“This was practical science, designed by parents to get their kids back to school,” Dr. Paniz-Mondolfi said.

Then it was time to pilot the tests in a real school environment. In January, Mount Sinai connected with KIPP NYC, which had been offering remote instruction since last spring. But it was hoping to reopen its schools in March, and administrators knew they would need to do some kind of in-school virus testing.

“One of the biggest fears that we had was around what it would mean to keep students safe,” said Glenn Davis, the principal of KIPP Infinity Middle School.

Mount Sinai and KIPP NYC agreed to begin a pilot saliva-testing project at five schools. The testing program, which eventually grew to include nine KIPP schools, was free for the schools and mandatory for all students who opted to return to in-person learning. (Some families chose to continue with remote education.)

Students, teachers and staff members are tested once a week. Medical assistants from Mount Sinai supervise the saliva collection and pack the bar-coded tubes into coolers for transportation back to the laboratory. (The samples are currently being processed at an existing Mount Sinai lab, but will be sent to the new lab when it opens next month.)

During the pilot project, 99.2 percent test results were returned within 24 hours, Mount Sinai says. Students or staff members who test positive typically have to quarantine for 10 days.

If a student tests positive, Mount Sinai also offers to send a team of “swabbers” to his or her home to administer free coronavirus tests to their family members and close contacts.

“We’ve detected a few mini outbreaks in that fashion, and hopefully prevented them from spreading by virtue of this screening program in the schoolkids,” Dr. Reich said.

Between March 10, when the pilot project began, and May 9, Mount Sinai conducted 13,067 tests and identified 46 coronavirus cases, a positivity rate of 0.4 percent. There have been no false positives and no known false negatives, Mount Sinai says.

The Mount Sinai team has submitted the data to the Food and Drug Administration, hoping to receive an emergency use authorization for the test.

Later this week, Mount Sinai will submit a formal proposal to New York City to take its testing program to the city’s public schools when they reopen in the fall. Mount Sinai declined to disclose the terms of the proposal, including what it plans to charge schools for the tests, but says it hopes to attract commercial clients to help defray, or possibly even eliminate, costs for schools.

In the meantime, it is approaching other charter school organizations in the city about using its tests during their summer sessions and programs.

“We can’t just sit there when this lab goes live in June and say, ‘OK, we’re waiting for September,’” Dr. Reich said. “Before the fall, we need to be doing a lot of tests.” The lab will initially have the capacity to run 25,000 tests a day, with the ability to scale up to 100,000 if there is sufficient interest.

For its part, KIPP NYC plans to expand the program to all of its schools in the fall, although the testing frequency may change, said Efrain Guerrero, managing director of operations for KIPP NYC. “I think parents see it and staff see it as just an additional safety measure that they appreciate,” he said. “For us it’s a no-brainer to continue to test at some frequency.”

Olga Ramirez, Bradley’s mother, had not initially wanted him to return to in-person learning. “I was very afraid at first,” she said. But Bradley, who desperately wanted to go back to school, managed to convince her, with the help of an informational video about the Mount Sinai testing program.

Ms. Ramirez now thinks that returning to school was the right decision. Bradley’s virus tests have all come back negative, and his grades are up since returning to in-person learning.

“I’ve seen his grades improve quite a lot, and I feel that my son is in good hands,” she said. She’s not alone, she added. “There’s so many mothers who are feeling the way I do.”

Elda Cantú contributed translation.

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Moderna Says Its Covid Vaccine Is Effective for 12- to 17-Year-Olds

Moderna said on Tuesday that its coronavirus vaccine, authorized only for use in adults, was powerfully effective in 12- to 17-year-olds, and that it planned to apply to the Food and Drug Administration in June for authorization to use the vaccine in adolescents.

If approved, its vaccine would become the second Covid-19 vaccine available to U.S. adolescents. Federal regulators authorized the Pfizer-BioNTech vaccine this month for 12- to 15-year-olds.

The Pfizer shot was initially authorized for use in people 16 and older, while Moderna’s has been available for those 18 and up.

