AUCKLAND, New Zealand — Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patch-wearing members of New Zealand’s plentiful street gangs and their families, who sat before him on a bright Saturday afternoon.
Covid is coming for them, he said. Cases in New Zealand’s hospitals are rising rapidly. Soon, dozens of new infections a day might be hundreds or even a thousand. People will die. And vaccination is the only defense. “When your doctors are scared, you should be scared,” he said.
By the end of the day, after an exhaustive question-and-answer session with other health professionals, roughly a third of those present chose to receive a dose then and there.
Having abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, New Zealand is now undergoing a difficult transition to trying to keep coronavirus cases as low as possible. On Friday, the country set a target of getting at least 90 percent of the eligible population fully vaccinated — a goal, the highest in the developed world, whose success hinges on persuading people like those who gathered to hear Dr. Jansen.
intensely criticized, including by police leaders.
Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
Chris Hipkins, the minister responsible for New Zealand’s Covid-19 response, acknowledged earlier this month that the decision to enlist gang leaders was an unusual one.
“Our No. 1 priority here is to stop Covid-19 in its tracks, and that means doing what we need to do to get in front of the virus,” he said. “Where we have been able to enlist gang leaders to help with that, and where they have been willing to do so, we have done that.”
Some gang leaders have acted independently to help the vaccination effort. They have connected members of their community to health officials, organized events with health professionals like Dr. Jansen, and streamed events on Facebook Live to allow an open forum for questions about rare health risks. In some cases, they have taken vaccines to communities themselves.
“Our community is probably less well informed; they’re probably not as health literate,” said Mr. Tam, the Mongrel Mob member, who is a former civil servant and who received the border exemption. Constant media criticism has turned them off from reading traditional news outlets, he added.
“They then resort to social media, because they have much greater control,” he said. “It’s also a space that perpetuates conspiracy theories and false information and all the rest of it.” Health advice has to come from trusted individuals and leaders in the community, he said.
In the past week, Mr. Tam has traveled almost the length of the country organizing pop-up vaccination events for members and their communities, as well as coordinating with other chapter leaders to get their members vaccinated, he said.
It was difficult work that put him at personal risk, he said, and that invited intense skepticism from people who thought of gangs only as violent or connected to organized crime.
“Why do we bother?” Mr. Tam said. “We bother because we care about those people that others don’t care about, as simple as that. They can talk about my gang affiliation, all the rest of it. But it’s that affiliation that allows me to have that penetration, that foot in the door. I can do the stuff that they can’t do.”
BERLIN — As concerns grow over the highly contagious Delta variant of the coronavirus, Germany on Monday became the biggest Western country yet to announce that it will offer vaccine booster shots to a wide range of people considered potentially vulnerable, adding to growing momentum in rich nations to give additional shots to fully vaccinated people.
The move by Germany came even as a top European Union official criticized the bloc as falling far short of its promises to donate vaccine doses to Africa and Latin America. And with a limited global vaccine supply, health experts say the top priorities should be distributing doses to poor countries that lag far behind in inoculations, and persuading vaccine-resistant people in wealthy countries to get their first shots.
There is also still no consensus among scientists on the need for booster shots, but as fears rise of more pandemic waves and more costly lockdowns, a growing number of countries are preparing to give their people booster doses — or have already started.
Starting in September, Germany, Europe’s largest economy, wants to administer a booster of the Pfizer-BioNTech or Moderna vaccine to older people, residents of care homes, and people with compromised immune systems — and also to anyone who was already fully vaccinated with the two-dose AstraZeneca or single-dose Johnson & Johnson shots, which clinical trials have shown are not as highly protective.
an early leader in vaccination, began administering boosters to people 60 and older last week. A month ago, Russia made additional shots available to anyone six months after inoculation, and on Sunday, Hungary began offering them four months post-vaccination.
