Dr. Kariko and Dr. Weissman were vaccinated on Dec. 18 at the University of Pennsylvania. Their inoculations turned into a press event, and as the cameras flashed, she began to feel uncharacteristically overwhelmed.

A senior administrator told the doctors and nurses rolling up their sleeves for shots that the scientists whose research made the vaccine possible were present, and they all clapped. Dr. Kariko wept.

Things could have gone so differently, for the scientists and for the world, Dr. Langer said. “There are probably many people like her who failed,” he said.

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Researchers Are Hatching a Low-Cost Covid-19 Vaccine

A new vaccine for Covid-19 that is entering clinical trials in Brazil, Mexico, Thailand and Vietnam could change how the world fights the pandemic. The vaccine, called NVD-HXP-S, is the first in clinical trials to use a new molecular design that is widely expected to create more potent antibodies than the current generation of vaccines. And the new vaccine could be far easier to make.

Existing vaccines from companies like Pfizer and Johnson & Johnson must be produced in specialized factories using hard-to-acquire ingredients. In contrast, the new vaccine can be mass-produced in chicken eggs — the same eggs that produce billions of influenza vaccines every year in factories around the world.

If NVD-HXP-S proves safe and effective, flu vaccine manufacturers could potentially produce well over a billion doses of it a year. Low- and middle-income countries currently struggling to obtain vaccines from wealthier countries may be able to make NVD-HXP-S for themselves or acquire it at low cost from neighbors.

“That’s staggering — it would be a game-changer,” said Andrea Taylor, assistant director of the Duke Global Health Innovation Center.

Vaccines work by acquainting the immune system with a virus well enough to prompt a defense against it. Some vaccines contain entire viruses that have been killed; others contain just a single protein from the virus. Still others contain genetic instructions that our cells can use to make the viral protein.

Once exposed to a virus, or part of it, the immune system can learn to make antibodies that attack it. Immune cells can also learn to recognize infected cells and destroy them.

spike, latches onto cells and then allows the virus to fuse to them.

But simply injecting coronavirus spike proteins into people is not the best way to vaccinate them. That’s because spike proteins sometimes assume the wrong shape, and prompt the immune system to make the wrong antibodies.

The researchers injected the 2P spikes into mice and found that the animals could easily fight off infections of the MERS coronavirus.

The team filed a patent for its modified spike, but the world took little notice of the invention. MERS, although deadly, is not very contagious and proved to be a relatively minor threat; fewer than 1,000 people have died of MERS since it first emerged in humans.

But in late 2019 a new coronavirus, SARS-CoV-2, emerged and began ravaging the world. Dr. McLellan and his colleagues swung into action, designing a 2P spike unique to SARS-CoV-2. In a matter of days, Moderna used that information to design a vaccine for Covid-19; it contained a genetic molecule called RNA with the instructions for making the 2P spike.

Other companies soon followed suit, adopting 2P spikes for their own vaccine designs and starting clinical trials. All three of the vaccines that have been authorized so far in the United States — from Johnson & Johnson, Moderna and Pfizer-BioNTech — use the 2P spike.

Other vaccine makers are using it as well. Novavax has had strong results with the 2P spike in clinical trials and is expected to apply to the Food and Drug Administration for emergency use authorization in the next few weeks. Sanofi is also testing a 2P spike vaccine and expects to finish clinical trials later this year.

Dr. McLellan’s ability to find lifesaving clues in the structure of proteins has earned him deep admiration in the vaccine world. “This guy is a genius,” said Harry Kleanthous, a senior program officer at the Bill & Melinda Gates Foundation. “He should be proud of this huge thing he’s done for humanity.”

But once Dr. McLellan and his colleagues handed off the 2P spike to vaccine makers, he turned back to the protein for a closer look. If swapping just two prolines improved a vaccine, surely additional tweaks could improve it even more.

HexaPro, in honor of its total of six prolines.

The structure of HexaPro was even more stable than 2P, the team found. It was also resilient, better able to withstand heat and damaging chemicals. Dr. McLellan hoped that its rugged design would make it potent in a vaccine.

Dr. McLellan also hoped that HexaPro-based vaccines would reach more of the world — especially low- and middle-income countries, which so far have received only a fraction of the total distribution of first-wave vaccines.