Proof of the vaccines’ efficacy and safety for adolescents is helping school officials and other leaders as they plan for the fall. On Monday, Mayor Bill de Blasio said that all public school students in New York City, the largest school system in the United States, would return to in-person learning in the fall.

Illinois, Massachusetts and New Jersey.

The Moderna results, which the company announced in a statement, are based on a clinical trial that enrolled 3,732 people ages 12 to 17, two-thirds of whom received two vaccine doses. There were no cases of symptomatic Covid-19 in fully vaccinated adolescents, the company reported. That translates to an efficacy of 100 percent, the same figure that Pfizer and BioNTech reported in a trial of their vaccine in 12- to 15-year-olds.

“These look like promising results,” said Dr. Kristin Oliver, a pediatrician and vaccine expert at Mount Sinai Hospital in New York. “The more vaccines we have to protect adolescents from Covid, the better.”

Moderna also reported that a single dose of its vaccine had 93 percent efficacy against symptomatic disease.

“Those cases that did occur between the two doses were mild, which is also a good indicator of protection against disease,” Saskia Popescu, an infectious disease epidemiologist at George Mason University, said in an email.

The side effects were consistent with what has been reported in adults: pain at the site of the injection, headache, fatigue, muscle pain and chills. “No significant safety concerns have been identified to date,” the company said.

The adolescents in the study will be monitored for a year after their second dose.

The results were announced in a news release that did not contain detailed data from the clinical trial. And Dr. Rasmussen said that the vaccines’ efficacy can be trickier to evaluate in children, who are less likely to develop symptomatic disease than adults.

Nevertheless, she said, the results are in line with what scientists expected and suggest “that adolescents respond to the vaccine comparably to adults who receive it.”

Moderna said it planned to submit the data for publication in a peer-reviewed journal.

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South Africa Vaccine Rollout Expands to People 60 and Older

CAPE TOWN — Facing a resurgence of Covid-19 infections and plagued by delays with vaccine supply, South Africa began the second phase of its public vaccination campaign on Monday, opening appointments for people aged 60 or older.

Only about 500,000 people in the country have been vaccinated to date, and most doses have gone to health care workers in a trial involving the Johnson & Johnson vaccine. South Africa is aiming to open vaccinations for people aged 40 or older in July, followed by the rest of the adult population in November.

South Africa has obtained nearly a million doses of the Pfizer-BioNTech vaccine and anticipates receiving around 4.5 million doses by the end of June.

The country has also ordered 3 million doses of the Johnson & Johnson vaccine, but only plans to begin using these in the public rollout following a verification process by international regulatory agencies, including the U.S. Food and Drug Administration.

some 1.6 million confirmed cases, South Africa has been hit harder by the pandemic than any other nation in Africa. Its most recent wave of infections, in December and January, was driven by a more contagious variant of the coronavirus, known as B.1.351, that was first detected in South Africa.

The government has set a goal to vaccinate 5 million people by the end of June, South Africa’s health minister, Zweli Mkhize, said Sunday. Just over 4,000 people were scheduled to receive vaccines on Monday.

The expanded eligibility comes at a critical phase: South Africa is experiencing a sustained rise in cases, and officials have warned of a third wave in the coming weeks, as the southern hemisphere heads into winter.

The slow rollout has underscored global problems of vaccine inequality, especially in Africa, where fewer than 23 million vaccines have been administered, according to the Africa C.D.C. Even vaccines manufactured in South Africa have been disproportionately exported to wealthier nations.

suspended use of the AstraZeneca-Oxford vaccine after ordering more than one million doses, and again in April, following safety concerns surrounding the Johnson & Johnson vaccine.

“For now, we can go on and protect the most vulnerable,” said Dr. Keith Cloete, the head of the health department in the Western Cape province, where more than 11,000 people have died from Covid-19.

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U.S. to Donate 20 Million Doses for Global Vaccination Effort

The United States will send at least 20 million coronavirus vaccine doses in June to countries struggling against the pandemic, answering calls that the Biden administration isn’t doing enough to help countries that face dire shortages of vaccines and other treatments.