France is offering them only to those with weak immune systems, and plans to give them this fall to those who were the first to be vaccinated early this year — mostly people over 75 and those with serious health problems.
government advisers recommended in late June that everyone over 50 should be eligible but said the priority should be getting the shots to people over 70, health workers, nursing home residents, and younger adults with immune problems or other serious vulnerabilities.
increasingly think that vulnerable populations may need additional shots even as research continues into how long the vaccines remain effective. Some people have already obtained boosters simply by not revealing previous vaccination.
But as governments, terrified of another surge in the virus, increasingly lean toward boosters, the need for them remains unclear.
Studies have indicated that immunity resulting from the Pfizer-BioNTech and Moderna vaccines is long-lasting, and researchers are still working to interpret recent Israeli data suggesting a decline in efficacy of the Pfizer-BioNTech vaccine months after inoculation.
although the vaccine remains powerfully effective against severe disease and death.
Experts were divided on the utility of booster shots so soon after vaccination began. Experience with other diseases indicates that older people and those with weak immune systems might benefit, but there is little hard evidence with the coronavirus.
“The problem here is, we’re just sort of going on immunological priors, rather than really great data to justify things one way or the other,” said Deepta Bhattacharya, an immunologist at the University of Arizona. “I totally understand the decision, but I think we have to acknowledge that there’s a wide range of uncertainty on what it’s going to do.”
Booster doses may help some people with weak immune systems, but others may show little improvement even after a third dose, and still others may not need a booster at all, scientists say.
While dozens of mostly wealthy countries, including the United States and most of Europe, have administered more than 100 doses per 100 people, many other nations remain below five per 100 — primarily in Africa, where cases have soared as the Delta variant spreads.
Understand the State of Vaccine Mandates in the U.S.
Doctors Without Borders said recently that it would be “unconscionable” to give booster doses in richer nations before people in poorer ones get their first doses.
“Wealthy governments shouldn’t be prioritizing giving third doses when much of the developing world hasn’t even yet had the chance to get their first Covid-19 shots,” Kate Elder, the senior vaccines policy adviser at Doctors Without Borders’ Access Campaign, said in a statement.
a so-called vector vaccine, like AstraZeneca or Johnson & Johnson.
It is the latest sign that governments are encouraging their citizens to mix and match vaccines in the hope of provoking a more protective immune response against Covid-19. Early results from a British vaccine study showed that volunteers produced high levels of antibodies and immune cells after getting one dose each of the Pfizer-BioNTech and AstraZeneca-Oxford shots.
The new German guidelines announced Monday also went a step further in encouraging parents to vaccinate children between 12 and 17, announcing that doctors and vaccination centers across the country would make the jab available to them before the start of the new school year.
Health ministers stopped short of making a formal recommendation for vaccinating children, but the move made plain their impatience with Germany’s Standing Committee on Vaccinations, which has so far refrained from guiding parents one way or the other, pending more data becoming available.
Vaccinating children “is one building block to allow a safe start into the new school year after the summer vacation,” Mr. Holetschek said.
Apoorva Mandavilli contributed reporting from New York, Benjamin Mueller from London, Aurelien Breeden from Paris, Gaia Pianigiani from Rome, Monika Pronczuk from Brussels, Raphael Minder from Madrid and Thomas Erdbrink from Amsterdam.
Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.
Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.
Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature.
The other study, which is also under review for publication in Nature, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.
Some scientists have interpreted this decrease as a sign of waning immunity, but it is exactly what’s expected, other experts said. If blood contained high quantities of antibodies to every pathogen the body had ever encountered, it would quickly transform into a thick sludge.
Instead, blood levels of antibodies fall sharply following acute infection, while memory B cells remain quiescent in the bone marrow, ready to take action when needed.
landmark study in 2007 showed that antibodies in theory could survive decades, perhaps even well beyond the average life span, hinting at the long-term presence of memory B cells. But the new study offered a rare proof of their existence, Dr. Gommerman said.