“The share of the vaccines they’ve received so far is terrible,” Dr. McLellan said.

To that end, the University of Texas set up a licensing arrangement for HexaPro that allows companies and labs in 80 low- and middle-income countries to use the protein in their vaccines without paying royalties.

Meanwhile, Dr. Innes and his colleagues at PATH were looking for a way to increase the production of Covid-19 vaccines. They wanted a vaccine that less wealthy nations could make on their own.

experimenting with Newcastle disease virus to create vaccines for a range of diseases. To develop an Ebola vaccine, for example, researchers added an Ebola gene to the Newcastle disease virus’s own set of genes.

The scientists then inserted the engineered virus into chicken eggs. Because it is a bird virus, it multiplied quickly in the eggs. The researchers ended up with Newcastle disease viruses coated with Ebola proteins.

At Mount Sinai, the researchers set out to do the same thing, using coronavirus spike proteins instead of Ebola proteins. When they learned about Dr. McLellan’s new HexaPro version, they added that to the Newcastle disease viruses. The viruses bristled with spike proteins, many of which had the desired prefusion shape. In a nod to both the Newcastle disease virus and the HexaPro spike, they called it NDV-HXP-S.

announced the start of a clinical trial of NDV-HXP-S. A week later, Thailand’s Government Pharmaceutical Organization followed suit. On March 26, Brazil’s Butantan Institute said it would ask for authorization to begin its own clinical trials of NDV-HXP-S.

Meanwhile, the Mount Sinai team has also licensed the vaccine to the Mexican vaccine maker Avi-Mex as an intranasal spray. The company will start clinical trials to see if the vaccine is even more potent in that form.

To the nations involved, the prospect of making the vaccines entirely on their own was appealing. “This vaccine production is produced by Thai people for Thai people,” Thailand’s health minister, Anutin Charnvirakul, said at the announcement in Bangkok.

In Brazil, the Butantan Institute trumpeted its version of NDV-HXP-S as “the Brazilian vaccine,” one that would be “produced entirely in Brazil, without depending on imports.”

Ms. Taylor, of the Duke Global Health Innovation Center, was sympathetic. “I could understand why that would really be such an attractive prospect,” she said. “They’ve been at the mercy of global supply chains.”

Madhavi Sunder, an expert on intellectual property at Georgetown Law School, cautioned that NDV-HXP-S would not immediately help countries like Brazil as they grappled with the current wave of Covid-19 infections. “We’re not talking 16 billion doses in 2020,” she said.

Instead, the strategy will be important for long-term vaccine production — not just for Covid-19 but for other pandemics that may come in the future. “It sounds super promising,” she said.

In the meantime, Dr. McLellan has returned to the molecular drawing board to try to make a third version of their spike that is even better than HexaPro.

“There’s really no end to this process,” he said. “The number of permutations is almost infinite. At some point, you’d have to say, ‘This is the next generation.’”

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Researchers Are Hatching a Low-Cost Coronavirus Vaccine

A new vaccine for Covid-19 that is entering clinical trials in Brazil, Mexico, Thailand and Vietnam could change how the world fights the pandemic. The vaccine, called NVD-HXP-S, is the first in clinical trials to use a new molecular design that is widely expected to create more potent antibodies than the current generation of vaccines. And the new vaccine could be far easier to make.

Existing vaccines from companies like Pfizer and Johnson & Johnson must be produced in specialized factories using hard-to-acquire ingredients. In contrast, the new vaccine can be mass-produced in chicken eggs — the same eggs that produce billions of influenza vaccines every year in factories around the world.

If NVD-HXP-S proves safe and effective, flu vaccine manufacturers could potentially produce well over a billion doses of it a year. Low- and middle-income countries currently struggling to obtain vaccines from wealthier countries may be able to make NVD-HXP-S for themselves or acquire it at low cost from neighbors.

“That’s staggering — it would be a game-changer,” said Andrea Taylor, assistant director of the Duke Global Health Innovation Center.

Vaccines work by acquainting the immune system with a virus well enough to prompt a defense against it. Some vaccines contain entire viruses that have been killed; others contain just a single protein from the virus. Still others contain genetic instructions that our cells can use to make the viral protein.

Once exposed to a virus, or part of it, the immune system can learn to make antibodies that attack it. Immune cells can also learn to recognize infected cells and destroy them.

spike, latches onto cells and then allows the virus to fuse to them.

