Although it seems unlikely that the United States will shift course, its neighbor to the north has embraced a delayed strategy to cope with a booming pandemic and a short supply of vaccines.

Dr. Catherine Hankins, a public health specialist at McGill University in Montreal and a member of Canada’s Covid-19 Immunity Task Force, endorsed that decision, based on the emerging evidence about single doses. And she said she thought that other countries facing even worse shortfalls should consider it as well.

“I will be advocating at the global level that countries take a close look at Canada’s strategy and think seriously about it,” Dr. Haskins said.

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Covid-19 Live Updates: AstraZeneca Vaccine Is 79% Effective in U.S. Study

provided strong protection against Covid-19 in a large clinical trial in the United States, completely preventing the worst outcomes from the disease while causing no serious side effects, according to results announced on Monday.

The findings, announced in a news release from AstraZeneca, may help shore up global confidence in the vaccine, which was shaken this month when more than a dozen countries, mostly in Europe, temporarily suspended the use of the shot over concerns about possible rare side effects.

The trial, involving more than 32,000 participants, was the largest test of its kind for the shot. The vaccine was 79 percent effective overall in preventing symptomatic infections, higher than observed in previous clinical trials. The trial also showed that the vaccine offered strong protection for older people, who had not been as well-represented in earlier studies.

But the fresh data may not make much difference in the United States, where the vaccine is not yet authorized and may not be needed.

If AstraZeneca wins authorization for emergency use in the United States based on the new results, the vaccine is unlikely to become available before May, when federal officials predict that three manufacturers that already have authorization will be producing enough doses for all the nation’s adults.

AstraZeneca said on Monday that it would continue to analyze the new data and prepare to apply “in the coming weeks” for emergency authorization from the Food and Drug Administration. It already has approval in more than 70 countries, but clearance from American regulators, if the company can secure it, would bolster the vaccine’s reputation globally.

The interim results announced on Monday were based on 141 Covid-19 cases that had turned up in volunteers. Two-thirds of participants were given the vaccine, with doses spaced four weeks apart, and the rest received a saline placebo. Volunteers were recruited from Chile and Peru as well as the United States.

None of the volunteers who got the vaccine developed severe symptoms or had to be hospitalized, a major selling point for the shot. Five participants who were given the placebo developed severe Covid-19, Ruud Dobber, an executive vice president at AstraZeneca, told CNBC on Monday.

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Police Break Up Spring Break Crowds in Miami Beach

The police fired pepper balls to disperse crowds after an 8 p.m. curfew went into effect on Saturday. Local Miami officials said people had flocked to the city because of its relatively few coronavirus restrictions.

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The police fired pepper balls to disperse crowds after an 8 p.m. curfew went into effect on Saturday. Local Miami officials said people had flocked to the city because of its relatively few coronavirus restrictions.CreditCredit…Cristobal Herrera-Ulashkevich/EPA, via Shutterstock

One day after the spring break oasis of South Beach descended into chaos, with the police struggling to control overwhelming crowds and making scores of arrests, officials in Miami Beach decided on Sunday to extend an emergency curfew for up to three weeks.

Officials went so far as to approve closing the famed Ocean Drive for four nights a week until April 12, including to pedestrians, during the 8 p.m. to 6 a.m. curfew. Residents, hotel guests and employees of local businesses are exempt.

The strip, frequented by celebrities and tourists alike, was the scene of a much-criticized skirmish on Saturday night in which police officers used pepper balls to disperse a large crowd of sometimes unruly and mostly unmasked revelers just hours after the curfew had been introduced.

The restrictions were a stunning concession to the city’s inability to control unwieldy crowds. The city and the state of Florida have aggressively courted visitors.



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“I believe it’s a lot of pent-up demand from the pandemic and people wanting to get out,” David Richardson, a member of the Miami Beach City Commission, said on Sunday. “And our state has been publicly advertised as being open, so that’s contributing to the issue.”

In an emergency meeting, the commission approved maintaining the curfew in the city’s South Beach entertainment district from Thursday through Sunday for three more weeks, which is when spring break typically ends. Bridges along several causeways that connect Miami Beach with the mainland will also continue to be shut during the curfew.

Law enforcement officials said many people had been drawn to the city for spring break this year because it has relatively few virus restrictions, mirroring the state at large. And hotel rooms and flights have been deeply discounted, to make up for the months of lost time.

Miami-Dade County, which includes Miami Beach, has recently endured one of the nation’s worst outbreaks, and more than 32,000 Floridians have died from the virus, an unthinkable cost that the state’s leaders rarely acknowledge. The state is also thought to have the highest concentration of B.1.1.7, the more contagious and possibly more lethal virus variant first identified in Britain.

GLOBAL ROUNDUP

A crowded market in Mumbai, India, on Friday. The surrounding state of Maharashtra is at the center of a new coronavirus outbreak.
Credit…Francis Mascarenhas/Reuters

The coronavirus, once seemingly in retreat in India, is again rippling across the country. On Monday, the government reported almost 47,000 new cases, the highest number in more than four months. It also reported 212 new deaths from the virus, the most since early January.

The outbreak is centered in the state of Maharashtra, home to Mumbai, the country’s financial hub. Entire districts of the state have gone back into lockdown. Scientists are investigating whether a new strain found there is more virulent, like variants found in Britain, South Africa and Brazil.

Officials are under pressure to aggressively ramp up testing and vaccination, especially in Mumbai, to avoid disruptions like the dramatic nationwide lockdown last year, which resulted in a recession.

But less than 3 percent of India’s population of 1.3 billion has received a jab, including about half of health care workers.

The campaign has also been plagued by public skepticism. The government approved a domestically developed vaccine, called Covaxin, before its safety and efficacy trials were even over, though preliminary findings since then have suggested it works.

The other jab available in India is the Oxford-AstraZeneca vaccine, which was suspended in some countries after a number of patients reported blood clots and strokes, though most have since reversed course and scientists haven’t found a link between the shots and the patients’ conditions.

In other developments around the world:

  • The leading opposition candidate for president in the Republic of Congo died while being transferred to France for treatment for Covid-19, Reuters reported on Monday, citing a spokesman. The candidate, Guy Brice Parfait Kolelas, 61, had been hospitalized in the capital, Brazzaville, after becoming ill in the final days of the campaign. In a video that circulated on social media over the weekend, he warned supporters that he was “fighting death” but asked them to “stand up and vote for change.” The election was on Sunday, and the incumbent, President Denis Sassou N’Guesso, is expected to extend his 36 years in power.

  • Taiwan, one of the few places in the world to successfully contain the coronavirus from the beginning of the pandemic, kicked off its vaccination drive on Monday. Premier Su Tseng-chang and Chen Shih-chung, the health minister, were among the first to be inoculated with the AstraZeneca vaccine, the only one authorized so far. The vaccinations were widely televised in Taiwan, part of an effort to increase confidence in the vaccine. Taiwan has been relatively slow to start inoculating, in part because it has had so few reported cases: As of Monday, the all-time total was 1,006, with 10 deaths, on an island of 24 million people.

