinated approach across the continent.

“Finally, we have a tangible solution to coordinating and harmonizing travel measures,” said Eduardo Santander, chief executive of the European Travel Commission, an association of national tourism organizations based in Brussels. “I think other countries like the U.S. will also come up with their own technological solutions that will be compatible and after a period of trials this summer, a global standard will be established.”

including Albania and Armenia.

As the number of cases has risen in Europe, and vaccination has been sluggish, several European Union countries have gone back into lockdown. France, Belgium and Portugal have reintroduced stringent measures that restrict nonessential travel, even from within the bloc and within what is known as the Schengen Zone, which includes nonmember countries that allow free movement across their borders.

“Right now, in some European countries, it might feel like you are in the middle of a storm, which is how we felt in the U.K a couple of months ago,” said Gloria Guevara Manzo, chief executive and president of the World Travel & Tourism Council, a forum that works with governments to raise awareness about the travel industry.

European Travel Agents’ and Tour Operators’ Association. “But right now, we are not talking about Americans visiting Europe.”

American travelers do have some options, though: Having brought the virus under control, Iceland is allowing all vaccinated travelers — including those from the United States — to enter without being subject to Covid-19 testing or quarantine measures.

Greece, one of the most popular European summer destinations for Americans, announced this month that it would reopen for all tourists in mid-May, as long as they show proof of vaccination, antibodies or a negative Covid-19 test result before traveling. All visitors will be subject to random testing upon arrival.

Turkey said it would not require international travelers to be vaccinated this summer and will re-evaluate testing policies after April 15.

Other European countries like Slovenia and Estonia are letting in vaccinated tourists, but not those from the United States.

several cruise lines have announced “staycation sailings” around the British Isles starting in June.

Many Britons traveled last summer when the virus seemed to have ebbed, and a recent study found that they brought a significant number of infections back into the United Kingdom. A ban on British travel abroad for leisure was enacted on Jan. 4 and was expected to expire in May, but the government introduced legislation this week that lays down the legal framework to extend the restrictions until the end of June.

It is not clear when exactly the United Kingdom lift its quarantine requirements for more tourism, but Visit Britain forecasts a slow recovery that will start toward late summer.

Earlier this month, the European Commission proposed a digital travel certificate that would prove that a person has been vaccinated, received a negative Covid-19 test result or recovered after contracting the virus.

States have different quarantine requirements, so travelers should check what their state requires before booking a vacation abroad.

Each country sets its own rules, but most safety protocols are unlikely to change this summer, even for those who have been vaccinated.

Visitors will be expected to wear masks and keep a safe distance in public spaces. Hotels, restaurants and event spaces will have enhanced cleaning protocols in place, and some may impose capacity restrictions.

Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places list for 2021.

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India Cuts Back on Vaccine Exports as Infections Surge at Home

NEW DELHI — With its own battle against the coronavirus taking a sharp turn for the worse, India has severely curtailed exports of Covid-19 vaccines, triggering setbacks for vaccination drives in many other countries.

The government of India is now holding back nearly all of the 2.4 million doses that the Serum Institute of India, the private company that is one of the world’s largest producers of the AstraZeneca vaccine, makes each day.

India is desperate for all the doses it can get. Infections are soaring, topping 50,000 per day, more than double the number less than two weeks ago. And the Indian vaccine drive has been sluggish, with less than 4 percent of India’s nearly 1.4 billion people getting a jab, far behind the rates of the United States, Britain and most European countries.

Just a few weeks ago, India was a major exporter of the AstraZeneca vaccine, and it was using that to exert influence in South Asia and around the world. More than 70 countries, from Djibouti to Britain, received vaccines made in India, with a total of more than 60 million doses. From mid January into March, not more than a few days passed between major vaccine shipments leaving India.

data from India’s foreign ministry. And Covax, the program set up by donor agencies to purchase vaccines for poorer nations, said on Thursday that it had told those countries that nearly 100 million doses expected in March and April would face delays because of “increased demand for Covid-19 vaccines in India.”