Dr. Nussenzweig’s team looked at how memory B cells mature over time. The researchers analyzed blood from 63 people who had recovered from Covid-19 about a year earlier. The vast majority of the participants had mild symptoms, and 26 had also received at least one dose of either the Moderna or the Pfizer-BioNTech vaccine.
So-called neutralizing antibodies, needed to prevent reinfection with the virus, remained unchanged between six and 12 months, while related but less important antibodies slowly disappeared, the team found.
confirming results from other studies; the shots also ramped up the body’s neutralizing ability by about 50-fold.
Senator Rand Paul, Republican of Kentucky, said on Sunday that he would not get a coronavirus vaccine because he had been infected in March of last year and was therefore immune.
But there is no guarantee that such immunity will be powerful enough to protect him for years, particularly given the emergence of variants of the coronavirus that can partially sidestep the body’s defenses.
The results of Dr. Nussenzweig’s study suggest that people who have recovered from Covid-19 and who have later been vaccinated will continue to have extremely high levels of protection against emerging variants, even without receiving a vaccine booster down the line.
“It kind of looks exactly like what we would hope a good memory B cell response would look like,” said Marion Pepper, an immunologist at the University of Washington in Seattle who was not involved in the new research.
The experts all agreed that immunity is likely to play out very differently in people who have never had Covid-19. Fighting a live virus is different from responding to a single viral protein introduced by a vaccine. And in those who had Covid-19, the initial immune response had time to mature over six to 12 months before being challenged by the vaccine.
“Those kinetics are different than someone who got immunized and then gets immunized again three weeks later,” Dr. Pepper said. “That’s not to say that they might not have as broad a response, but it could be very different.”
India’s federal health ministry raised an alarm on Thursday, asking state governments to immediately report all cases of a potentially deadly fungal infection that appears to be spreading quickly among Covid-19 patients.
The rare condition, mucormycosis, commonly known as black fungus, was present in India before the pandemic, but it is affecting those with Covid or those who have recently recovered.
Many health experts blame the spread on a central coronavirus treatment, steroids. These drugs can limit inflammation of the lungs, but they also dull the response of the immune system, which can allow infections like the black fungus to take hold.
More broadly, Covid patients with weakened immune systems and underlying conditions, particularly diabetes, are especially vulnerable to black fungus, which has a high mortality rate.
Video of a woman saying she would jump off the roof of a hospital if it failed to arrange injections of the medication for her husband spread widely on social media early this week.
The woman, in the central Indian state of Madhya Pradesh, said, “If I don’t get the injection today, then I will jump off the roof of the hospital and commit suicide. I have no other option left.” She added that the hospital had none of the medication and said of her husband, “Where should I take him in this condition?”
amid a virulent second wave.
Of the medication for the disease she said: “It is not one of the common over-the-counter medications. This is a toxic medication by itself. It can’t be given by all and sundry. It is not something which you can take at home. It needs strict monitoring of body parameters because it is a toxic drug.”
The federal government directive requiring state governments to immediately disclose cases follows those of many Indian states that had already required hospitals to report cases of mucormycosis.
This obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.
For nearly four decades, William R. Harris devoted his career to safeguarding his fellow citizens.
As an international lawyer and a sought-after consultant, he drafted treaties to prevent the proliferation of nuclear weapons and reduce the risk of accidental war. He modeled a framework for the government to continue functioning during a national catastrophe. He helped extend Daylight Saving Time to conserve fuel and focused officials on protecting the electrical grid from digital sabotage.
He practiced what he preached, too, making sure to get his first vaccination for the coronavirus in early February, as soon as he was eligible and the vaccine was available. He completed the regimen by the end of the month.
In late March, though, his family said, he received a jarring diagnosis: Covid-19. Mr. Harris also had chronic lymphocytic leukemia, and family members said that a few weeks after learning that he had Covid, he read an article in a scientific journal suggesting that the vaccine might not be fully effective for people with that type of leukemia.
The New York Times last month.
