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.

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.

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In Germany, an Early Vaccine Shot Comes With Disapproving Looks

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.”

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Why the C.D.C. Changed Its Advice on Masks

Advice from federal health officials that fully vaccinated people could drop their masks in most settings came as a surprise to Americans, from state officials to scientific experts. Even the White House got less than a day’s notice from the Centers for Disease Control and Prevention, the press secretary, Jen Psaki, said at a news briefing on Friday.

“The C.D.C., the doctors and medical experts there, are the ones who determined what this guidance would be based on their own data, and what the timeline would be,” Ms. Psaki said. “That was not a decision directed by or made by the White House.”

For months, federal officials have vigorously warned that wearing masks and social distancing were necessary to contain the pandemic. So what changed?

Introducing the new recommendations on Thursday, Dr. Rochelle P. Walensky, the C.D.C. director, cited two recent scientific findings as significant factors: Few vaccinated people become infected with the virus, and transmission seems rarer still; and the vaccines appear to be effective against all known variants of the coronavirus.

There is no doubt at this point that the vaccines are powerful. On Friday, the C.D.C. released results from another large study showing that the vaccines made by Pfizer-BioNTech and Moderna are 94 percent effective in preventing symptomatic illness in those who were fully vaccinated, and 82 percent effective even in those only partly vaccinated.

“The science is quite clear on this,” said Zoë McLaren, a health policy expert at the University of Maryland, Baltimore County. Mounting evidence indicates that people who are vaccinated are highly unlikely to catch or transmit the virus, she noted.

The risk “is definitely not zero, but it’s clear that it’s very low,” she said.

One of the lingering concerns among scientists had been that even a vaccinated person might carry the virus — perhaps briefly, without symptoms — and spread it to others. But C.D.C. research, including the new study, has consistently found few infections among those who received the Pfizer-BioNTech and Moderna vaccines.

“This study, added to the many studies that preceded it, was pivotal to C.D.C. changing its recommendations for those who are fully vaccinated against Covid-19,” Dr. Walensky said in a statement on Friday.

Other recent studies confirm that people who are infected after vaccination carry too little virus to infect others, said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai.

“It’s really hard to even sequence the virus sometimes because there’s very little virus, and it’s there for a short period of time,” he said.

Still, most of the data has been gathered on the Pfizer-BioNTech and Moderna vaccines, Dr. Krammer cautioned. Because Johnson & Johnson’s vaccine was authorized later, there are fewer studies assessing its effectiveness.

In clinical trials, the Johnson & Johnson vaccine had 72 percent efficacy — lower than the figure for the Pfizer and Moderna vaccines. And effectiveness was measured in terms of moderate and severe disease, rather than mild disease.

“It’s a very good vaccine, and I’m sure it will save many, many, many lives,” Dr. Krammer said. “But we need more data on how well the J.&J. vaccine prevents infection, and how well it prevents transmission.”

Variants of the virus have been a particular worry for scientists. While Dr. Walensky cited evidence showing that the mRNA vaccines like those from Pfizer and Moderna are effective against the variants circulating in the United States, there is little data about variants and the Johnson & Johnson vaccine. And new variants are emerging constantly.

“I’m not at all saying that this is now a big problem,” Dr. Krammer said. But before lifting the masking requirements, “I might have waited a little bit longer to look at the numbers.”

In a statement on Friday, a C.D.C. spokesman said, “All of the authorized vaccines provide strong protection against serious illness, hospitalization, and death, and we are accumulating data that our authorized vaccines are effective against the variants that are circulating in this country.”

Fully immunized people are unlikely to get seriously ill, even if they are infected with the coronavirus. The risk of infection is greater for the people around them — unvaccinated children and adults, or vaccinated people who remain unprotected because of a medical condition or treatment.

C.D.C. officials said they weighed those factors and were confident in their assessment of the science. And the new advice has other salutary effects, rewarding fully immunized people by giving them permission to end their social isolation — and perhaps incentivizing others to opt for vaccination.