  • The Chinese company CanSino Biologics said on Monday that Hungary had authorized its Covid-19 vaccine for emergency use, the first European country to do so. The vaccine, known as Convidecia, is a single-dose product developed with the Chinese military, and the company said that authorization had been granted based on the interim results of Phase 3 clinical trials. Hungary is also using another Chinese-made vaccine, from Sinovac, and Russia’s Sputnik V, as well as the Western ones approved elsewhere in the European Union.

  • Norway reported on Sunday that two more people had died after receiving the AstraZeneca Covid-19 vaccine, bringing the country’s total number of such deaths to four. The Norwegian Medicines Agency said in a statement that it “cannot rule out that these cases may be related to the AstraZeneca vaccine,” although the European Medicines Agency, the continent’s top drug regulator, said last week that it considered the vaccine safe. Denmark reported over the weekend that two people had experienced brain hemorrhages after receiving the AstraZeneca vaccine, one of whom died.

  • France’s labor minister, Élisabeth Borne, has been hospitalized with Covid-19, the authorities announced on Monday, a first for a top French official. “Her health is improving,” according to a statement from her ministry. President Emmanuel Macron had the virus in December, and several other ministers have announced positive test results, including the culture minister two days ago.

  • The Philippines reported record-breaking numbers of new coronavirus infections over the weekend, leading the government to place metropolitan Manila and four surrounding provinces under the second-highest level of lockdown for the next two weeks. On Saturday, officials reported 7,999 cases, the most the country has had in a single day. President Rodrigo Duterte approved restrictions including a ban on all mass gatherings and a curfew from 10 p.m. to 5 a.m. Nonessential travel to or from the area is banned. The restrictions will disrupt in-person religious services for Holy Week, a popular travel period, for the second year in a row.

  • Health officials in South Africa say the country has sold its unused doses of the AstraZeneca vaccine to 14 other states in the African Union, Reuters reported on Sunday. It paused the use of the vaccine last month after a small trial showed it offered only minimal protection against mild to moderate illness caused by the dominant local variant of the virus. At the time, South Africa had received one million AstraZeneca doses from the Serum Institute of India, with 500,000 more pending.

  • With cases rising sharply in Germany, Chancellor Angela Merkel and state leaders are expected on Monday to extend the country’s lockdown. The new rules, which are likely to be in effect until at least April 18, would reverse steps toward reopening that the leaders had approved just weeks ago.

  • Australia and New Zealand are moving closer to opening a travel bubble, with Prime Minister Jacinda Ardern of New Zealand saying on Monday that she would announce a date for the start of quarantine-free travel on April 6. Both countries have all but eliminated the coronavirus. Though Australia has lifted its quarantine requirement for passengers arriving from New Zealand, New Zealand has yet to reciprocate, despite pressure from opposition parties and the country’s tourism sector. On Sunday, Australia also amended its travel ban legislation to exclude New Zealand visitors from a requirement to seek government permission before leaving.

The stimulus package signed by President Biden includes billions to ramp up coronavirus vaccinations.
Credit…Al Drago for The New York Times

The Biden administration, with hundreds of billions of dollars to spend to end the Covid-19 crisis, has set aggressive benchmarks to determine whether the economy has fully recovered, including returning to historically low unemployment and helping more than one million Black and Hispanic women return to work within a year.

But restoring economic activity, which was central to President Biden’s pitch for his $1.9 trillion stimulus package, faces logistical and epidemiological challenges unlike any previous recovery. New variants of the virus are spreading. Strained supply chains are holding up the distribution of rapid coronavirus tests, which could be critical to safely reopen schools, workplaces, restaurants, theaters and concert venues.

Then there are questions of whether the money can reach schools and child care providers quickly enough to make a difference for parents who were forced to quit their jobs to care for their children.

Economic optimism is rising as the pace of vaccinations steadily increases. Unemployment has already fallen from its pandemic peak of 14.8 percent last April to 6.2 percent in February. Federal Reserve officials now expect the unemployment rate to slip below 4 percent by next year and for the economy to grow faster this year than in any year since the Reagan administration.

But risks remain. For the economy to fully bounce back, Americans need to feel confident in returning to shopping, traveling, entertainment and work. No matter how much cash the administration pumps into the economy, recovery could be stalled by the emergence of new variants, the reluctance of some Americans to get vaccinated and, in the coming weeks, spotty compliance with social distancing guidelines and other public health measures.

At the Union Turnpike station in Queens. Ridership on the New York subway is at about one third of its pre-pandemic levels.
Credit…Jonah Markowitz for The New York Times

A year ago the pandemic drained the New York City subway of nearly all its riders, sickened thousands of transit workers and plunged North America’s largest public transit agency into its worst financial emergency ever.

Today ridership on the subway has crept back up to about one third of its usual levels, from an all-time low of 7 percent last spring. An infusion of billions of dollars in federal aid has kept the Metropolitan Transportation Authority afloat. And the agency, which operates the subway, buses and two commuter rail lines, was further lifted by another $6 billion in President Biden’s rescue plan.

But the M.T.A.’s long-term survival depends on the return of its largest funding source: riders. Fares provide early 40 percent of the agency’s operating revenue, a higher percentage than almost any other major American transit system.

Now, as more people are vaccinated and urban life slowly rebounds, public transit officials are confronting a sobering reality: a growing consensus that ridership may never return entirely to its prepandemic levels.

Though public health experts generally agree that riding trains and buses is not a major risk factor for exposure to the virus, transit experts say some commuters with the means to do so are still likely to stay with the alternatives — like using cars or bikes — that they turned to during the pandemic.

Prime Minister Benjamin Netanyahu of Israel takes personal credit for the country’s vaccination campaign, which has fully vaccinated about half the population of nine million.
Credit…Menahem Kahana/Agence France-Presse — Getty Images

JERUSALEM — Vaccinated Israelis are working out in gyms and dining in restaurants. They’re partying at nightclubs and cheering at soccer matches by the thousands.

Prime Minister Benjamin Netanyahu is taking credit for bringing Israel “back to life,” as he calls it, and banking on the country’s giddy, post-pandemic mood of liberation to put him over the top in a close election on Tuesday.

But nothing is quite that simple in Israeli politics.

Even as most Israelis appreciate the government’s world-leading vaccination campaign, many worry that the grand social and economic reopening may prove premature and suspect that the timing is political.

Instead of a transparent reopening process led by public health professionals, “decisions are made at the last minute, at night, by the cabinet,” said Hagai Levine, an epidemiologist at the Hebrew University-Hadassah Braun School of Public Health in Jerusalem. “The timing, right before the election, is intended to declare mission accomplished.”

The parliamentary election on Tuesday will be the country’s fourth in two years. Mr. Netanyahu is on trial on corruption charges and analysts say his best chance of avoiding conviction lies in heading a new right-wing government. He has staked everything on his handling of the coronavirus crisis.

He takes personal credit for the country’s inoculation campaign, which has fully vaccinated about half the population of nine million — outpacing the rest of the world — and he has declared victory over the virus.

“Israel is the world champion in vaccinations, the first country in the world to exit from the health corona and the economic corona,” he said at a pre-election conference last week.