President Biden said on Monday that those 20 million doses, of Pfizer-BioNTech, Moderna and Johnson and Johnson vaccines, would be in addition to 60 million doses of AstraZeneca’s vaccine, which the U.S. plans to donate once the vaccine is cleared for use by the Food and Drug Administration. It is not clear exactly how long it will take the F.D.A. to authorize AstraZeneca’s vaccine.

“We know America will never be fully safe until the pandemic that’s raging globally is under control,” Mr. Biden said during a news conference at the White House. “No ocean’s wide enough, no wall is high enough, to keep us safe.”

Mr. Biden’s announcement on Monday afternoon came not long after a World Health Organization news conference at which the director general, Dr. Tedros Adhanom Ghebreyesus, said that countries with high vaccination rates had to do more to help countries that were being hit hard by the coronavirus, or the entire world would be imperiled.

Britain, which have seen a decline in cases and deaths in recent weeks, relaxed restrictions as the virus battered India and other Asian countries.

Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.

Dr. Tedros called for well-supplied nations to send more of their vaccine supplies and allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.

Ms. Fore released a statement on Monday saying that Covax would soon complete delivering 65 million doses, but that it should have delivered at least 170 million and that the effort could be short by as much as 190 million doses by the time Group of 7 leaders gather in England in June.

convincing the remaining unvaccinated people to get the shot.

Last week the Centers for Disease Control and Prevention changed its guidance to allow people who have been vaccinated to forgo their masks indoors and outdoors in many situations. The decision caused confusion in states and individuals, some who were eager to return to a semblance of normalcy and others who said they planned to stay masked indefinitely.

Dr. Rochelle Walensky, the director of C.D.C., said on “Meet the Press” on Sunday that the agency’s suggestions were “not permission to shed masks for everybody, everywhere.”

On Monday, Dr. Tedros’s message was more straightforward.

“No one is safe until we are all safe,” he said.

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Why Vaccinating the World Against Covid-19 Will Be Hard

In delivering vaccines, pharmaceutical companies aided by monumental government investments have given humanity a miraculous shot at liberation from the worst pandemic in a century.

But wealthy countries have captured an overwhelming share of the benefit. Only 0.3 percent of the vaccine doses administered globally have been given in the 29 poorest countries, home to about 9 percent of the world’s population.

Vaccine manufacturers assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses. Each month, 400 million to 500 million doses of the vaccines from Moderna, Pfizer and Johnson & Johnson are now being produced, according to an American official with knowledge of global supply.

But the world is nowhere close to having enough. About 11 billion shots are needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity, researchers at Duke University estimate. Yet, so far, only a small fraction of that has been produced. While global production is difficult to measure, the analytics firm Airfinity estimates the total so far at 1.7 billion doses.

dangerous new variants emerge, requiring booster shots and reformulated vaccines, demand could dramatically increase, intensifying the imperative for every country to lock up supply for its own people.

The only way around the zero-sum competition for doses is to greatly expand the global supply of vaccines. On that point, nearly everyone agrees.

But what is the fastest way to make that happen? On that question, divisions remain stark, undermining collective efforts to end the pandemic.

Some health experts argue that the only way to avert catastrophe is to force drug giants to relax their grip on their secrets and enlist many more manufacturers in making vaccines. In place of the existing arrangement — in which drug companies set up partnerships on their terms, while setting the prices of their vaccines — world leaders could compel or persuade the industry to cooperate with more companies to yield additional doses at rates affordable to poor countries.

Those advocating such intervention have focused on two primary approaches: waiving patents to allow many more manufacturers to copy existing vaccines, and requiring the pharmaceutical companies to transfer their technology — that is, help other manufacturers learn to replicate their products.

more than 100 countries in asking the W.T.O. to partially set aside vaccine patents.

But the European Union has signaled its intent to oppose waivers and support only voluntary tech transfers, essentially taking the same position as the pharmaceutical industry, whose aggressive lobbying has heavily shaped the rules in its favor.

Some experts warn that revoking intellectual property rules could disrupt the industry, slowing its efforts to deliver vaccines — like reorganizing the fire department amid an inferno.

“We need them to scale up and deliver,” said Simon J. Evenett, an expert on trade and economic development at the University of St. Gallen in Switzerland. “We have this huge production ramp up. Nothing should get in the way to threaten it.”