The new advice “signals that we really are on the final stretch here, and I think that’s a very good thing for people,” said Dr. Joshua Sharfstein, the vice dean for public health practice and community engagement at Johns Hopkins University Bloomberg School of Health.

“It’s unlikely that we’re going to have another huge surge in cases,” he added. “But will the final stretch last for weeks or months is still a question.”

The difficulty with the new recommendations, he and other experts said, is not so much the science underpinning them as their implementation.

Leaders at the state, city and county levels still have the authority to require masks even for vaccinated people, as the C.D.C. was quick to acknowledge on Thursday. After the agency’s announcement, some states instantly lifted mask mandates, while others said they would need more time to weigh the evidence.

But in states without mask mandates, the onus of checking vaccination status will fall on shopkeepers, restaurant workers, school officials and workplace managers.

“Without a means to verify vaccination, we will have to rely on an honor system,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University.

The number of cases in the country is the lowest it has been since September, and many experts support lifting mask mandates in much of the country. But doing so will be riskier in places like Michigan, where there are more cases, and for people who are unprotected, including children under 12 and people with a weak immune systems, Dr. Rivers said.

“People who are unvaccinated should continue to wear masks in public indoors and avoid crowds,” she said.

In Nacogdoches, Texas, Dr. Ahammed Hashim fretted that only 36 percent of the population was immunized and the pace seemed to have stalled. And yet only one or two people in 10 in the local shops wore masks.

“I think the C.D.C. might send a wrong message saying that everything’s OK,” said Dr. Hashim, a pulmonologist. “It would feel much better if we had a 60 or 70 percent vaccination.”

The C.D.C.’s guidance is intended for fully vaccinated individuals, and should only be interpreted as such, Dr. Sharfstein cautioned. Nationwide, only 36 percent of the population is fully vaccinated.

“What we’re just seeing is a little bit of the distance between advice that is entirely appropriate for people who are vaccinated, and the reality that there are places that still are seeing viral transmission and a lot of people who aren’t vaccinated,” he said.

Individuals may make choices based on their perception of their own risks, but state and local leaders must decide what’s best for the community based on the rate of infections. “Those are two different things,” Dr. Sharfstein said. “And when they get conflated, that’s when people may make bad judgments about policy.”

The new guidelines should serve as a reminder to health officials to step up their outreach and investment to ensure that everyone has access to vaccines, Dr. McLaren said. Parents of children under 12 should continue to urge them to wear masks indoors.

The C.D.C.’s new policy shifts the onus onto the immunocompromised as well, to protect themselves from unmasked and unvaccinated people.

“When we make policy, we need to balance the needs and desires of everyone,” Dr. McLaren said. “We could keep masking forever, but there are benefits to getting back to a life that looks more normal.”

Health officials should emphasize that the situation may yet change, and official recommendations with it, she added: “We really need to practice being good at responding to changing situations.”

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FDA Authorizes Pfizer-BioNTech Vaccine for Children 12 to 15

Vaccinating children is crucial to building up population levels of immunity and curtailing the spread of the coronavirus. Though children spread the virus less efficiently than adults do, they make up about 23 percent of the population.

Experts have said that the country is unlikely to reach the “herd immunity” threshold — the point at which virus transmission essentially stalls — but vaccinating children will be important for getting as close as possible.

Ty Dropic, 14, one of the trial participants, urged others his age to be vaccinated so they could build up widespread immunity and protect themselves. He had no side effects, leading him to suspect that he got the placebo. If that turns out to be the case, he plans to be immunized as soon as possible.

“I know it can be kind of scary, but it’s really not as bad as it seems,” he said. “If you do get Covid, it’ll be a lot worse than getting stuck with a needle for, like, two seconds.”

Ty’s three siblings, ages 8, 10 and 16, are also enrolled in vaccine trials for their age groups. Their mother, Dr. Amanda Dropic, a pediatrician in northern Kentucky, said that in her practice, most parents were eager to have their children vaccinated so they could regain some semblance of normalcy.