The vaccination campaign has been powered by early delivery of several million doses from Pfizer, and Mr. Netanyahu has presented himself as the only candidate who could have pulled off that deal, boasting of his personal appeals to Pfizer’s chief executive, Albert Bourla, who, as a son of Holocaust survivors, has great affinity for Israel.

Mr. Netanyahu even posted a clip from “South Park,” the American animated sitcom, acknowledging Israel’s vaccination supremacy.

But experts said his claim that the virus was in the rearview mirror was overly optimistic.

A seating area in the main atrium of a remodeled Microsoft office in Redmond, Washington in 2017.
Credit…Stuart Isett for The New York Times

Microsoft announced Monday that it would begin allowing more workers back into its headquarters in Redmond, Wash., starting on March 29.

In this stage of reopening, which Microsoft described as Step 4 in a six-step “dial,” the Redmond campus will give nonessential on-site employees the choice to work from the office, home or a combination of both. Microsoft will also continue to require employees to wear masks and maintain social distancing.

Microsoft plans to open its office without restrictions only once the virus acts “more like an endemic virus such as the seasonal flu,” wrote Kurt DelBene, an executive vice president at the tech giant. But even then, office life for Microsoft’s 160,000 employees is not likely to look like what it did before the pandemic.

“Once we reach a point where Covid-19 no longer presents a significant burden on our communities, and as our sites move to the open stage of the dial, we view working from home part of the time (less than 50 percent) as standard for most roles,” Mr. DelBene wrote on the company blog.

Microsoft also released on Monday the results of a survey of that it says shows the work force has changed after a year of working remotely. In the survey of more than 30,000 full-time and self-employed workers, 73 percent said they wanted flexible remote work options to continue, and 46 percent said they were planning to move this year now that they could work remotely.

“There are some companies that think we’re just going to go back to how it was,” Jared Spataro, the corporate vice president for Microsoft 365, said in an interview. “However, the data does seem to indicate that they don’t understand what has happened over the last 12 months.”

People receiving the Sinopharm Covid-19 vaccine in Dubai last month.
Credit…Kamran Jebreili/Associated Press

The distributor of China’s Sinopharm vaccine in the United Arab Emirates says it has started offering a “very small number” of people a third shot after these recipients reported insufficient levels of antibodies following a two-dose regimen.

The distributor, G42 Healthcare, has found that some people were “not really responsive” to the Sinopharm vaccine, Walid Zaher, the company’s chief researcher, told Dubai Eye Radio on Sunday.

Dr. Zaher’s disclosure could add to questions about the overall efficacy of the Sinopharm vaccine, which has been rolled out to at least six countries. The state-owned company has not reported detailed Phase 3 clinical data for scientists to independently assess the strength of its vaccines. Sinopharm did not respond to a request for comment.

It is unclear which of Sinopharm’s two vaccines Dr. Zaher was referring to. One was developed in conjunction with the Beijing Institute of Biological Products, and the other with the Wuhan Institute of Biological Products. In December, the Emirates became the first government to approve the vaccine that was made with the Beijing Institute.

Dr. Zaher said that G42 Healthcare had approached people to be part of a study in which they were given a third shot.

“No one vaccine will be working for everyone,” he said.

Pfizer and BioNTech said last month that they planned to test a third booster shot in response to concerns over coronavirus variants. Similarly, Moderna said it had shipped doses of a newly adjusted vaccine to the National Institutes of Health for testing that would address the variant first detected in South Africa, known as B.1.351.

Dr. Farida al-Hosani, a spokeswoman for the Emirates’ health sector, has also said that residents and Emiratis inoculated with the Sinopharm vaccine can get a third dose if they do not develop sufficient antibodies, telling the National newspaper this month that only a small number of people would be affected.

Dr. Zaher said he did not know the exact number of people who would require a third shot “because obviously we did not measure everyone, but it’s a very small number.” He said anyone who was concerned about their antibody levels after receiving the Sinopharm vaccine could approach their doctor about getting a third shot.

Sinopharm has said the vaccine made with the Beijing Institute has an efficacy rate of 79 percent, while the one made with the Wuhan Institute of Biological Products has an efficacy rate of 72.5 percent. Both are above the 50 percent threshold that the World Health Organization has said would make a vaccine effective for general use.

In addition to Sinopharm, the Emirates, which is inoculating its population faster than any country except Israel and the Seychelles, is also using the Pfizer-BioNTech, Oxford-AstraZeneca and Sputnik V vaccines. The government is donating some of the Sinopharm doses it purchased to countries where it has strategic or commercial interests, including the Seychelles and Egypt.

But some doctors in Egypt have been reluctant to receive the shots, citing a lack of trust in the data released by Sinopharm and the Emirates, where some of the trials were held. Malaysia, one of the Emirates’ biggest trading partners, also declined an offer of 500,000 doses, saying that regulators would have to independently approve the Sinopharm vaccine.

Kent Taylor, the founder and chief executive of the Texas Roadhouse restaurant chain, died on Thursday.
Credit…Ron Bath/Texas Roadhouse

Kent Taylor, the founder and chief executive of the Texas Roadhouse restaurant chain, died by suicide on Thursday after suffering from post-Covid-19 symptoms, the company and his family said in a statement. He was 65.

“After a battle with post-Covid-related symptoms, including severe tinnitus, Kent Taylor took his own life this week,” the statement said.

His body was found in a field on his property near Louisville, Ky., the Kentucky State Police told The Louisville Courier Journal. The State Police and the Oldham County coroner did not immediately respond to requests for comment on Sunday.

Mr. Taylor, who was also the chairman of the company’s board of directors, founded Texas Roadhouse in 1993. He sought to create an “affordable, Texas-style” restaurant but was turned down more than 80 times as he tried to find investors, according to a biography provided by the company.

Eventually, he raised $300,000 from three doctors from Elizabethtown, Ky., and sketched out the design for the first Texas Roadhouse on a cocktail napkin for the investors.

The first Texas Roadhouse opened in Clarksville, Ind., in 1993. Three of the chain’s first five restaurants failed, but it went on to open 611 locations in 49 states, and 28 international locations in 10 countries.

Until his death, Mr. Taylor had been active in Texas Roadhouse’s operations, the company said. He oversaw decisions about the menu, selected the murals for the restaurants and picked songs for the jukeboxes.

Greg Moore, the lead director of the company’s board, said in a statement that Mr. Taylor gave up his compensation package during the coronavirus pandemic to support frontline workers in the company.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.

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The U.A.E. offers a third dose of Chinese vaccine to some with low immune response.

The distributor of China’s Sinopharm vaccine in the United Arab Emirates says it has started offering a “very small number” of people a third shot after these recipients reported insufficient levels of antibodies following a two-dose regimen.

The distributor, G42 Healthcare, has found that some people were “not really responsive” to the Sinopharm vaccine, Walid Zaher, the company’s chief researcher, told Dubai Eye Radio on Sunday.

Dr. Zaher’s disclosure could add to questions about the overall efficacy of the Sinopharm vaccine, which has been rolled out to at least six countries. The state-owned company has not reported detailed Phase 3 clinical data for scientists to independently assess the strength of its vaccines. Sinopharm did not respond to a request for comment.