Others counter that trusting the pharmaceutical industry to provide the world with vaccines helped create the current chasm between vaccine haves and have-nots.

The world should not put poorer countries “in this position of essentially having to go begging, or waiting for donations of small amounts of vaccine,” said Dr. Chris Beyrer, senior scientific liaison to the Covid-19 Prevention Network. “The model of charity is, I think, an unacceptable model.”

halting vaccine exports a month ago. Now, as a wave of death ravages the largely unvaccinated Indian population, the government is drawing fire at home for having let go of doses.

poses universal risks by allowing variants to take hold, forcing the world into an endless cycle of pharmaceutical catch-up.

“It needs to be global leaders functioning as a unit, to say that vaccine is a form of global security,” said Dr. Rebecca Weintraub, a global health expert at Harvard Medical School. She suggested that the G7, the group of leading economies, could lead such a campaign and finance it when the members convene in England next month.

Pfizer expects to sell $26 billion worth of Covid vaccines this year; Moderna forecasts that its sales of Covid vaccines will exceed $19 billion for 2021.

History also challenges industry claims that blanket global patent rights are a requirement for the creation of new medicines. Until the mid-1990s, drug makers could patent their products only in the wealthiest markets, while negotiating licenses that allowed companies in other parts of the world to make generic versions.

Even in that era, drug companies continued to innovate. And they continued to prosper even with the later waivers on H.I.V. drugs.

“At the time, it rattled a lot of people, like ‘How could you do that? It’s going to destroy the pharmaceutical industry,’” recalled Dr. Anthony S. Fauci, President Biden’s chief medical adviser for the pandemic. “It didn’t destroy them at all. They continue to make billions of dollars.”

Leaders in the wealthiest Western nations have endorsed more equitable distribution of vaccines for this latest scourge. But the imperative to ensure ample supplies for their own nations has won out as the virus killed hundreds of thousands of their own people, devastated economies, and sowed despair.

The drug companies have also promised more support for poorer nations. AstraZeneca’s vaccine has been the primary supply for Covax, and the company says it has sold its doses at a nonprofit price.

stumbled, falling short of production targets. And producing the new class of mRNA vaccines, like those from Pfizer-BioNTech and Moderna, is complicated.

Where pharmaceutical companies have struck deals with partners, the pace of production has frequently disappointed.

“Even with voluntary licensing and technology transfer, it’s not easy to make complex vaccines,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center.

Much of the global capacity for vaccine manufacturing is already being used to produce other lifesaving inoculations, he added.

But other health experts accuse major pharmaceutical companies of exaggerating the manufacturing challenges to protect their monopoly power, and implying that developing countries lack the acumen to master sophisticated techniques is “an offensive and a racist notion,” said Matthew Kavanagh, director of the Global Health Policy and Politics Initiative at Georgetown University.

With no clear path forward, Ms. Okonjo-Iweala, the W.T.O. director-general, expressed hope that the Indian and South African patent-waiver proposal can be a starting point for dialogue.

“I believe we can come to a pragmatic outcome,” she said. “The disparity is just too much.”

Peter S. Goodman reported from London, Apoorva Mandavilli from New York, Rebecca Robbins from Bellingham, Wash., and Matina Stevis-Gridneff from Brussels. Noah Weiland contributed reporting from New York.

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What Would It Take to Vaccinate the World Against Covid?

In delivering vaccines, pharmaceutical companies aided by monumental government investments have given humanity a miraculous shot at liberation from the worst pandemic in a century.

But wealthy countries have captured an overwhelming share of the benefit. Only 0.3 percent of the vaccine doses administered globally have been given in the 29 poorest countries, home to about 9 percent of the world’s population.

Vaccine manufacturers assert that a fix is already at hand as they aggressively expand production lines and contract with counterparts around the world to yield billions of additional doses. Each month, 400 million to 500 million doses of the vaccines from Moderna, Pfizer and Johnson & Johnson are now being produced, according to an American official with knowledge of global supply.