No vaccine is 100 percent effective, and some so-called breakthrough infections can be expected, even in healthy people who have been fully vaccinated. But those cases are rare. As of April 26, the Centers for Disease Control and Prevention reported 9,245 breakthrough cases, out of 95 million fully vaccinated Americans; 132 people died.
In a eulogy on Facebook, Mr. Harris’s daughter Darcy R. Harris described him this way: “As an international lawyer and policy wonk, his work spanned arms control treaties and verification, energy policy, space law. He was a consummate researcher, an early adopter, an innovator. On top of that, he was always working for free and helping others out.”
Dr. William A. Horwitz and Dr. Henriette Klein, both of whom were professors of clinical psychiatry at Columbia University.
He attended the Dalton School in Manhattan and, after graduating from the Choate School, now Choate Rosemary Hall, in Wallingford, Conn., earned a bachelor’s degree in history from Harvard College in 1962 and a law degree from Harvard Law School in 1966.
In 1968, he married Elizabeth Jones. Along with his wife and their daughter Darcy, he is survived by another daughter, Rebecca Harris Deane; a son, William Proctor Harris; four grandchildren; and his sister, Susan Harris Molnar.
The vaccines produced similar responses in all three groups of women, eliciting both antibody and T-cell responses against the coronavirus, the scientists found. Of particular note, experts said, was the fact that the shots produced high levels of neutralizing antibodies, which can prevent the virus from entering cells, in both pregnant and nonpregnant women.
“Clearly, the vaccines were working in these people,” said Akiko Iwasaki, an immunologist at Yale University who was not involved in the research. “These levels are expected to be quite protective.”
The researchers also found neutralizing antibodies in the breast milk of vaccinated mothers and in umbilical cord blood collected from infants at delivery. “Vaccination of pregnant people and lactating people actually leads to transfer of some immunity to their newborns and lactating infants,” said Dr. Ai-ris Y. Collier, a physician-scientist at Beth Israel who is the first author of the paper.
The results are “really encouraging,” Dr. Iwasaki said. “There is this added benefit of conferring protective antibodies to the newborn and the fetus, which is all the more reason to get vaccinated.”
The scientists also measured the women’s immune responses to two variants of concern: B.1.1.7, which was first identified in Britain, and B.1.351, which was first identified in South Africa. All three groups of women produced antibody and T-cell responses to both variants after vaccination, although their antibody responses were weaker against the variants, especially B.1.351, than against the original strain of the virus, according to the study.
“These women developed immune responses to the variants, although the asterisk is that the antibody responses were reduced several-fold,” said Dr. Dan Barouch, a study author and virologist at Beth Israel.(Dr. Barouch and his colleagues developed the Johnson & Johnson vaccine, which was not included in this study.)
“Overall, it’s good news,” he added. “And it increases the data that suggests that there is a substantial benefit for pregnant women to be vaccinated.”
The first dose of Russia’s Sputnik V coronavirus vaccine provides sufficient protection on its own to be used without a second injection, the country’s Ministry of Health said on Thursday, clearing the way for a faster vaccination campaign in Russia.
The new policy arose from a debate among public health officials in Russia and a number of other countries about the benefits and drawbacks of accelerating vaccinations by skipping or delaying the second dose of vaccines that were originally designed to be administered in two shots a few weeks apart.
As is the case with other two-dose coronavirus vaccines, Sputnik V provides substantial protection, at least for the short term, after the first shot.
The ministry said in a statement that people in Russia who, for various reasons, skipped their second shot of Sputnik V were still far less likely to become sick than unvaccinated people were.
Sputnik V to be 79.4 percent effective after a single shot. Russia has previously reported an efficacy of 91.6 percent after two shots.
The observational study was less precise than a standard vaccine trial, because it compared rates of infection in single-shot recipients with the general infection rate in the population, not with a control group. The ministry did not say how many single-shot recipients were studied. A separate placebo-controlled study of the issue is still underway.
The Russian vaccine uses two common cold viruses that have been genetically modified to carry genes of the coronavirus, which prime the immune system to prevent infection. Developers of the vaccine have said the second dose lengthens the period of time a recipient is immune.