It is unclear which of Sinopharm’s two vaccines Dr. Zaher was referring to. One was developed in conjunction with the Beijing Institute of Biological Products, and the other with the Wuhan Institute of Biological Products. In December, the Emirates became the first government to approve the vaccine that was made with the Beijing Institute.

test a third booster shot in response to concerns over coronavirus variants. Similarly, Moderna said it had shipped doses of a newly adjusted vaccine to the National Institutes of Health for testing that would address the variant first detected in South Africa, known as B.1.351.

Dr. Farida al-Hosani, a spokeswoman for the Emirates’ health sector, has also said that residents and Emiratis inoculated with the Sinopharm vaccine can get a third dose if they do not develop sufficient antibodies, telling the National newspaper this month that only a small number of people would be affected.

Dr. Zaher said he did not know the exact number of people who would require a third shot “because obviously we did not measure everyone, but it’s a very small number.” He said anyone who was concerned about their antibody levels after receiving the Sinopharm vaccine could approach their doctor about getting a third shot.

Sinopharm has said the vaccine made with the Beijing Institute has an efficacy rate of 79 percent, while the one made with the Wuhan Institute of Biological Products has an efficacy rate of 72.5 percent. Both are above the 50 percent threshold that the World Health Organization has said would make a vaccine effective for general use.

inoculating its population faster than any country except Israel and the Seychelles, is also using the Pfizer-BioNTech, Oxford-AstraZeneca and Sputnik V vaccines. The government is donating some of the Sinopharm doses it purchased to countries where it has strategic or commercial interests, including the Seychelles and Egypt.

But some doctors in Egypt have been reluctant to receive the shots, citing a lack of trust in the data released by Sinopharm and the Emirates, where some of the trials were held. Malaysia, one of the Emirates’ biggest trading partners, also declined an offer of 500,000 doses, saying that regulators would have to independently approve the Sinopharm vaccine.

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Scientists Say They Found Cause of Rare Blood Clotting Linked to AstraZeneca Vaccine

BERLIN—Scientists in Europe said they had identified a mechanism that could lead the AstraZeneca PLC vaccine to cause potentially deadly blood clots in rare instances as well as a possible treatment for it.

Two teams of medical researchers in Norway and Germany have independently found that the vaccine could trigger an autoimmune reaction causing blood to clot in the brain, which would offer an explanation for isolated incidents across Europe in recent weeks.

Several European countries briefly halted their rollouts of the vaccine this week after more than 30 recipients were diagnosed with the condition known as cerebral venous sinus thrombosis or CVST. Most of the people affected were women under the age of 55.

The issue affected a tiny portion of those who had received the shot however, and after investigating, the European drugs regulator ruled that the benefits outweighed the potential risks of the vaccine, and recommended vaccinations resume.

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Some countries, such as Germany, France and Italy, resumed vaccination with AstraZeneca’s shot on Friday, with an added warning that it could be linked to blood clotting. The French healthcare authority, which recorded three cases of CVST connected to the vaccine, advised the government on Friday to only administer the shot to people older than 55.

Others, including Norway, Sweden and Denmark, said they needed more research before restarting their rollouts. Norway registered three cases of CVST, one of them fatal. The country vaccinated around 120,000 people with the shot. Finland suspended the use of AstraZeneca on Friday, after recording two cases of what the authorities called unusual blood clotting.

Pål André Holme, a professor of hematology and chief physician of the Oslo University Hospital who headed an investigation into the Norwegian cases, said his team had identified an antibody created by the vaccine that was triggering the adverse reaction.

​Europe’s top drug regulator endorsed AstraZeneca’s vaccine after it was suspended in several countries over blood-clot concerns. WSJ explains what’s at stake for a shot that’s been widely used around the world and may soon be considered for emergency use in the U.S. Photo: Mykola Tys/SOPA Images

“Nothing but the vaccine can explain why these individuals had this immune response,” Prof. Holme said.

Norway’s health authority cited the findings when announcing that it would not resume the vaccination.

A team of German researchers around Andreas Greinacher, professor of transfusion medicine at the Greifswald University Clinic, said they had independently come to the same conclusion as Prof. Holme in a statement and a press conference on Friday.

In Germany, 13 cases of CVST were detected among around 1.6 million people who received the AstraZeneca vaccine. Twelve patients were women and three died.

The German researchers, who coordinated with colleagues in Austria, Ireland and Britain, said in a statement that patients who show symptoms four days after vaccination, such as headaches, dizziness or impaired vision, could be quickly diagnosed with a blood test. Prof. Greinacher said the news meant that people should not fear the vaccine.

“Very, very few people will develop this complication,” Prof. Greinacher said in a press conference Friday. “But if it happens we now know how to treat the patients.”

Pål André Holme’s team at Oslo University Hospital identified an antibody created by the AstraZeneca vaccine that was triggering the adverse reaction.

Photo: Terje Pedersen/Associated Press

He said that, after a swift diagnosis, the condition could be treated in any mid-sized hospital.

The German government said it was examining the findings, but stuck to its decision to resume use of the AstraZeneca vaccine.

AstraZeneca didn’t immediately react to a request for comment. Neither did the medicines regulators in Britain, Germany, Austria and The Netherlands, where vaccinations using the AstraZeneca vaccine have either resumed or weren’t suspended this week.

The European Medicines Agency, or EMA, which regulates medicines for most European countries, said that it had assessed the cases from Germany and Norway and discussed them with the relevant national authorities.

A spokeswoman for EMA said that the vaccine may be associated with very rare cases of blood clots, including CVST, but that the benefits of the vaccine outweigh that risk.

“A causal link with the vaccine is not proven, but is possible and deserves further analysis,” the spokeswoman said in a statement.

Neither the German nor the Norwegian findings were published or peer reviewed. Prof. Greinacher said he had submitted his findings for publication to the British medical journal The Lancet.

The German Society for Thrombosis and Hemostasis Research reviewed Prof. Greinacher’s work and issued a statement Friday advising physicians how to diagnose and treat the condition should it arise in vaccine recipients.

Dr. Robert Klamroth, deputy-chairman of the Society for Thrombosis and Hemostasis Research, said the rare autoimmune reaction occurred more frequently in Germany because the country initially only authorized the vaccine for people younger than 64. Britain, which had fewer incidents but vaccinated many more people, was predominantly giving the shot to older recipients.

Once diagnosed, the condition should be treated with blood thinning medication and immunoglobulin, which targets the antibody that causes the problem.

“We believe the most likely hypothesis is that this particular vaccine is causing a rare autoimmune reaction that triggers antibodies, which then interact with the platelets, but we don’t know why this is happening,” Dr. Klamroth said.

Covid-19 Vaccines

Write to Bojan Pancevski at bojan.pancevski@wsj.com

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AstraZeneca Vaccine’s Woes in Europe Aren’t Hurting Its Appeal Elsewhere

In the European Union, vaccine skepticism, contradictory statements by governments and reports of adverse reactions have eroded trust in the shot developed by AstraZeneca PLC and University of Oxford, delaying an inoculation campaign that was already proceeding at a glacial pace.

