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Fauci, Anthony S

Top health officials urge Americans to get vaccinated but barely address the J.&J. dose pause.

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Three top federal health officials appeared on Capitol Hill on Thursday and implored Americans to get vaccinated against the coronavirus, but said little about the investigation into whether the Johnson & Johnson vaccine may be linked to a small number of cases of rare blood clots, or when that vaccine might be put back into use.

“Hopefully we’ll get a decision quite soon, as to whether or not we can get back on track with this very effective vaccine,” Dr. Anthony S. Fauci, President Biden’s top medical adviser for the coronavirus, told a House panel.

Dr. Fauci’s comments came as the future of the Johnson & Johnson one-shot vaccine hung in the balance. Earlier this week, the Food and Drug Administration and the Centers for Disease Control and Prevention called for a pause in the use of the vaccine in the wake of reports of a small number of rare blood clots in recipients. Though it is unclear whether the vaccine was responsible for the clots, injections came to a sudden halt across the country.

On Wednesday, a C.D.C. advisory panel suggested that it would be a week to 10 days before they had enough information to assess the vaccine’s risks and could make a decision about its future. In the meantime, the officials — Dr. Fauci; Dr. Rochelle Walensky, the C.D.C. director; and Dr. David Kessler, who runs the Biden administration’s vaccine effort — urged Americans to continue to get vaccinated.

an immediate pause in the use of Johnson & Johnson’s single-dose Covid-19 vaccine after six recipients in the United States developed a rare disorder involving blood clots within one to three weeks of vaccination.

  • All 50 states, Washington, D.C. and Puerto Rico temporarily halted or recommended providers pause the use of the vaccine. The U.S. military, federally run vaccination sites and a host of private companies, including CVS, Walgreens, Rite Aid, Walmart and Publix, also paused the injections.
  • Fewer than one in a million Johnson & Johnson vaccinations are now under investigation. If there is indeed a risk of blood clots from the vaccine — which has yet to be determined — that risk is extremely low. The risk of getting Covid-19 in the United States is far higher.
  • The pause could complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy.
  • Johnson & Johnson has also decided to delay the rollout of its vaccine in Europe amid concerns over rare blood clots, dealing another blow to Europe’s inoculation push. South Africa, devastated by a more contagious virus variant that emerged there, suspended use of the vaccine as well. Australia announced it would not purchase any doses.

    • The reports of blood clots were the second recent blow to the Johnson & Johnson vaccine. Earlier this month, an ingredient mix-up at a Baltimore manufacturing plant owned by Emergent BioSolutions ruined up to 15 million doses of the vaccine. The F.D.A. is now inspecting the plant to see whether any vaccine doses manufactured there can be released to the public.

    About 7.7 million Americans had received the Johnson & Johnson vaccine as of Wednesday, accounting for less than 4 percent of the more than 198 million doses administered across the country. The Pfizer and Moderna vaccines are in much greater supply.

    Officials note that the blood clots are extremely rare; the handful of cases represent less than one in one million recipients, although that incidence estimate could go up if more cases are reported.

    Biden administration officials say that the absence of the Johnson & Johnson vaccine might not have a major impact on the U.S. vaccination campaign. But if use of the vaccine is severely restricted worldwide, it could prove disastrous for the global vaccination effort.

    Health officials had hoped that the Johnson & Johnson vaccine, along with a similar vaccine developed by AstraZeneca, would help supply the world because they are less expensive and easier to store and handle than the Pfizer and Moderna vaccines.

    Denmark, where two recipients suffered severe blood clots, permanently suspended use of the AstraZeneca vaccine.

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    U.S. Risks a ‘Fourth Wave’ Fueled by Variants and Eased Restrictions, Fauci Warns

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    The Centers for Disease Control and Prevention has been warning about it since January: A more contagious and possibly deadlier variant of the coronavirus, first found in Britain, is likely to become predominant in the United States, perhaps leading to a wrenching surge in cases and deaths.

    The first part of that warning seems to be coming true: The variant, known as B.1.1.7, is doubling its share of all new U.S. cases about every 10 days.

    But the second part is harder to make out, at least so far. The steep fall in new cases from the January peak halted in mid-February, but the trend since then has been roughly steady or only slightly downward, rather than a feared “fourth wave.”