The Indian government has not publicly commented on what’s happening, and would not when reached by The New York Times for this article. But health experts say the explanation is obvious: India is drawing up its gates as a second wave of infections hits home, holding tight to a vaccine that it didn’t develop but that is being produced in huge quantities on its soil.

a heavy-handed nationalist, has regulatory control over how many vaccine doses can be exported at any given time, and it seems India is going in the same direction as the European Union, which is moving to curb exports.

Adar Poonawalla, the chief executive of the Serum Institute and scion of the billionaire family that runs the company, finds himself in a highly uncomfortable spot. The Serum Institute has a reputational interest in keeping its word to its foreign customers and to AstraZeneca, and fulfilling the contracts it has signed.

Mr. Poonawalla tweeted in late February. “We are trying our best.”

a deal it signed last year with AstraZeneca, the pharmaceutical giant that teamed up with the scientists at Oxford who developed its vaccine.

Production issues at other AstraZeneca facilities in Belgium and the Netherlands have led to wealthier nations like Canada, Saudi Arabia and Britain to rely on Serum Institute’s doses as well, making the company even more critical to the global supply chain of AstraZeneca’s vaccine.

the global vaccine supply chain.

With new variants spreading, he said, it’s in the interests of all countries to work together to vaccinate the world.

“Many countries around the world, poorer ones in particular, are counting on India,” Mr. Wouters said. “Vaccine nationalism hurts us all.”

Nepal, one of Asia’s poorest nations and next door to India, has had to halt its vaccination campaign. It was heavily reliant on doses of the AstraZeneca vaccine made at the Serum Institute, but with its national stockpile running low, Nepal stopped administering vaccines on March 17.

Dr. Jhalak Sharma, chief of the immunization department within Nepal’s health ministry, said the country had received a donation of one million doses from the Indian government and had already paid 80 percent of the price for the next two million but that didn’t seem to have made a difference.

according to Reuters. Morocco is now scrambling to secure more of Russia’s Sputnik V vaccine or get doses from other sources, Moroccan news media reported.

The Serum Institute’s manufacturing capacity was always central to a plan to get vaccines to the poor. A spokesman for AstraZeneca would not disclose exactly what percentage of the global supply of its vaccine that Serum manufactures, but a recent AstraZeneca statement called the contribution “substantial.” Serum has committed to making around a third of the total 3 billion doses that AstraZeneca said it will produce by the end of 2021, though meeting that timeline seems increasingly unlikely.

The alliance between Serum, which started out as a ranch that made serums from horse blood, and Oxford-AstraZeneca has resulted in the world’s cheapest Covid-19 shot: just $2. The vaccines developed by Pfizer and Moderna, by comparison, cost much more and require extreme cold storage, adding to the difficulty.

Serum is also playing a huge role in the Covax program for poorer nations. Documents from the World Health Organization show that the Indian company was expected to contribute 240 million doses by the end of June.

But the data from the Indian foreign ministry, and the statement Thursday from Covax, indicate that vaccine drives around the world are likely to be further delayed.

The Serum Institute has supplied Covax with 28 million doses so far, according to the international program. India’s foreign ministry showed that 18 million doses had been shipped abroad under Covax, suggesting that about 10 million doses of India’s domestic vaccination also came from the program, which lists India as qualifying for a share.

In contrast, about 34 million doses have been supplied in commercial deals and about 8 million donated by the government of India as part of its vaccine diplomacy.

On April 1, India will expand eligibility and allow anyone 45 or older to get a jab.

“It’s a fluid situation,” said K. Srinath Reddy, a health policy expert at India’s nonprofit Public Health Foundation. “But at the moment, given the fact that vaccine supply and Covid situation is dynamic, I think it’s only appropriate that government of India takes a pause and says, ‘Let’s hold onto the stocks.’”

Benjamin Mueller contributed from London, and Bhadra Sharma from Kathmandu, Nepal.

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