But a number of countries around the world are forging ahead with it, expressing confidence in a Covid-19 shot that has emerged as the most widely used among the Western front-runners and is crucial for inoculation campaigns in the developing world.

Reports of blood clots following administration of the AstraZeneca shot led some EU countries to suspend it over the past week. On Thursday, the EU’s health agency said that the benefits of the vaccine outweigh the potential risks and that it found no increase in overall risk of blood clots.

​Europe’s top drug regulator endorsed AstraZeneca’s vaccine after it was suspended in several countries over blood-clot concerns. WSJ explains what’s at stake for a shot that’s been widely used around the world and may soon be considered for emergency use in the U.S. Photo: Mykola Tys/SOPA Images

It isn’t clear whether that will restore confidence in the shot and get back on track European vaccination campaigns that have been plagued by a slow authorization process, delivery problems and a refusal by many Europeans to take it.

By contrast, developing world countries such as India and other wealthy countries outside the EU say they will continue to use AstraZeneca in their vaccination drives. The jab has become the go-to vaccine for many poor countries for its affordable price of generally less than $5 a shot and the fact that it can be stored in a regular refrigerator, unlike the Pfizer shot, which requires ultracold storage.

India has already given its citizens more than 35 million doses of the vaccine over the past two months and has found no such side effects, a senior Indian government official said Wednesday.

“We are mindful of the concerns reported in some countries. But there aren’t any signs of concerns in India,” said V.K. Paul, who leads the health team at the National Institution for Transforming India, a government think tank that has helped lead the vaccination drive.

AstraZeneca is also the main vaccine being distributed through the World Health Organization-backed Covax facility, which supplies poor countries with vaccines.

Most African countries that have in recent weeks received their first shipments of AstraZeneca vaccines from Covax are giving the shots to healthcare and other front-line workers.

On Thursday, the WHO’s Africa director, Matshidiso Moeti, and John Nkengasong, the director of the Africa Centers for Disease Control and Prevention, encouraged governments to continue to use the vaccine, arguing that the benefits of preventing more Covid-19 deaths outweigh the risks of potential vaccine side effects.

The high commissioner of India to Canada, Ajay Bisaria, far left, and Canadian Minister of Public Services and Procurement Anita Anand, second from right, mark the arrival of the first AstraZeneca doses from the Serum Institute of India, in Milton, Ontario, on March 3.

Photo: carlos osorio/Reuters

“We are in a race against time,” Dr. Moeti said at a media briefing. Speaking at the same briefing, Angola’s health minister, Silvia Lutucuta, said her country hadn’t recorded any serious side effects since it started administering the shots two weeks ago.

One notable exception is the Democratic Republic of Congo, which said on Saturday that it was delaying its rollout of 1.7 million AstraZeneca doses, citing the precautionary measures taken in Europe.

Another is South Africa, which suspended its planned rollout of the shots in February after a small clinical trial found that it was less effective against a new strain circulating in the country.

Egypt said it has no plans to halt use of AstraZeneca vaccines as the Health Ministry reported no serious side effects. Egypt started using AstraZeneca vaccines earlier this March; it has so far obtained only 50,000 doses.

The country expects to receive 60 million doses of the two-shot vaccine, enough to cover close to a third of its 100 million people.

Outside the EU, other rich countries are also proceeding.

Canada said it plans to use the doses it has received from AstraZeneca’s manufacturer in India, Serum Institute of India. To allay concerns about reports of blood clotting, Canadian public-health officials have noted that the doses from the drugmaker administered in Canada are from a different lot than those produced for the European countries that have raised concerns.

Canadian officials said Tuesday that there is no evidence to date of safety concerns related to the AstraZeneca vaccine and that European countries might have acted with “excessive caution” in suspending its use.

“Here in Canada, our AstraZeneca supply is coming from India—from a completely different lot. It isn’t produced in the same location as the lots being used in Europe,” Dr. Howard Njoo, Canada’s deputy chief public-health officer, told reporters at a briefing.

The 500,000 AstraZeneca vaccine doses that have arrived in Canada are from India’s Serum Institute, with another 1.5 million doses expected from there by mid-May. Canada has a separate contract with AstraZeneca for 20 million doses of the drugmaker’s Covid-19 vaccine, and those doses will be produced in the U.S., according to Canada’s procurement minister, Anita Anand.

Canada and Mexico are also in talks with the Biden administration to receive a combined four million doses of the AstraZeneca vaccine from the U.S. The administration is assessing how it can loan the doses to its North American partners with the expectation the countries would later send doses to the U.S. The U.S. has yet to authorize use of the vaccine, although it has seven million “releasable doses” available, White House press secretary Jen Psaki said Thursday.

Australia said it would also continue to use the vaccine, citing guidance from the WHO that there is no evidence of a link between the adverse reactions and the AstraZeneca shot.

In the U.K., more than 11 million doses of the AstraZeneca shot have been given in Britain since December, according to the Medicine and Healthcare Products Regulatory Agency, the country’s medicines regulator. Shots have continued to be administered since reports of blood clots surfaced elsewhere in Europe. British officials and scientists say there is no evidence that the clots are a result of vaccination and that the benefits of vaccination against Covid-19 outweigh the risks.

Through Feb. 28, there were 30 instances of blood clots among those vaccinated with the AstraZeneca shot, and 38 among those receiving the Pfizer shot, an MHRA spokeswoman said.

The vaccine has been embraced by Prime Minister Boris Johnson as a valuable asset in the fight against Covid-19. Mr. Johnson said Thursday that he will be vaccinated with the AstraZeneca shot on Friday.

“The Oxford jab is safe and the Pfizer jab is safe,” he said at a press conference. “The thing that isn’t safe is catching Covid.”

Write to Rajesh Roy at rajesh.roy@wsj.com and Paul Vieira at paul.vieira@wsj.com

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AstraZeneca Vaccine Cleared by EU After Blood-Clot Concerns

The European Union’s health agency said that the Covid-19 vaccine produced by AstraZeneca PLC was “safe and effective” and didn’t increase the risk of blood clots, a decision that could clear the way for the resumption of inoculation campaigns that have been halted in much of the region.

The European Medicines Agency said that new expert analysis concluded that the benefits of using a Covid-19 vaccine produced by AstraZeneca outweigh its potential risks and inoculations with it should proceed.

EU authorities are hoping the EMA’s statement could put a problem-plagued vaccination campaign back on track, although it remains to be seen whether the new analysis will overcome mistrust of the AstraZeneca shot among many Europeans.

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Many European countries, including Germany, France and Italy, suspended the vaccine’s use over the past week following reports that people who had received it developed rare blood clots, and some had died, further slowing Europe’s already sluggish vaccination rollout.

Those reports compounded the delays and uncertainties surrounding a drive that has left the EU far behind the U.S. and the U.K. in vaccinating its citizens.