In other countries, health authorities have been wary about approving a simplified single-shot approach for vaccination using vaccines that were tested in trials using two shots.
But the first shot of Sputnik V uses the same common cold virus as the single-dose Johnson & Johnson vaccine, which already has been approved for use in the United States and other countries and has been shown to be safe and effective, with an efficacy of 72 percent in the United States.
The Russian version of this single-shot approach is called Sputnik Lite.
The two-dose Sputnik V vaccine is still being offered in Russia and to dozens of other countries. Russia’s export customers could also speed up their vaccination campaigns if they follow the Russian Ministry of Health’s lead in approving a single-dose strategy.
In early 2020, dozens of scientific teams scrambled to make a vaccine for Covid-19. Some chose tried-and-true techniques, such as making vaccines from killed viruses. But a handful of companies bet on a riskier method, one that had never produced a licensed vaccine: deploying a genetic molecule called RNA.
The bet paid off. The first two vaccines to emerge successfully out of clinical trials, made by Pfizer-BioNTech and by Moderna, were both made of RNA. They both turned out to have efficacy rates about as good as a vaccine could get.
In the months that followed, those two RNA vaccines have provided protection to tens of millions of people in some 90 countries. But many parts of the world, including those with climbing death tolls, have had little access to them, in part because they require being kept in a deep freeze.
Now a third RNA vaccine may help meet that global need. A small German company called CureVac is on the cusp of announcing the results of its late-stage clinical trial. As early as next week, the world may learn whether its vaccine is safe and effective.
Novavax, a company based in Maryland whose vaccine uses coronavirus proteins, is expected to apply for U.S. authorization in the next few weeks. In India, the pharmaceutical company Biological E is testing another protein-based vaccine that was developed by researchers in Texas. In Brazil, Mexico, Thailand and Vietnam, researchers are starting trials for a Covid-19 shot that can be mass-produced in chicken eggs.
Vaccines experts are particularly curious to see CureVac’s results, because its shot has an important advantage over the other RNA vaccines from Moderna and Pfizer-BioNTech. While those two vaccines have to be kept in a deep freezer, CureVac’s vaccine stays stable in a refrigerator — meaning it could more easily deliver the newly discovered power of RNA vaccines to hard-hit parts of the world.
“It’s gone largely under the radar,” said Jacob Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington, D.C. But now, he added, “they look pretty well positioned to clean up the global market.”
For CureVac’s co-founder, the biologist Ingmar Hoerr, the company’s Covid-19 vaccine trial is the culmination of a quarter-century’s worth of work with RNA, a molecule that helps turn DNA into the proteins that do the work of our cells. As a graduate student at the University of Tübingen in the 1990s, Dr. Hoerr injected RNA into mice and found that the animals could make the protein encoded by the molecules. He was surprised to find that the mice’s immune systems made antibodies against the new proteins.
only a few scientists in the world considered an RNA vaccine a serious possibility. But proponents thought it might change medicine. You could, in theory, craft an RNA molecule to immunize people against any virus. You might even be able to create an RNA vaccine to cure cancer, if you could make an RNA molecule that encoded a tumor protein.
In 2001, Dr. Hoerr co-founded CureVac to chase the idea, but for the first few years the company struggled to survive. To keep the lights on, it took orders from other labs for custom-built RNA molecules. On the side, CureVac’s scientists tinkered with their own designs for RNA vaccines.
Over time, they found subtle tweaks to RNA vaccine molecules that caused cells to make more proteins. The more potent the RNA, the lower the dose they needed in vaccines.
CureVac’s researchers also figured out how to put the RNA molecules in fatty bubbles to protect them from destruction on their journey to cells. And perhaps most important, they used a form of RNA that could stay stable at relatively warm temperatures. Instead of requiring a deep freezer, CureVac’s vaccine could be refrigerated.