But the world is nowhere close to having enough. About 11 billion shots are needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity, researchers at Duke University estimate. Yet, so far, only a small fraction of that has been produced. While global production is difficult to measure, the analytics firm Airfinity estimates the total so far at 1.7 billion doses.

more than 100 countries in asking the W.T.O. to partially set aside vaccine patents.

But the European Union has signaled its intent to oppose waivers and support only voluntary tech transfers, essentially taking the same position as the pharmaceutical industry, whose aggressive lobbying has heavily shaped the rules in its favor.

Some experts warn that revoking intellectual property rules could disrupt the industry, slowing its efforts to deliver vaccines — like reorganizing the fire department amid an inferno.

“We need them to scale up and deliver,” said Simon J. Evenett, an expert on trade and economic development at the University of St. Gallen in Switzerland. “We have this huge production ramp up. Nothing should get in the way to threaten it.”

Others counter that trusting the pharmaceutical industry to provide the world with vaccines helped create the current chasm between vaccine haves and have-nots.

The world should not put poorer countries “in this position of essentially having to go begging, or waiting for donations of small amounts of vaccine,” said Dr. Chris Beyrer, senior scientific liaison to the Covid-19 Prevention Network. “The model of charity is, I think, an unacceptable model.”

Pfizer expects to sell $26 billion worth of Covid vaccines this year; Moderna forecasts that its sales of Covid vaccines will exceed $19 billion for 2021.

History also challenges industry claims that blanket global patent rights are a requirement for the creation of new medicines. Until the mid-1990s, drug makers could patent their products only in the wealthiest markets, while negotiating licenses that allowed companies in other parts of the world to make generic versions.

Even in that era, drug companies continued to innovate. And they continued to prosper even with the later waivers on H.I.V. drugs.

“At the time, it rattled a lot of people, like ‘How could you do that? It’s going to destroy the pharmaceutical industry,’” recalled Dr. Anthony S. Fauci, President Biden’s chief medical adviser for the pandemic. “It didn’t destroy them at all. They continue to make billions of dollars.”

Leaders in the wealthiest Western nations have endorsed more equitable distribution of vaccines for this latest scourge. But the imperative to ensure ample supplies for their own nations has won out as the virus killed hundreds of thousands of their own people, devastated economies, and sowed despair.

The drug companies have also promised more support for poorer nations. AstraZeneca’s vaccine has been the primary supply for Covax, and the company says it has sold its doses at a nonprofit price.

stumbled, falling short of production targets. And producing the new class of mRNA vaccines, like those from Pfizer-BioNTech and Moderna, is complicated.

Where pharmaceutical companies have struck deals with partners, the pace of production has frequently disappointed.

“Even with voluntary licensing and technology transfer, it’s not easy to make complex vaccines,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center.

Much of the global capacity for vaccine manufacturing is already being used to produce other lifesaving inoculations, he added.

But other health experts accuse major pharmaceutical companies of exaggerating the manufacturing challenges to protect their monopoly power, and implying that developing countries lack the acumen to master sophisticated techniques is “an offensive and a racist notion,” said Matthew Kavanagh, director of the Global Health Policy and Politics Initiative at Georgetown University.

With no clear path forward, Ms. Okonjo-Iweala, the W.T.O. director-general, expressed hope that the Indian and South African patent-waiver proposal can be a starting point for dialogue.

“I believe we can come to a pragmatic outcome,” she said. “The disparity is just too much.”

Peter S. Goodman reported from London, Apoorva Mandavilli from New York, Rebecca Robbins from Bellingham, Wash., and Matina Stevis-Gridneff from Brussels. Noah Weiland contributed reporting from New York.

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Businesses Offer Perks to Vaccinated Customers

At Fort Bragg, soldiers who have gotten their coronavirus vaccines can go to a gym where no masks are required, with no limits on who can work out together. Treadmills are on and zipping, unlike those in 13 other gyms where unvaccinated troops can’t use the machines, everyone must mask up and restrictions remain on how many can bench-press at one time.

Inside Dodgers Stadium in Los Angeles, where lines not long ago snaked for miles with people seeking coronavirus vaccines, a special seating area allows those who are fully inoculated to enjoy games side by side with other fans.