The EMA’s safety committee found the vaccine to be “safe and effective in preventing Covid-19, and its benefits outweigh its risk,” said committee chair Sabine Straus. Dr. Straus said that since blood clots are associated with Covid-19, by inoculating people against the disease, the vaccine “likely reduces the risk of thrombotic incidents overall.”

Health officials have noted that blood clots are widespread for a variety of reasons. Clots have also been noted among people receiving other Covid-19 vaccines and can be caused by medications as common as birth-control pills.

Dr. Straus said the EMA identified a predominance of the blood clots found were among women, particularly younger women. She said it remained “premature to conclude” whether this is linked to greater risk among the groups or the makeup of the populations receiving the vaccine.

EMA Executive Director Emer Cooke said the experts found a limited number of blood clots that require further study and the agency “still cannot rule out definitively a link.”

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The EMA as a result recommended “raising awareness” by including a warning with the vaccination and informing the public. Such a campaign could help people who receive the AstraZeneca vaccine to know what to look for after getting the shot.

Ms. Cooke on Tuesday had expressed concern that doubts being cast on it could hurt public trust in vaccines. Asked in a news conference Wednesday if she personally would get the AstraZeneca shot, she said, “If it was me, I would be vaccinated tomorrow, but I would want to know that if something happened to me,” what to do.

Ms. Cooke, noting that many EU countries had suspended use of the AstraZeneca vaccine pending the EMA’s review, said its conclusions should give them “the information they need to take an informed decision regarding the use of the AstraZeneca vaccine in their vaccination campaigns.”

So far seven million people in the EU have received the vaccine and 11 million in the U.K., Ms. Cooke said.

Analysis of the vaccine took on extra urgency this week after the Paul Ehrlich Institute, Germany’s medicines regulator, Monday recommended suspending the vaccine’s rollout pending further investigation.

Alerts and web-browser tools can help you book a Covid-19 vaccine appointment. WSJ’s Joanna Stern met up with Kris Slevens, an IT guy who has booked over 300 appointments for New Jersey seniors, to learn the best tricks to compete in the vaccine-booking Hunger Games. Photo illustration: Emil Lendof for The Wall Street Journal

Institute President Klaus Cichutek defended the recommendation, saying his experts identified seven cases in Germany of cerebral vein thrombosis, a severe brain condition, and three of the people died. Germany’s healthcare ministry said that, based on the number of vaccinations given, it would have expected as many as 1.4 cases of cerebral vein thrombosis, and the seven cases merited a pause.

The EMA collected reports from across Europe, giving it a much larger data set to analyze.

Some EU countries, including Greece and Belgium, have continued using the vaccine, as have Australia, Canada and India.

The U.K., where AstraZeneca developed the vaccine with scientists from University of Oxford, is relying heavily on the vaccine for its relatively fast vaccination campaign. British politicians have criticized their EU counterparts for suspending the vaccine’s use against expert advice.

The AstraZeneca shot is the world’s most widely used Covid-19 vaccine.

Many medical experts in Europe and beyond criticized politicians’ decisions to halt vaccinations, saying the known risks posed by the coronavirus are greater than possible ones from AstraZeneca shots. German officials said their suspension was merited because they are urging citizens to take the vaccine, unlike other medications such as contraceptives, which are a personal choice.

European officials who paused vaccinations framed their decisions as precautionary. But based on available data and Covid-19 risks, “The cautionary approach would be to carry on vaccinating,” said Prof. David Spiegelhalter, an expert on statistics and risk at the University of Cambridge. “Casting doubt—lasting doubt—on the safety of the vaccines is not a precautionary position.”

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How Israel Delivered the World’s Fastest Vaccine Rollout

TEL AVIV—In the world’s fastest coronavirus vaccine rollout to date, Israel has given at least one shot to nearly 60% of its residents, a feat propelled by an ample supply of doses and an uncommon healthcare system that combines competition with tax-funded universal coverage.

Israel, a small, wealthy nation with a young population, was uniquely qualified to confront the pandemic: Prime Minister Benjamin Netanyahu had secured enough vaccine stocks by paying more, as well as by offering access to Israelis’ personal health data to gauge the vaccine’s effectiveness. Its healthcare system had the means to quickly deliver the shots into the arms of Israelis.

The country’s four health-management organizations used centralized data-keeping, technology and the cradle-to-grave ties between Israelis and their doctors to speed up the vaccination drive, targeting residents nationwide with text messages, emails and phone calls. The efficiencies of Israel’s HMOs have been honed by years of competing for patients—and for the tax revenue gained by adding each new member—as they try to outdo each other in quality and availability of care.

“It’s really a unique structure,” said economist Moshe Bar Siman Tov, who oversaw Israel’s coronavirus response last year. “I’m not sure it’s possible to duplicate it. It’s a mixture of socialist fundamentals and entrepreneurial spirit.”

Israel’s bars and restaurants reopened last week to vaccinated people, prompting street parties in Tel Aviv, and the country is now looking ahead to a broader economic rebound.

Crowds of masked people passing through Carmel Market in Tel Aviv.

Photo: Kobi Wolf/Bloomberg News

The tiered “green passport” system has drawn protests by some who don’t want to get inoculated. But, in a country where anyone can get a jab on the spot, this strategy has been broadly accepted. Mr. Netanyahu, who is up for re-election Tuesday, is campaigning largely on the vaccination drive’s success.

Agam Rafaeli-Farhadian, 33 years old, received his first shot of the Pfizer-BioNTech vaccine in January. “I got the text and was like, ‘Whoa, this is cool,’ ” he said, adding that it took 30 seconds to sign up and five minutes to get each of his two shots.

While Israel’s vaccination rate is the world’s highest, its HMOs are still struggling to overcome reluctance in some population groups. Health officials say full herd immunity will require inoculating 80% of the population, a number that includes children under 16, for whom no approved vaccine exists so far.

Meanwhile, vaccinating as many remaining adults as possible will be key to avoiding more lockdowns and not overloading health systems. Trying to reach that goal, the HMOs are working with Magen David Adom, Israel’s emergency response services, to set up pop-up vaccination points on busy streets, at workplaces and in night-life districts.

Unlike Israel’s healthcare providers, many of Europe’s national health services buckled under the wave of coronavirus infections last year, and European Union nations are still struggling with the vaccine rollout. The U.S., after initial difficulties, is rapidly gaining speed. The U.K., which has the fastest vaccination rollout among large countries, has an inoculation rate that is a third of Israel’s.

Since the start of the pandemic, 6,057 people or 700 per million have died from Covid-19 in Israel. In the U.S., the latest number is 536,914 people or 1,625 per million. In the U.K., the death rate was 1,857 per million.

Many in Israel credit its hybrid healthcare model with providing high-level care that kept the death toll low. Israel’s relative youth—the average age is 30—has also blunted the pandemic’s severity. Most of the coronavirus deaths world-wide have been among older people.

Another advantage: Israelis agree to share personal information with government-supervised systems, part of a cohesive social compact forged in a country where men and women must serve in the army and where military conflicts break out every few years. Patient data allowed Israel’s four HMOs to monitor individuals who contracted the virus and to intervene early as the disease progressed.