In time, other companies entered the RNA vaccine business as well: BioNTech in Germany in 2008, then Moderna in Boston in 2011. Their experiments began showing that these vaccines could protect animals against an assortment of viruses. In 2013, CureVac injected human volunteers with a rabies RNA vaccine, in the first clinical trial of the technology against an infectious disease.
For years, CureVac and other RNA vaccine companies toiled on perfecting their vaccines. CureVac’s first attempt at a rabies vaccine demonstrated it was safe, but it yielded a weak response from the immune system. The company has since retooled that vaccine, and the updated version has shown promise in early clinical studies. But other efforts ended in failure. In 2017, CureVac announced that its RNA vaccine against prostate cancer offered no benefits to patients.
$1 billion to move its operations to the United States. CureVac denied the reports, but the chief executive suddenly left, to be replaced by Dr. Haas.
CureVac’s researchers moved ahead with their limited resources, designing an RNA molecule encoding a protein found on the surface of the coronavirus, called spike. Experiments on hamsters showed that it could protect the animals from the virus.
Phase 3 trial, recruiting 40,000 volunteers in Europe and Latin America. The company will get its first look at the data when 56 volunteers develop Covid-19. If most of them are in the placebo group, and few in the vaccinated group, it will be proof that the vaccine works.
with a lawsuit.
In April, the European Union finally fixed this shortfall, negotiating with Pfizer and BioNTech to get 1.8 billion doses of their vaccine between now and 2023. That arrangement has left analysts wondering how much demand will be left for CureVac.
“They’re going to miss the boat on the major, advanced-economy markets,” said Dr. Kirkegaard. “The U.S., Europe and Japan are going to be largely vaccinated using these Moderna and Pfizer vaccines.”
Dr. Haas countered that most of the bloc’s doses from Pfizer-BioNTech won’t come until next year. “CureVac sees itself as a major player in ending the Covid-19 pandemic in Europe and elsewhere,” he said.
Ursula von der Leyen, president of the European Commission, said that if the CureVac vaccine worked, it would be in the mix, thanks to two advantages: It is an mRNA vaccine, and it was created in Europe. It is also possible that individual European nations will make side deals with the company.
Billions of other people in low- and middle-income countries have yet to receive a vaccine, and experts say that CureVac may meet some of their demand. “We still need a lot of vaccine globally,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai in New York. “I think a lot of people can benefit from it.”
The vaccines from Moderna and Pfizer-BioNTech are challenging to distribute in the developing world because of the equipment and power supply required to freeze these vaccines. CureVac’s RNA vaccine can stay stable for at least three months at 41 degrees Fahrenheit, and it can sit for 24 hours at room temperature before it is used.
“The stability is a real advantage,” Dr. Jackson said. C.E.P.I. is “in very active discussions” with CureVac, he said, about distributing the company’s vaccine through Covax, an initiative to distribute vaccines to low- and middle-income countries.
But CureVac is also designing a new generation of vaccines with a goal of eventually moving into markets in the United States and other wealthy nations. Because its potent RNA requires only a small dose, the company could potentially create vaccines for different variants and mix them in a single shot.
But such possibilities are meaningless until CureVac can prove that its vaccine works. Mary Warrell, a vaccine researcher at the University of Oxford, is reluctant to speculate about the fate of the vaccine before that milestone.
“Prediction during this pandemic has rarely been profitable,” she warned.
Doctors, the public and the media point to anecdotal evidence of infections even among the vaccinated. Scientists say the data is too thin and cite other reasons behind the country’s second wave.
NEW DELHI — At Sir Ganga Ram Hospital, a huge facility in the middle of India’s capital, 37 fully vaccinated doctors came down with Covid-19 earlier this month.
The infections left most with mild symptoms, but it added to their growing fears that the virus behind India’s catastrophic second wave is different. They wonder if a more contagious variant that dodges the immune system could be fueling the epidemic inside the world’s hardest-hit nation.