When Bill Duggan reopens Madam’s Organ, his legendary blues bar in Washington, D.C., people will not be allowed in to work, drink or play music unless they can prove they have had their shots. “I have a saxophone player who is among the best in the world. He was in the other day, and I said, ‘Walter, take a good look around because you’re not walking in here again unless you get vaccinated.’”

Evite and Paperless Post are seeing a big increase in hosts requesting that their guests be vaccinated.

actually doughnuts, beers and cheesecake — to prod laggards along. Some have even offered cold hard cash: In Ohio, Gov. Mike DeWine this week went so far as to say that the state would give five vaccinated people $1 million each as part of a weekly lottery program.

On Thursday, federal health officials offered the ultimate incentive for many when they advised that fully vaccinated Americans may stop wearing masks.

Now, private employers, restaurants and entertainment venues are looking for ways to make those who are vaccinated feel like V.I.P.s, both to protect workers and guests, and to possibly entice those not yet on board.

Come summer, the nation may become increasingly bifurcated between those who are permitted to watch sports, take classes, get their hair cut and eat barbecue with others, and those who are left behind the spike protein curtain.

for children ages 12 through 15.

But even without a mandate, a nudge can feel like a shove. The military has been strongly encouraging vaccines among the troops. Acceptance has been low in some branches, like the Marines, with only 40 percent having gotten one or more shots. At Fort Bragg, one of the largest military installations in the country and among the first to offer the vaccine, just under 70 percent have been jabbed.

podcast designed to knock down misinformation — a common misbelief is that the vaccines affect fertility — plays around the base. In addition to their freedom gym, vaccinated soldiers may now eat in groups as they please, while the unvaccinated look on as they grab their grub and go.

With soldiers, experts “talk up to decliners versus talk down,” said Col. Joseph Buccino, a spokesman at Fort Bragg.

promoting inoculations, and stadiums have become a new line of demarcation, where vaccinated sections are highlighted as perks akin to V.I.P. skyboxes.

In Washington, Gov. Jay Inslee recently announced that sporting venues and churches would be able to increase their capacity by adding sections for the vaccinated.

Some businesses — like gyms and restaurants — where the coronavirus was known to spread easily are also embracing a reward system. Even though many gyms have reopened around the country, some still haven’t allowed large classes to resume.

Others are inclined to follow the lead of gyms like solidcore in Washington, D.C., which seeks proof of inoculation to enroll in classes listed as “Vaccine Required: Full Body.” “Our teams are now actively evaluating where else we think there will be client demand and will be potentially introducing it to other markets in the weeks ahead,” said Bryan Myers, chief executive officer of the national fitness studio chain, in an email.

specific invitation designs with the inoculated in mind, vaccinated only please RSVP.

Not everyone endorses this type of exclusion as good public policy. “I worry about the operational feasibility,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Coronavirus Resource Center. “In the U.S., we don’t yet have a standard way to prove vaccination status. I hope we’ll see by fall such low levels of infection in the U.S. that our level of concern about the virus will be very low.”

But few dispute that it is legal. “Having dedicated spaces at events reserved for vaccinated people is both lawful and ethical,” said Lawrence O. Gostin, an expert in health law at Georgetown Law School. “Businesses have a major economic incentive to create safer environments for their customers, who would otherwise be reluctant to attend crowded events. Government recommendations about vaccinated-only sections will encourage businesses and can help us back to more normal.”

so far to impose vaccine mandates for workers, especially in a tight labor market. “Our association came out in favor of masks,” said Emily Williams Knight, president of the Texas Restaurant Association. “We probably will not be taking a position on mandates, which are incredibly divisive.”

But some companies are moving that way. Norwegian Cruise Line is threatening to keep its ships out of Florida ports if the state stands by a law prohibiting businesses from requiring vaccines in exchange for services.

Public health mandates — from smoking bans to seatbelt laws to containing tuberculosis outbreaks by requiring TB patients to take their medicines while observed — have a long history in the United States.

“They fall into a cluster of things in which someone is essentially making the argument that what I do is only my business,” said Dr. Frieden, who is now chief executive of Resolve to Save Lives, a program designed to prevent epidemics and cardiovascular disease. “A lot of times that’s true, unless what you do might kill someone else.”