“The anxiety and depression that we’re seeing with kids, the social delays, has been tremendous,” she said.

Dr. Dropic said her children understood the risks and were willing to volunteer because they saw it as a civic duty. Every medicine available today came to be because “somebody was willing to go first,” she added.

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Vaccinations Rise in the E.U. After a Long, Slow Start

Vaccinations are picking up pace in the European Union, a stunning turnaround after the bloc’s immunization drive stalled for months.

On average over the last week, nearly three million doses of the Covid-19 vaccine were being administered each day in the European Union, a group of 27 nations, according to Our World in Data, a University of Oxford database. Adjusted for population, the rate is roughly equivalent to the number of shots given each day in the United States, where demand has been falling.

The E.U. vaccination campaign, marred by disruptions in supplies of the AstraZeneca and Johnson & Johnson Covid-19 vaccines, pivoted last month to rely heavily on the Pfizer-BioNTech vaccine.

Last month, Ursula von der Leyen, the European Commission president, said that Pfizer had agreed to an early shipment of doses that she said should likely allow the bloc to reach its goal of inoculating 70 percent of adults by the end of the summer. The European Union is also on the verge of announcing a deal with Pfizer and its German partner BioNTech for 2022 and 2023 that will lock in 1.8 billion doses for boosters, variants and children’s vaccines.

customer than an investor.

“I think it is overdue that the E.U. has stepped up their vaccination campaign,” said Beate Kampmann, director of the Vaccine Center at the London School of Hygiene and Tropical Medicine.

“I think in the context of the rate of deaths we’ve seen and new cases we’ve seen in the E.U., it is absolutely vital that we get the vaccine to people there very, very quickly,” she added.

The E.U.’s increase underscores the global disparities in vaccination efforts.

About 83 percent of Covid shots have been given in high- and upper-middle-income countries, while only 0.3 percent of doses have been given in low-income countries. In North America, more than 30 percent of people have received at least one dose, according to Our World in Data. In Europe, the figure is nearly 24 percent. In Africa, it’s slightly more than one percent.

waiving intellectual property protections for Covid vaccines, which would need approval from the World Trade Organization. And even then, experts warn that pharmaceutical companies around the world would need technological help to make the vaccines and time to ramp up production.

European leaders like Ms. von der Leyen and President Emmanuel Macron have made it clear they think President Biden should take a different approach, and instead lift export restrictions on vaccines, which the United States has employed to keep most doses for use domestically. “We call upon all vaccine-producing countries to allow export and to avoid measures that disrupt the supply chains,” Ms. von der Leyen said in a speech last week.

But the matter is not so absolute, said Dr. Thomas Tsai, a professor who researches health policy at Harvard University. “What’s really needed is an all-of-the-above approach,” he said. Waiving patents is a big long-term step, he said, but lifting export bans would provide help sooner.

“There is a need to move toward a more comprehensive strategy” in vaccinating the world, Dr. Tsai said. “We need that same sort of Warp Speed type of commitment. It’s an investment.”

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Pfizer Seeks Full FDA Approval for Its Covid-19 Vaccine

Pfizer and the German company BioNTech have become the first companies to apply to the U.S. Food and Drug Administration for full approval of their Covid-19 vaccine for use in people 16 and older. The vaccine is currently being administered to adults in America under an emergency use authorization granted in December.

The approval process is likely to take months.

The companies said in a statement on Friday that they had submitted their clinical data, which includes six months of information on the vaccine’s safety and efficacy, to the F.D.A. They plan to submit additional material, including information about the manufacturing of the vaccine, in the coming weeks.

“We are proud of the tremendous progress we’ve made since December in delivering vaccines to millions of Americans, in collaboration with the U.S. government,” Dr. Albert Bourla, Pfizer’s chief executive, said in the statement. “We look forward to working with the F.D.A. to complete this rolling submission and support their review, with the goal of securing full regulatory approval of the vaccine in the coming months.”