But simply injecting coronavirus spike proteins into people is not the best way to vaccinate them. That’s because spike proteins sometimes assume the wrong shape, and prompt the immune system to make the wrong antibodies.

The researchers injected the 2P spikes into mice and found that the animals could easily fight off infections of the MERS coronavirus.

The team filed a patent for its modified spike, but the world took little notice of the invention. MERS, although deadly, is not very contagious and proved to be a relatively minor threat; fewer than 1,000 people have died of MERS since it first emerged in humans.

But in late 2019 a new coronavirus, SARS-CoV-2, emerged and began ravaging the world. Dr. McLellan and his colleagues swung into action, designing a 2P spike unique to SARS-CoV-2. In a matter of days, Moderna used that information to design a vaccine for Covid-19; it contained a genetic molecule called RNA with the instructions for making the 2P spike.

Other companies soon followed suit, adopting 2P spikes for their own vaccine designs and starting clinical trials. All three of the vaccines that have been authorized so far in the United States — from Johnson & Johnson, Moderna and Pfizer-BioNTech — use the 2P spike.

Other vaccine makers are using it as well. Novavax has had strong results with the 2P spike in clinical trials and is expected to apply to the Food and Drug Administration for emergency use authorization in the next few weeks. Sanofi is also testing a 2P spike vaccine and expects to finish clinical trials later this year.

Dr. McLellan’s ability to find lifesaving clues in the structure of proteins has earned him deep admiration in the vaccine world. “This guy is a genius,” said Harry Kleanthous, a senior program officer at the Bill & Melinda Gates Foundation. “He should be proud of this huge thing he’s done for humanity.”

But once Dr. McLellan and his colleagues handed off the 2P spike to vaccine makers, he turned back to the protein for a closer look. If swapping just two prolines improved a vaccine, surely additional tweaks could improve it even more.

HexaPro, in honor of its total of six prolines.

The structure of HexaPro was even more stable than 2P, the team found. It was also resilient, better able to withstand heat and damaging chemicals. Dr. McLellan hoped that its rugged design would make it potent in a vaccine.

Dr. McLellan also hoped that HexaPro-based vaccines would reach more of the world — especially low- and middle-income countries, which so far have received only a fraction of the total distribution of first-wave vaccines.

“The share of the vaccines they’ve received so far is terrible,” Dr. McLellan said.

To that end, the University of Texas set up a licensing arrangement for HexaPro that allows companies and labs in 80 low- and middle-income countries to use the protein in their vaccines without paying royalties.

Meanwhile, Dr. Innes and his colleagues at PATH were looking for a way to increase the production of Covid-19 vaccines. They wanted a vaccine that less wealthy nations could make on their own.

experimenting with Newcastle disease virus to create vaccines for a range of diseases. To develop an Ebola vaccine, for example, researchers added an Ebola gene to the Newcastle disease virus’s own set of genes.

The scientists then inserted the engineered virus into chicken eggs. Because it is a bird virus, it multiplied quickly in the eggs. The researchers ended up with Newcastle disease viruses coated with Ebola proteins.

At Mount Sinai, the researchers set out to do the same thing, using coronavirus spike proteins instead of Ebola proteins. When they learned about Dr. McLellan’s new HexaPro version, they added that to the Newcastle disease viruses. The viruses bristled with spike proteins, many of which had the desired prefusion shape. In a nod to both the Newcastle disease virus and the HexaPro spike, they called it NDV-HXP-S.

announced the start of a clinical trial of NDV-HXP-S. A week later, Thailand’s Government Pharmaceutical Organization followed suit. On March 26, Brazil’s Butantan Institute said it would ask for authorization to begin its own clinical trials of NDV-HXP-S.

Meanwhile, the Mount Sinai team has also licensed the vaccine to the Mexican vaccine maker Avi-Mex as an intranasal spray. The company will start clinical trials to see if the vaccine is even more potent in that form.

To the nations involved, the prospect of making the vaccines entirely on their own was appealing. “This vaccine production is produced by Thai people for Thai people,” Thailand’s health minister, Anutin Charnvirakul, said at the announcement in Bangkok.