Amanda Lounsbury, a 33-year-old environmental researcher in Tel Aviv, tested positive in January. Right away, she started receiving daily calls from her HMO’s family doctors and nurses. The provider sent her a pulse oximeter to check her blood oxygen level and report the reading during their calls, a standard practice.

“I felt very much not alone,” said Ms. Lounsbury, who is originally from Connecticut. She has since made a full recovery.

Supply side

Pfizer Inc. and BioNTech agreed to supply their vaccine to Israel ahead of other nations, in part, because the country’s assent to share medical data would provide them insights for future research. Privacy experts say the agreement shows how far Israel lags behind European nations in protecting confidential personal data.

An Israeli woman gets a coronavirus vaccine shot at the Kupat Holim Meuhedet clinic in Jerusalem.

Photo: menahem kahana/Agence France-Presse/Getty Images

“We’re all very, very happy about the results of the vaccine efficiency research, but you need to take a very, very careful look at the process,” said Tehilla Shwartz Altshuler, a senior fellow at the Israel Democracy Institute, a Jerusalem-based, nonpartisan think tank. “Israel is a kind of lab for the world. It’s frightening. We need to have stricter rules in terms of asking for consent.”

Israel’s healthcare system is mandatory. All residents pay up to 4.8% of their income in health taxes, part of their overall tax bill. Residents can switch their HMO provider, though only 1% to 2% actually do each year.

“There is no competition over money, because everybody pays the same.” said Ehud Davidson, chief executive of Clalit, the largest Israeli HMO. Many medical services are free with the occasional copay.

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Clalit and the three other HMOs, all of them not-for-profit entities, are reimbursed by the state according to a formula based partly on the number of members, their ages and where they live. Providers that lose patients to rivals also lose revenue. To retain members, the HMOs have an incentive to provide better levels of service and easier access to doctors, clinics and diagnostic facilities.

“We based our conversations with Pfizer on the very existence of Israel’s HMOs,” Israel Health Minister Yuli Edelstein said. “We were able to say to Pfizer, ‘If we get the vaccine quickly, we will run such a massive operation and such a quick one, the whole world will be talking about the Pfizer vaccine.’ ” Israel has almost exclusively relied on the Pfizer-BioNTech vaccine.

During the peak of the pandemic, hospitals in Italy, the U.K. and parts of the U.S. were overrun and had to ration access to lifesaving treatments. Israel escaped those shortages, even though it had similar or higher infection rates and significantly fewer hospital beds per 1,000 people. Some of this can be explained by the relative youth of Israel’s population. But with one of the world’s highest life expectancies, there are many Israeli’s in their 80s and 90s.

“There was enough equipment, ventilators, monitors and drugs,” said Mr. Davidson of Clalit. “There was never a situation of collapse in any Israeli hospital, and every patient received maximum treatment.”

Cradle to grave

Israel’s healthcare reform of 1995 required the country’s four HMOs to accept everyone and to provide similar medical services, regardless of either pre-existing conditions or affiliation with labor unions or political parties. Clalit accounted for 63% of the market at the time and has since seen its share dented by rivals, particularly Maccabi, now the second-largest.

A medic of Israel’s Maccabi health-management organization collects a swab sample at a mobile-testing station for Covid-19.

Photo: ahmad gharabli/Agence France-Presse/Getty Images

In Israel’s system, family doctors affiliated with an HMOs each supervise between 1,000 and 1,500 residents, developing lifelong connections.

“In healthcare, Israeli citizens are very traditional. When they have a relationship with a doctor, they have it from birth to death,” said Sigal Regev Rosenberg, chief executive of the Meuhedet HMO, with 1.2 million members.

All four HMOs operate their own networks, in addition to providing coverage for independent and state-owned hospitals and, if care is unavailable in Israel, for treatment in specialized facilities overseas.

While all of Israel’s 9 million Jewish and Arab citizens have the same basic healthcare coverage, the quality of service is higher in affluent secular Jewish communities, such as in Tel Aviv, compared with poorer ultra-Orthodox Jewish and Arab neighborhoods.

Dr. Osama Tanous, a pediatrician in Haifa who is currently at Emory University on a fellowship, said the system, with its roots in the Jewish settlement movement in the early 20th century under Ottoman and British rule, never adjusted to the needs of Israel’s 1.6 million Arab citizens. As a result, Israel’s Arabs have worse outcomes than Israel’s Jews in parameters that include heart disease, diabetes and neonatal health.

Unlike Israel’s Arab citizens, the 5.1 million Palestinians in the West Bank and the Gaza Strip aren’t covered by the Israeli healthcare system. The exception are some 340,000 Palestinians, who are not citizens of Israel, living in annexed East Jerusalem.

The 1993 Oslo agreements between Israel and the Palestine Liberation Organization that established the Palestinian Authority in the West Bank and Gaza transferred the Israeli-run health infrastructure there under the Palestinian ministry of health, which provides far more limited services. In Gaza, where the Islamist Hamas movement seized power in 2007, a United Nations agency has become the most important healthcare provider.

Palestinians who work in Israel stand in line for a Covid-19 vaccine shot at the Tarkumiya crossing between the West Bank and Israel.

Photo: Sebastian Scheiner/Associated Press

The cash-strapped Palestinian Authority has been much slower than Israel in organizing a vaccination campaign, which will mostly rely on the Covax program led by the World Health Organization. Criticized by human-rights groups for neglecting to share with the Palestinians, Israel recently donated about 5,000 vaccine doses to healthcare workers in the West Bank. Last week, it began vaccinating some 120,000 Palestinians who work in Israel and the Jewish settlements in Israeli-run sites at border crossings and industrial areas inside the settlements. Covax doses also began arriving this week.

The United Arab Emirates, meanwhile, shipped some 20,000 doses of the Russian Sputnik V vaccine to the Gaza Strip, as part of its world-wide vaccine diplomacy campaign.

Israel’s swift vaccine rollout figures prominently in Mr. Netanyahu’s re-election campaign. He showed up to receive the first shipment of vaccines at the Tel Aviv airport and got inoculated during a prime-time TV broadcast. In recent weeks, he has hosted the leaders of Austria, Denmark, the Czech Republic and Hungary to share Israel’s vaccination experience.

Mr. Netanyahu, who faces a trial on corruption charges that he denies, is running to retain power in Israel’s fourth national election in two years after a previous coalition collapsed. His final campaign poster, released ahead of the vote, shows him standing with two thumbs up, surrounded by flying confetti; above, a motto proclaims: “Back to Life.”

A woman getting a Covid-19 vaccination at a temporary Clalit clinic, set up on a basketball court in Petah Tikva, Israel.

Photo: ammar awad/Reuters

Write to Felicia Schwartz at felicia.schwartz@wsj.com Yaroslav Trofimov at yaroslav.trofimov@wsj.com

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For Doctors in Poor Countries, Covid Vaccine Comes Too Late

JOHANNESBURG—Between treating patients at a hospital in northern Zambia, Kelvin Moonga closely followed the accelerating rollout of Covid-19 vaccines in countries like the U.S. and the U.K. Suffering from asthma and hypertension, Dr. Moonga knew he was at high risk if he caught the coronavirus as infections surged across the southern African nation.