As of Thursday, more than 134 million doses of the vaccine had been administered in the United States, according to the Centers for Disease Control and Prevention. Full approval would allow Pfizer and BioNTech to market the vaccine directly to customers.

said in December that employers could mandate vaccination, and legal experts have generally agreed.

Many companies have been hesitant to require the vaccines, especially while they have only emergency authorization, which is designed to be temporary. Some institutions, like the University of California and California State University systems, have said that they would do so only after a vaccine has full approval.

Full approval could also prompt the U.S. military, which has had low uptake of Covid-19 vaccines, to mandate vaccinations for service members.

If the F.D.A. grants full approval, it could also help raise confidence in the vaccine. The pace of vaccination has slowed in the United States in recent weeks, and a recent national survey indicated that most people in the country who planned to get the shots had already done so.

The agency is also expected to issue an emergency authorization for use of the Pfizer-BioNTech vaccine in 12- to 15-year-olds next week. The companies have said that they plan to file for emergency authorization for 2- to 11-year-olds in September.

Moderna plans to apply for full approval for its Covid-19 vaccine this month, the company said during its quarterly earnings call on Thursday.

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Pfizer Reaps Hundreds of Millions in Profits From Covid Vaccine

The pricing for the United States was in line with the cost of seasonal flu vaccines and much less expensive than vaccines for conditions like shingles, which can run into several hundred dollars.

“That price point does not seem offensive, even if you don’t spend a lot of time thinking about prescription drugs,” said Stacie Dusetzina, an associate professor of health policy at Vanderbilt University Medical Center. “Just thinking about any prescription you’d fill, you’d be hard-pressed to find pretty much anything for $20.”

But the fact that Pfizer appears to have earned something like $900 million in pretax profits from its vaccine — coupled with its comparatively small sales to poor countries — suggests that profits have trumped other considerations. That could undercut the company’s embrace of loftier principles.

“At Pfizer, we believe that every person deserves to be seen, heard and cared for,” the chief executive, Albert Bourla, said in January as the company announced it would join Covax. “We share the mission of Covax and are proud to work together so that developing countries have the same access as the rest of the world.”

But the company seems to have prioritized higher-priced sales.

“Despite all the talk about Covax, they have been far more interested in bilateral deals, because that’s where they make their money,” said Richard Kozul-Wright, director of the division on globalization and development strategies at the United Nations Conference on Trade and Development in Geneva. “It’s one of the great public relations triumphs of recent corporate history.”

Multiple factors explain the inequitable nature of Pfizer’s vaccine distribution.

The shot, which must be stored and transported at very low temperatures, is less practical for hard-to-reach parts of the world than other shots, like those from AstraZeneca and Johnson & Johnson, that can simply be refrigerated. Some poor countries were initially not hit hard by the virus, and so their governments had less urgency to place orders for the Pfizer vaccine, to the extent that they could afford to pay for the shots.

“Not everyone was interested in the vaccine or prepared to take steps; thus, conversations continue, including working with Covax beyond their initial order of 40 million doses,” said Ms. Castillo, the Pfizer spokeswoman.

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How Europe Sealed a Pfizer Vaccine Deal With Texts and Calls

BRUSSELS — It was February and things were going from bad to worse for the European Union’s vaccination campaign, and for its top executive, Ursula von der Leyen.

Much of Europe was in lockdown, people were dying and the bloc was running low on doses of vaccines after its biggest supplier, AstraZeneca, announced production problems. Critics inside and outside the European Union questioned Ms. von der Leyen’s leadership and accused her of mishandling the crisis.

It was at that low point that she caught a break.

For a month, Ms. von der Leyen had been exchanging texts and calls with Albert Bourla, the chief executive of Pfizer, another vaccine supplier to the bloc. And as they spoke, two things became clear: Pfizer might have more doses it could offer the bloc — many more. And the European Union would be thrilled to have them.