In Brazil, the Butantan Institute trumpeted its version of NDV-HXP-S as “the Brazilian vaccine,” one that would be “produced entirely in Brazil, without depending on imports.”

Ms. Taylor, of the Duke Global Health Innovation Center, was sympathetic. “I could understand why that would really be such an attractive prospect,” she said. “They’ve been at the mercy of global supply chains.”

Madhavi Sunder, an expert on intellectual property at Georgetown Law School, cautioned that NDV-HXP-S would not immediately help countries like Brazil as they grappled with the current wave of Covid-19 infections. “We’re not talking 16 billion doses in 2020,” she said.

Instead, the strategy will be important for long-term vaccine production — not just for Covid-19 but for other pandemics that may come in the future. “It sounds super promising,” she said.

In the meantime, Dr. McLellan has returned to the molecular drawing board to try to make a third version of their spike that is even better than HexaPro.

“There’s really no end to this process,” he said. “The number of permutations is almost infinite. At some point, you’d have to say, ‘This is the next generation.’”

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Virus Variants Threaten to Draw Out the Pandemic, Scientists Say

For weeks, the mood in much of the United States has been buoyant. Cases, hospitalizations and deaths from the coronavirus have fallen steeply from their highs, and millions of people are being newly vaccinated every day. Restaurants, shops and schools have reopened. Some states, like Texas and Florida, have abandoned precautions altogether.

In measurable ways, Americans are winning the war against the coronavirus. Powerful vaccines and an accelerating rollout all but guarantee an eventual return to normalcy — to backyard barbecues, summer camps and sleepovers.

But it is increasingly clear that the next few months will be painful. So-called variants are spreading, carrying mutations that make the coronavirus both more contagious and in some cases more deadly.

Even as vaccines were authorized late last year, illuminating a path to the pandemic’s end, variants were trouncing Britain, South Africa and Brazil. New variants have continued to pop up — in California one week, in New York and Oregon the next. As they take root, these new versions of the coronavirus threaten to postpone an end to the pandemic.

rising exponentially in the United States.

Limited genetic testing has turned up more than 12,500 cases, many in Florida and Michigan. As of March 13, the variant accounted for about 27 percent of new cases nationwide, up from just 1 percent in early February.

pledged a “down payment” of $200 million to ramp up surveillance, an infusion intended to make it possible to analyze 25,000 patient samples each week for virus variants. It’s an ambitious goal: The country was sequencing just a few hundred samples each week in December, then scaling up to about 9,000 per week as of March 27.

Until recently, B.1.1.7’s rise was camouflaged by falling rates of infection over all, lulling Americans into a false sense of security and leading to prematurely relaxed restrictions, researchers say.

“The best way to think about B.1.1.7 and other variants is to treat them as separate epidemics,” said Sebastian Funk, a professor of infectious disease dynamics at the London School of Hygiene and Tropical Medicine. “We’re really kind of obscuring the view by adding them all up to give an overall number of cases.”

Other variants identified in South Africa and Brazil, as well as some virus versions first seen in the United States, have been slower to spread. But they, too, are worrisome, because they contain a mutation that diminishes the vaccines’ effectiveness. Just this week, an outbreak of P.1, the variant that crushed Brazil, forced a shutdown of the Whistler Blackcomb ski resort in British Columbia.

as fast as possible.

Infections are rising again, driven to an uncertain degree by B.1.1.7 and other variants. Earlier this week, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, pleaded with Americans to continue to practice masking and social distancing, saying she felt a sense of “impending doom.”

60 percent more contagious and 67 percent more deadly than the original form of the virus, according to the most recent estimates.

The variant is no different from the original in how it spreads, but infected people seem to carry more of the virus and for longer, said Katrina Lythgoe, an evolutionary biologist at the University of Oxford. “You’re more infectious for more days,” she said.

So contagious is B.1.1.7 that Britain succeeded in driving down infections only after nearly three months of strict stay-at-home orders, plus an aggressive vaccination program. Even so, cases fell much more slowly than they did during a similar lockdown in March and April.

three-quarters of new infections, some hospitals have had to move coronavirus patients to Belgium to free up beds. Roughly as many people are dying each day from Covid-19 in Europe as were this time a year ago.

For too long, government officials disregarded the threat. “Case plateaus can hide the emergence of new variants,” said Carl Pearson, a research fellow at the London School of Hygiene and Tropical Medicine. “And the higher those plateaus are, the worse the problem is.”