“If the vaccine comes here, I’ll be the first one to get it,” Dr. Moonga told a friend.

But the 51-year-old surgeon, who was also a prolific author, never got his Covid-19 shot. He died on Jan. 24, days after testing positive for the virus and without saying goodbye to his wife and seven children, the youngest of whom had just turned 2 years old the day before.

The global scramble for Covid-19 vaccines has left developing countries in Latin America, Asia and Africa far behind rich nations in inoculating their citizens. That means months after colleagues in developed countries have been immunized—and as some governments are now making shots available to their entire populations—healthcare workers in nations like Zambia are still risking their lives in the fight against the pandemic.

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They often do so without the protective gear that reduces the likelihood of infection, and knowing that sophisticated treatments, such as laboratory-made antibodies or at times even ventilators and oxygen, won’t be available to them should they catch the disease.

Nowhere is the vaccine shortage more acute than in sub-Saharan Africa, which has administered fewer Covid-19 shots per capita than any other continent and where most countries are dependent on free immunizations provided by a World Health Organization-backed facility known as Covax.

Since the start of the year, more than 500 healthcare workers, among them well-known public-health experts and experienced surgeons like Dr. Moonga, have died of Covid-19 in sub-Saharan Africa, according to the WHO. South Africa’s health ministry, one of the first in Africa to start vaccinating healthcare workers in mid-February, said they were three to four times as likely to catch Covid-19 as the general population.

The cost of these deaths goes beyond the personal loss experienced by their families and friends. Because of limited training capacities and brain-drain to richer nations, sub-Saharan Africa has only about two doctors for every 10,000 people—about one-tenth of the WHO-recommended minimum and far below the 26 doctors per 10,000 people working in the U.S. That means the death of a surgeon like Dr. Moonga, who spent time treating patients in rural Zambia and was known to operate at no charge when people couldn’t afford hospital fees, can affect patient care for years to come.

“Many more people are going to die because he can no longer provide these services,” said Francis Mupeta, who heads the infectious-disease unit at the University Teaching Hospital in Zambia’s capital, Lusaka.

Dr. Kelvin Moonga knew he was at high risk if he were to get Covid-19; he died Jan 24.

Photo: Moonga family

Dr. Mupeta recalled being sick at home with Covid-19 in January, and going on social media where doctor friends in the U.S. and other countries were posting pictures of themselves getting their Covid-19 shots. Meanwhile, he received news of colleagues in Zambia being transferred to intensive care or dying.

“The risks we are exposed to are the same, but we are not protected yet,” said Dr. Mupeta, who said he struggled going back to the Covid-19 ward after he recovered and has had to counsel younger doctors terrified of having to declare one of their colleagues dead. “It’s not fair.”

Funded by donations from rich nations such as the U.S. and charitable organizations like the Bill & Melinda Gates Foundation, the Covax facility aims to vaccinate 20% of the populations of the world’s 92 poorest nations by the end of the year. But with governments in developed countries having bought up much of the early supplies, Covax has so far shipped 14.9 million doses to 22 countries in Africa, a continent of 1.4 billion people. Slow local approvals in some countries, and some governments’ decisions to give priority to other professions have also delayed getting shots to healthcare workers.

Covax has so far shipped 14.9 million doses to 22 countries in Africa, a continent of 1.4 billion people.

Photo: Agence France-Presse/Getty Images

Officially, Africa has recorded far fewer cases of Covid-19 than Europe or the Americas, but limited testing suggests that the true toll is much higher. In one study recently published in the peer-reviewed British Medical Journal, the authors, which included Dr. Mupeta, found that nearly one in five corpses in Lusaka’s main morgue tested positive for Covid-19, with only a fraction having been diagnosed before they died.

Dr. Mupeta said he worried that without vaccines, a mutating coronavirus would continue killing Africans long after it has been brought under control elsewhere, similar to malaria, tuberculosis or the virus that causes AIDS.

“We have to make sure that Covid doesn’t become an African problem,” he said.

Even before large numbers of Covid-19 infections had been identified in Zambia, Dr. Moonga, who had done part of his training in China, started warning friends and relatives about the coronavirus. A writer who was constantly taking notes, he meticulously tracked the pandemic from the outbreak in the Chinese city of Wuhan, where the first confirmed cases emerged in December 2019.

“Four months into the outbreak, I realized my story was becoming a documentary,” Dr. Moonga wrote in the foreword of the novel he started in early 2020.

In “Undying Memory: A Covid-19 Tale,” which he self-published last July and dedicated to those who lost their lives to the virus, Dr. Moonga followed a group of graduate doctors thrown onto the front lines just as the pandemic reaches Zambia. Early in the book, the young doctors are warned by their supervisor not to expect N-95 respirator masks, which can filter out virus particles.

As highly transmissible coronavirus variants sweep across the world, scientists are racing to understand why these new versions of the virus are spreading faster, and what this could mean for vaccine efforts. New research says the key may be the spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood/WSJ

Pulling extra shifts in a hospital some 500 miles away from his family, Dr. Moonga never spoke much about the conditions at work, family members and friends said. But he had often said that his novels were partly autobiographical, and other Zambian doctors say it is common for healthcare workers outside Covid-19 wards to rely on regular surgical masks, which provide only limited protection.

Dr. Moonga’s younger brother, Benedict, a pediatrician in Lusaka, said there is little doubt that he picked up Covid-19 at work, since he lived on his own on the hospital grounds. Within days of testing positive, Dr. Moonga’s oxygen levels had dropped to 60%. His wife traveled to see him but wasn’t allowed to enter the intensive-care ward where he was kept.

In the days after his death, comments from bereft friends and former patients filled Dr. Moonga’s Facebook wall, many recalling how his surgeries saved their lives. His brother, meanwhile, went back to work at his Lusaka hospital. “It’s hard,” he said. “But at the same time, patients need to be seen.”

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Ventas Declares First Quarter 2021 Dividend of $0.45 per Common Share

CHICAGO–(BUSINESS WIRE)–Ventas, Inc. (NYSE: VTR) (“Ventas” or the “Company”) today announced that its Board of Directors has declared a quarterly dividend of $0.45 per common share. The dividend will be payable in cash on April 14, 2021 to stockholders of record as of the close of business on April 1, 2021.

About Ventas

Ventas, an S&P 500 company, operates at the intersection of two powerful and dynamic industries – healthcare and real estate. As one of the world’s foremost Real Estate Investment Trusts (REIT), we use the power of capital to unlock the value of real estate, partnering with leading care providers, developers, research and medical institutions, innovators and healthcare organizations whose success is buoyed by the demographic tailwind of an aging population. For more than twenty years, Ventas has followed a successful strategy that endures: combining a high-quality diversified portfolio of properties and capital sources to manage through cycles, working with industry leading partners, and a collaborative and experienced team focused on producing consistent growing cash flows and superior returns on a strong balance sheet, ultimately rewarding Ventas stakeholders. As of December 31, 2020, Ventas owned or managed through unconsolidated real estate entities approximately 1,200 properties.

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