    Experts are not sure why. The accelerating pace of vaccinations and the remaining virus-control measures in much of the country might be balancing out the spread of the more contagious variant, so that total cases neither rise nor fall very much. But it is difficult to know how long that equilibrium might last, or whether the next clear turn in the trend will be upward or downward.

    New York Times database. That is the lowest seven-day average since October and about 10 percent below the average on Feb. 21, when the steep decline slowed. Still, the figure is close to the peak level of the surge last summer. Death reports are also falling but remain high, regularly topping 2,000 a day.

    In an interview Sunday on the CBS program “Face the Nation,” Dr. Fauci said that over the past week and a half, the decline in cases had stalled. “We’re plateauing at quite a high level — 60 to 70,000 new infections per day is quite high,” he said.

    This trend is particularly worrisome, he said, because in the United States over the past year, when the daily level of new infections plateaued at a high level, surges in cases followed. And recently in Europe, infection levels were declining, then plateaued and “over the last week or so, they’ve had about a 9 percent increase in cases,” Dr. Fauci said.

    Experts say they need more data to understand why the United States has not yet seen a surge in cases as the fearsome B.1.1.7 variant has spread so rapidly, already accounting for more than one-fifth of new cases.

    William Hanage, a Harvard epidemiologist, said there could be several reasons B.1.1.7 has not started ravaging the United States the way it consumed Britain, including more widespread vaccination, improving weather and the patchwork of pandemic restrictions across the states.

    Florida, Mr. Hanage and other experts say, is an interesting example, because infections have not surged even though restrictions are looser than in other states and the variant makes up at least an estimated 30 percent of cases, the highest proportion in the nation.

    Dr. Fauci said on Sunday that a variant first identified in New York is “not widespread yet, but it seems to be spreading pretty efficiently through the New York City metropolitan area and beyond.”

    He said there is evidence that the variant may partly elude protection conferred by vaccines and monoclonal antibody treatments, although the variant does not evade vaccines and treatments as much as one first identified in South Africa.

    The best way to prevent further spread is to “get people vaccinated as quickly and as expeditiously as possible and, above all, maintain the public health measures that we talk about so often: the masking, the physical distancing, and the avoiding of congregate settings, particularly indoors.” Dr. Fauci said. “That’s what you can do to prevent the spread of a worrisome variant.”

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    Fauci Warns Coronavirus Cases Could Spike as States Ease Restrictions

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    The B.1.1.7 variant, first identified in Britain, is spreading so rapidly in the United States that data analysis suggest that, as of this week, it has most likely grown to account for 20 percent of new U.S. cases. And scientists in Oregon have identified a single case of a homegrown variant with the same spine as B.1.1.7 that carries a mutation that could blunt the effectiveness of vaccines.

    Earlier this week, Texas and Mississippi, both Republican-led states, lifted mask mandates. President Biden denounced those moves as “a big mistake” that reflected “Neanderthal thinking,” saying it was critical for public officials to follow the guidance of doctors and public health leaders as the coronavirus vaccination campaign gains momentum.

    Other Republicans have been more cautious. Gov. Mike DeWine of Ohio said he would lift all public health measures aimed at curbing the virus crisis, but only once new cases there drop under a certain threshold. In Alabama, Gov. Kay Ivey said she would extend the state’s mask mandate through April 9.

    In Arizona, Gov. Doug Ducey has taken what he calls a “measured approach” requiring schools to offer in-person learning no later than March 15, barring local leaders from enacting measures that shut down businesses and allowing major league sports to restart if they receive approval from the state’s Department of Health Services.

    Among Democrats, Gov. Gretchen Whitmer of Michigan said on Tuesday that she was easing restrictions on businesses and would allow family members who had tested negative for the coronavirus to visit nursing home residents. In California, the state’s public health department also loosened some restrictions Friday, saying that amusement parks could reopen on a limited basis as soon as April 1.

    In New York City, limited indoor dining has returned. And on Thursday, Connecticut’s governor said the state would end capacity limits later this month on restaurants, gyms and offices. Masks remain required in both places.

    Dr. Rochelle P. Walensky, the director of the Centers for Disease and Prevention, has implored states not to relax their restrictions yet. A new report from the C.D.C. found that counties that allowed restaurants to open for in-person dining in the United States had a rise in daily infections weeks after. The study also said that counties that issued mask mandates reported a decrease in virus cases and deaths within weeks.

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