In the United States, coronavirus infections began a rapid decline in January, soon prompting many state leaders to reopen businesses and ease restrictions. But scientists repeatedly warned that the drop would not last. After the rate bottomed out at about 55,000 cases and 1,500 deaths per day in mid-March, some states — notably Michigan — began seeing an uptick.

Since then, the national numbers have steadily risen. As of Saturday, the daily count was up to nearly 69,000, and the weekly average was 19 percent higher than the figure two weeks earlier.

Pfizer-BioNTech and Moderna vaccines seem to be slightly less effective against B.1.351, the variant identified in South Africa. That variant contains the Eek mutation, which seems to enable the virus to partly sidestep the body’s immune response. The vaccines made by Johnson & Johnson, AstraZeneca and Novavax were even less potent against B.1.351.

“I think for the next year or two, E484K will be the most concerning” mutation, said Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.

The mutation slightly alters the so-called spike protein sitting on the surface of the coronavirus, making it just a bit harder for antibodies to latch on and destroy the invader.

The good news is that the virus seems to have just a few survival tricks in its bag, and that makes it easier for scientists to find and block those defenses. “I’m feeling pretty good about the fact that there aren’t that many choices,” said Michel Nussenzweig, an immunologist at Rockefeller University in New York.

The Eek mutation seems to be the virus’s primary defense against the immune system. Researchers in South Africa recently reported that a new vaccine directed against B.1.351 ought to fend off all other variants, as well.

Pfizer, BioNTech and Moderna already are testing newly designed booster shots against B.1.351 that should work against any variants known to blunt the immune response.

Instead of a new vaccine against variants, however, it may be just as effective for Americans to receive a third dose of the Pfizer-BioNtech or Moderna vaccines in six months to a year, said Dr. Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases.

That would keep antibody levels high in each recipient, overwhelming any variant — a more practical strategy than making a specialized vaccine for each new variant that emerges, he said.

“My only concern about chasing all the variants is that you’d almost be playing Whac-A-Mole, you know, because they’ll keep coming up and keep coming up,” Dr. Fauci said.

In one form or another, the new coronavirus is here to stay, many scientists believe. Multiple variants may be circulating in the country at the same time, as is the case for common cold coronaviruses and influenza. Keeping them at bay may require an annual shot, like the flu vaccine.

The best way to deter the emergence of dangerous variants is to keep cases down now and to immunize the vast majority of the world — not just the United States — as quickly as possible. If significant pockets of the globe remain unprotected, the virus will continue to evolve in dangerous new ways.

“This might be something that we have to deal with for a long time,” said Rosalind Eggo, an epidemiologist at London School of Hygiene and Tropical Medicine.

Still, she added, “Even if it changes again, which it is very likely to do, we are in a better, much stronger position than a year ago to deal with it.”

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Getting One Vaccine Is Good. How About Mix-and-Match?

In January, Britain made a change to its vaccine guidelines that shocked many health experts: If the second dose of one vaccine wasn’t available, patients could be given a different one.

The new rule was based on sheer guesswork; there was no scientific data at the time demonstrating that mixing two coronavirus vaccines was safe and effective. But that may change soon.

In February, researchers at the University of Oxford began a trial in which volunteers received a dose of the Pfizer-BioNTech vaccine followed by a dose of AstraZeneca’s formulation, or vice versa. This month, the researchers will start analyzing the blood of the subjects to see how well the mix-and-match approach works.

As growing numbers of vaccines are being authorized, researchers are testing other combinations. A few are in clinical trials, while others are being tested in animals for now.

created an Ebola vaccine whose first dose contained a virus called an adenovirus. The second shot used another virus, called vesicular stomatitis virus.

When the Covid-19 pandemic began last year, the Gamaleya researchers used a similar strategy to create vaccines against the new coronavirus. The first dose used the same adenovirus as in their Ebola vaccine, called Ad5. The second dose contained a different human adenovirus, Ad26. The researches inserted a gene into both viruses for the protein on the surface of the coronavirus, called spike.

Studies revealed that the vaccine, now known as Sputnik V, provided a strong defense against Covid-19. In clinical trials, the researchers found that it had an efficacy of 91.6 percent. Sputnik V is now in use in Russia and 56 other countries.