That personal diplomacy played a big role in a deal, to be finalized this week, in which the European Union will lock in 1.8 billion doses from Pfizer, which, with its smaller German partner, BioNTech, made the first Covid-19 vaccine to get regulatory approval in the European Union.

Our World in Data.

suing over the missed doses — and has moved forward its target date for getting 70 percent of its adults fully immunized. It is now July, instead of September.

The bloc is already one of the world’s biggest producers and exporters of Covid-19 vaccines, with just over 159 million doses shipped to 87 countries since December. That is almost exactly as many as it has kept at home to immunize its own people.

The agreement with Pfizer and BioNTech will stipulate that the shots be produced in Europe, bringing home not just the finished product, but also most of the 280 components that go into making it, Ms. von der Leyen and Mr. Bourla of Pfizer said.

The contract will also allow for a range of different vaccine products.

An internal European Commission assessment of the bloc’s needs over the next two years, which is still being reviewed and was seen by The Times, lays out ballpark figures for how many doses might be necessary under different scenarios. According to the draft assessment, the bloc might require up to 510 million booster doses in 2022 and 2023.

Mr. Bourla said he expected a booster would be needed six to twelve months after people get their second shot, although some public health experts note that it is not clear yet whether that will be necessary. And the assessment includes a worst-case scenario for a new vaccine to target an “escape mutant,” a variant of the coronavirus that is too resistant to existing shots. The draft says the European Union would require 640 million doses of this type of vaccine for two doses per adult. And it puts the number of pediatric vaccines at 130 million for 2022 and 65 million for 2023.

The deal is not without risks, or critics. Countries and experts worry that the European Union may be becoming too dependent on Pfizer, and failing to hedge its bets in the event of problems with the vaccine or its production.

“I would caution against going for Pfizer/BioNTech only,” said Prof. Peter Piot, a microbiologist who advises Ms. von der Leyen. “That is too high risk for me, scientifically,” he said, though he noted that mRNA technology vaccines like Pfizer’s have so far been working well.

Of the new E.U. deal with Pfizer, Professor Piot said, “My interpretation is, what works is who can deliver.”

Ms. von der Leyen said the European Union could still procure doses from other companies.

She said the bloc was following the development of protein-based vaccines made by Novavax and Sanofi, as well as mRNA vaccines from Moderna, which are already being used in Europe, and CureVac, which is under review by the E.U. regulator. The Johnson & Johnson vaccine, which was rolled out in Europe this month, is also attractive because of its single-dose regimen and easy storage, she said.

The Pfizer shot is also expensive. While the financial details of the new agreement have not been disclosed, the previous contract priced the shot at approximately 15.5 euros, or about 19 dollars, making it the second-most expensive vaccine in the region after Moderna.

European Union members will each decide whether they want to use their full allocations of doses, or leave some for others to absorb, or to be resold or donated. They will also be free to make bilateral agreements with other pharmaceutical companies for vaccines in the future.

The new contract does little to address mounting global calls for the release of patents or for technology transfers to ensure that more of the world gets vaccinated soon. With India in the throes of a catastrophic wave of the virus, and the majority of the world’s population still far from getting access to a first dose of any vaccine, Europe’s talk of doses for children and boosters seems out of step with global needs, health experts say.

And while Ms. von der Leyen says the deal will enable the European Union to help poorer regions, it reinforces the fact that the rich are still coming first in the global scramble for vaccines.

Siddartha Sankar Datta, a senior official with the World Health Organization in Europe, said he worried about how the deal would affect global supply.

“I think the bottom line should be that the access to this vaccine should not be a prerogative of the purchasing power of the country,” he said. He said, “As countries make the effort to ensure their population base gets benefits, we have to still keep pushing ourselves to ensure more equitable access.”

Still, for Ms. von der Leyen, and for the European Union, the deal with Pfizer and BioNTech offers a chance to remedy past mistakes.