Dr. Frieden was the main official who pushed for a smoking ban in bars and restaurants in 2003 when he was the New York City health commissioner under former Mayor Michael R. Bloomberg. Other senior aides at the time felt certain the ban would cost Mr. Bloomberg a second term. “When I was fighting for that, a City Council member who was against the ban said of bars, ‘That is my place of entertainment.’ And I said, ‘Well, that’s someone’s place of employment.’ It did have impact.”

Mr. Duggan, the bar owner in Washington, said protecting his workers and patrons are of a piece. “As we hit a plateau with vaccines, I don’t think we can sit and wait for all the nonbelievers,” he said. “If we are going to convince them, it’s going to be through them not being able to do the things that vaccinated people are able to do.”

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With shots at schools, parks and even the beach, the U.S. races to vaccinate children.

The world’s first mass coronavirus inoculation campaign for children kicked off in earnest in the United States on Thursday after the federal government recommended making the Pfizer-BioNTech vaccine available to those aged 12 to 15.

Even as the decision was embraced by millions of parents wearied by pandemic restrictions and desperate to get their children back into classrooms, states, counties and school districts around the country were trying to figure out the most reassuring and expedient ways to offer the shots.

The various authorities were making plans to offer vaccines not only in schools, but also at pediatricians’ offices, day camps, parks and even beaches.

President Biden, who hailed the vaccine as “safe, effective, easy, fast and free,” said that as many as 20,000 pharmacies stood ready to start giving shots on Thursday.

recommend use of the vaccine.

Some states, including Delaware, Georgia and Maine, had already started to offer doses to children after the authorization of the vaccine by the Food and Drug Administration on Monday.

But the ruling by the C.D.C. was the final step in the federal process that allows for widespread inoculations of the roughly 17 million children in the United States ages 12-15.

For many parents, it could not come too soon. About one-third of eighth graders, usually 13 or 14 years old, are still in remote learning.

But the authorities must also overcome a significant amount of hesitancy. A recent survey by the Kaiser Family Foundation found that many parents — even some who eagerly got their own coronavirus shots — were reluctant to vaccinate pubescent children.

health authorities require anyone younger than 18 to be accompanied by a parent, guardian or responsible adult and to present photo identification and verification of age, county officials said.

In Maine, a parent does not need to be with the child as long as the adult provides permission over the phone or signs a form beforehand.

Federal and local officials said that there should be no problem with supply meeting demand. The expansion of the U.S. vaccination effort underscored the widening gulf in the world’s inoculation campaigns even as the pandemic gathers force in several regions.

Referring to the global situation, Dr. Oliver Morgan, director of the risk assessment department at the W.H.O., said on Wednesday, “Throughout the month of March and April, there has been a steady increase in the number of cases each week and the weekly number of cases is now higher than any time in the pandemic.”

At the same time, many of the countries being walloped by the virus — and those where the threat of new outbreaks is growing — have not been able to secure vaccines to inoculate even health workers or those most at risk of serious illness and death.

Research shows that children are mostly spared severe disease and are not significant drivers of coronavirus spread, as they are for influenza, for example.

Young children are thought to spread the virus less often than adults do, but their ability to transmit increases with age. Teenagers may transmit the virus as readily as adults.

Vaccinating children is viewed as an important increase to the level of immunity in a population, driving down the number of cases broadly, while offering protection to more people.

While risk of severe illness in youngsters is low compared with that in adults, the coronavirus has infected more than 1.5 million children and sent more than 13,000 to hospitals, more than are hospitalized for flu in an average year, according to data collected by the C.D.C.

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C.D.C. Advisers Endorse Pfizer Vaccine for Children Ages 12 to 15

The federal government on Wednesday took a final step toward making the Pfizer-BioNTech coronavirus vaccine available to adolescents in the United States, removing an obstacle to school reopenings and cheering millions of families weary of pandemic restrictions.

An advisory committee to the Centers for Disease Control and Prevention voted to recommend the vaccine for use in children ages 12 to 15. The C.D.C. director, Dr. Rochelle Walensky, is expected to review the recommendations and approve them later on Wednesday.