So far the evidence is inconclusive, and researchers caution that other factors could explain the viciousness of the outbreak, which has overwhelmed India’s capital so quickly that hospitals are entirely overrun and crematories burn nonstop. Still, the presence of the variant could complicate the taming of India’s Covid-19 disaster.
“The current wave of Covid has a different clinical behavior,” said Dr. Sujay Shad, a senior cardiac surgeon at Sir Ganga Ram Hospital, where two of the doctors needed supplemental oxygen to recover. “It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected.”
is much higher. Daily new infections also surged to nearly 357,700, another record.
most common source of new infection in the United States
“While it’s almost certainly true B.1.617 is playing a role, it’s unclear how much it’s contributing directly to the surge and how that compares to other circulating variants, especially B.1.1.7,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego.
India has just scraped the surface in terms of vaccinating its population, with less than 2 percent fully vaccinated. Experts also blame lax public behavior after last year’s first wave and missteps by Prime Minister Narendra Modi, such as recently holding large political rallies that may have spread the disease and sent a message to the people that the worst was over.
“There is a lot of jumping to conclusions that B.1.67 is the explanation for what’s happening,” said Jeffrey Barrett, director of the Covid-19 genomics initiative at the Wellcome Sanger Institute in Britain. “These other things are probably more likely to be the explanation.”
still responsive to vaccines, although slightly less so. India relies heavily on the Oxford-AstraZeneca vaccine, which clinical trials show is less powerful than the vaccines made by Pfizer-BioNTech and Moderna and could perhaps be more easily thwarted by mutations.
“For now the vaccines remain effective, but there is a trend toward less effectiveness,” said Dr. Céline Gounder, an infectious disease physician and epidemiologist at Bellevue Hospital in New York.
In India, a number of doctors point to anecdotal evidence that people who have been fully vaccinated are getting sick. Those doctors also say they are seeing children with serious symptoms, such as severe diarrhea, acidosis and falling blood pressure, even among otherwise healthy patients.
“This is very different from what we saw last year,” said Dr. Soonu Udani, head of critical care services at the SRCC Children’s Hospital in Mumbai.
report in The Wire, an Indian online publication, pointed to logistical challenges, bureaucratic red tape and the lack of funding as some of the reasons.
data from the Indian Council of Medical Research up to April 21 shows an extremely low breakthrough infection rate, though perhaps not as low as that of the United States. The data shows 0.02 percent to 0.04 percent of vaccinated people falling ill. The rate in the United States, which relies on different vaccines, is 0.008 percent.
At Sir Ganga Ram hospital, the 37 doctors who became infected after immunization had received their first dose between late January to early February and then their second dose four to six weeks after that. The hospital employs about 500 doctors.
Dr. Shad, the cardiac surgeon, was reluctant to jump to conclusions about variants breaking through the immunizations. “I don’t think anyone has the serological data” to answer that, he said.
A broad lack of data plagues the scientific chase for variants and whether they are contributing to the severity of India’s crisis. Fast-moving mutations complicate the picture because it isn’t immediately clear how quickly they spread or how they respond to vaccines.
In India, the health care system wasn’t on alert for the impact of variants at home, even as they began to spread globally, said Dr. Thekkekara Jacob John, a senior virologist in the southern state of Tamil Nadu.
“We were not looking for variants at all,” he said. “In other words, we missed the boat.”
After a long year and a lot of anticipation, getting the vaccine can be cause for celebration, which for some might mean pouring a drink and toasting to their new immunity. But can alcohol interfere with your immune response?
The short answer is that it depends on how much you drink.
There is no evidence that having a drink or two can render any of the current Covid vaccines less effective. Some studies have even found that over the longer term, small or moderate amounts of alcohol might actually benefit the immune system by reducing inflammation.
Heavy alcohol consumption, on the other hand, particularly over the long term, can suppress the immune system and potentially interfere with your vaccine response, experts say. Since it can take weeks after a Covid shot for the body to generate protective levels of antibodies against the novel coronavirus, anything that interferes with the immune response would be cause for concern.