“Europe has decided to make sure that, under any circumstances, they will be prepared if there’s more need, and as a consequence of that political decision, they are now prepared to take much bigger risks,” said Moncef Slaoui, who led the U.S. vaccine effort Operation Warp Speed, and is in frequent contact with Ms. von der Leyen on E.U. strategy.

“Politics and science are intertwined here,” he said.

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European Union Promises Extra Covid-19 Vaccine Doses From Pfizer

The European Union will receive an extra 50 million doses this month of the coronavirus vaccine developed by Pfizer and BioNTech, the leader of the bloc’s executive arm said on Wednesday, a lift in its effort to meet inoculation targets in the face of difficulties with vaccines developed by AstraZeneca and Johnson & Johnson.

The 27-nation bloc has also entered negotiations with Pfizer over the supply of 1.8 billion new vaccine doses — including booster shots to prolong immunity and new vaccines to tackle emerging variants — in 2022 and 2023, said Ursula von der Leyen, the president of the European Commission, its executive arm.

With these two announcements, the European Union embarked on a hard pivot to mRNA vaccines such as Pfizer’s, staking its coronavirus response on them, a day after Johnson & Johnson suspended the rollout of its vaccine in the European Union and as the bloc continued to suffer the fallout from restrictions on the AstraZeneca vaccine, after reports of extremely rare but serious potential side effects from both.

In another setback for AstraZeneca, Denmark on Wednesday became the first country to permanently stop the administration of the vaccine developed by the British-Swedish drugmaker. Denmark has heavily relied on Pfizer’s vaccine and has approved two others — Moderna’s, and Johnson & Johnson’s.

suffering blow after blow, first with major supply disruptions from AstraZeneca, and then as it has sought to respond to the reports of potential rare side effects.

Ms. von der Leyen’s announcements on Wednesday were significant in two ways.

Pfizer’s commitment to bring forward the delivery of the 50 million doses, which were originally slated for the end of the year, means the company will deliver a total of 250 million doses to the bloc by the end of June. Ms. von der Leyen said 100 million people in the European Union had already been inoculated.

But it also signaled that the bloc would seek to peg its strategy to tackle variants and the need for boosters in the medium term on mRNA vaccines, a newer technology being used by Pfizer and Moderna, moving away from vaccines based on other approaches like those from AstraZeneca and Johnson & Johnson.

“We need to focus now on technologies that have proven their worth: mRNA vaccines are a clear case in point,” Ms. von der Leyen said.

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My Family’s Global Vaccine Journey

On Feb. 22, Mom texted that she and Dad had booked a March 11 appointment to get their first shots, followed by second doses in April. A day later, she reported that Dad hadn’t pressed the button to confirm the appointment on the online booking system and had lost the slots.

The next week, they texted again: They had walked to a private clinic that was dispensing Sinovac shots. After a short wait, they received the vaccine. On April 2, they told us that they had gotten their second dose of Sinovac and were feeling fine. Mom groused that even though they had an appointment, they “still need to wait for half an hour.”

Our responses were more enthusiastic.

“Great news,” I wrote.

“Yay!” Pui-Ying texted, followed by celebratory emojis.

“Congrats!” Pui Ling said.

Pui-Ying had moved with her family to Malawi in 2016 to work as a doctor and conduct clinical research on children’s health. Resources at the Queen Elizabeth Central Hospital, where she works, were limited. When Madonna’s charity helped finance the construction of a new children’s wing at the hospital, which opened in 2017, it was big news.

Staffing was tight even before the coronavirus, Pui-Ying said. When the pandemic came, the hospital decided on a one-week-on, one-week-off routine to reduce staff exposure to Covid-19 while ensuring that enough medical professionals would be working at all times. Masks, gloves and other protective equipment were scarce.

In pediatrics, Pui-Ying and her colleagues set up a “respiratory zone” for children with Covid-19. It was essentially a two-room ward, with about a dozen beds in the main room. The second room, which was an isolation unit, had space for four children.

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