“Approving Covid-19 vaccines for children 12 to 15 years of age is an important step in removing barriers for vaccinating children of all ages,” said Dr. Yvonne Maldonado, who represents the American Academy of Pediatrics on the federal Advisory Committee on Immunization Practices.

Many parents are eagerly anticipating the availability of vaccines for children, at least in part to speed their return to schools. Roughly one-third of eighth graders, usually 13 or 14 years old, are still learning fully remotely.

at least as effective in 12- to 15-year-olds as it has been in older teenagers and adults. Apart from a slight increase in the frequency of fevers, the shots also seemed to have comparable, mostly negligible side effects.

The company plans to continue monitoring trial participants for two years after the second dose to assess the vaccine’s long-term safety and efficacy.

The Food and Drug Administration reviewed the clinical data and on Monday authorized the Pfizer vaccine for use in these children, capping weeks of anticipation from parents and children about a swifter return to normalcy.

“While it’s true that children are generally spared from severe disease, the fact that they’ve been unable to be vaccinated has caused major disruptions in their lives that have real developmental consequences,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “Vaccination of this age cohort will allow these children to more fully return to their normal lives.”

about 20,000 pharmacies nationwide are expected to offer the vaccine for free to these children.

survey by the Kaiser Family Foundation.

Some of those parents may change their minds, as other children safely receive vaccines and resume in-person schooling, or rejoin team sports like football and basketball that involve close contact, the researchers suggested.

Others may wait until they must comply with school requirements. Public schools in all 50 states require certain vaccines, but officials may not be able to enforce compliance until the Pfizer-BioNTech vaccine gains the F.D.A.’s full approval.

The vaccine has emergency authorization now. Pfizer has applied to the F.D.A. for full approval, but that process is expected to take several months. Even after approval, students may still opt out by citing medical reasons or religious beliefs.

State and local leaders will need to make particular efforts to reach children in low-income families or in communities of color. Black and Hispanic adults have among the lowest rates of vaccination: As of May 3, just 25 percent of Black people and 27 percent of Hispanic people had been inoculated, compared with 39 percent of white people.

Making the vaccine accessible to these communities will require easier transportation and storage of doses. The Pfizer-BioNTech vaccine can be stored for only five days in standard refrigerators. The companies are planning to ship smaller packs for use in doctors’ offices, and are developing a formulation that can be refrigerated for up to 10 weeks.

Pfizer and BioNTech plan in September to submit requests for authorization of the vaccine in children ages 2 to 11.

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To Vaccinate Younger Teens, States and Cities Look to Schools, Camps, Even Beaches

Not all teenagers long for the vaccine. Many hate getting shots. Others say that because young people often get milder cases of Covid, why risk a new vaccine?

Patsy Stinchfield, a nurse practitioner who oversees vaccination for Children’s Minnesota, has stark evidence that some cases in young people can be serious. Not only have more children with Covid been admitted to the hospital recently, but its intensive care unit also has Covid patients who are 13, 15, 16 and 17 years old.

The F.D.A.’s new authorization means all those patients would be eligible for the shots, she noted. “If you can prevent your child ending up in the I.C.U. with a safe vaccine, why wouldn’t you ?” she said.

Mr. Quesnel, the East Hartford, Conn., superintendent, said the most powerful message for reaching older adolescents would probably appeal just as much to younger ones. Rather than focusing on the fact that the shot will protect them, he said, they seize on the idea that it will keep them from having to quarantine if they are exposed.

“They’re not so afraid of the health care dangers from Covid but the social losses that come along with it,” he said, adding that 60 percent of his district’s seniors, or about 300 students, got their first dose at a mass vaccination site run by Community Health Center on April 26. “Some of our greatest leverage right now is that social component — ‘You won’t be quarantined.’”

Michael Jackson of North Port, Fla., can’t wait for his 14-year-old son, Devin, to get the vaccine. During the past year, he said, his son’s beloved Little League games went on hiatus and the family had to suspend their regular Sunday suppers with grandparents And Devin, an eighth grader, had to quarantine three times after being exposed to Covid.

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