Recently, the Gamaleya institute joined forces with AstraZeneca, which makes its own Covid-19 vaccine. AstraZeneca’s consists of two doses of a chimpanzee adenovirus called ChAdOx1. Last week, the company reported that its vaccine had an efficacy of 76 percent.

found that the mixture worked better than two doses of the spike or of the R.B.D.

The researchers suspect that the first dose produces a broad range of antibodies that can stick to spots along the length of the spike protein, and that the second dose delivers a big supply of particularly potent antibodies to the tip of the spike. Together, the assortment of antibodies does a better job of stopping the coronavirus.

held back exports of vaccines to other countries as it grappled with a surge of Covid-19. For countries that were counting on those vaccines, a safe alternative for second doses could save lives.

After Britain was criticized in January for suggesting that vaccines could be mixed, researchers at the University of Oxford set out to put the idea to a formal test. In a trial called Com-Cov, they recruited 830 volunteers to test the two vaccines authorized by the British government: AstraZeneca’s adenovirus-based vaccine and the vaccine by Pfizer-BioNTech.

Pfizer-BioNTech’s vaccine uses a fundamentally different technology to produce spike proteins in the body. It contains tiny bubbles with genetic molecules called RNA. Once the bubbles fuse to cells, the cells use the RNA to make spike proteins.

stronger immune responses than mice that received the same vaccine for both doses.

Whether scientists carry out more experiments on other vaccines will depend on the willingness of the vaccine manufacturers. “You’re requiring quite large pharmaceutical companies to play nice together,” Dr. Wheatley said.

Dr. Bernard Moss, a virologist at the National Institute of Allergy and Infectious Diseases, suspects that a number of companies will be willing to let their vaccines be tested in combinations. “It’s always better to be a part of something that is going to be used,” he said, “than to wholly own something that isn’t.”

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Free With Your Covid Shot: Krispy Kreme Doughnuts

The benefits of getting vaccinated against Covid-19 — namely, protection against a dangerous virus — should be obvious by this stage in the pandemic.

If that isn’t sufficient motivation, consider the swag.

Businesses across the United States and beyond are offering free merchandise and other stuff to people who receive Covid shots. The perks include free rides, doughnuts, money, arcade tokens and even marijuana.

Experts in behavioral motivation say that offering incentives is not necessarily the most effective or cost-efficient way to increase vaccine uptake. But that hasn’t stopped the freebies from piling up.

In Cleveland, the Market Garden Brewery is offering 10-cent beers to the first 2021 people who show a Covid-19 vaccine certificate. “Yes, you read that right,” the brewery says on its website. “Ten Cents.”

prerolled joint until the end of the month.

Chobani provides free yogurt at some vaccination sites. And Krispy Kreme said on Monday that for the rest of the year, it would give one glazed doughnut per day to anyone who provides proof of a Covid-19 vaccination.

As vaccinations accelerated across the United States, “We made the decision that said, ‘Hey, we can support the next act of joy,’ which is, if you come by, show us a vaccine card, get a doughnut any time, any day, every day if you choose to,” the company’s chief executive, Michael Tattersfield, told Fox News.

The Krispy Kreme initiative is no relation to the “vaccinated doughnuts” that were sold last month by a bakery in Germany, garnished with plastic syringes that dispense a sweet, lemony-ginger amuse-bouche. It also does not entitle vaccinated Americans to endless doughnuts, as Mr. Tattersfield seemed to imply in his Fox News interview — just one per day, as the company notes on its website.

In a promotion it is calling “Tokens for Poke’ns,” Up-Down, a chain of bars featuring vintage arcade games, is offering $5 in free tokens to guests who present a completed vaccination card. Up-Down, which has six locations in five Midwestern states, is extending the offer to guests who visit within three weeks of their final dose.

Cleveland Cinemas, a movie-theater chain in Ohio, is offering a free 44-ounce popcorn at two of its locations to anyone who presents a vaccination card through April 30.

The Times of Israel reported.

Presenting cards for so many promotions might cause some wear and tear. To protect the cards from damage, Staples is offering to laminate them at no charge after customers have received their final dose. The promotion runs through May 1.

Some vaccine perks flow from corporations to their employees. Tyson Foods, Trader Joe’s and others pay for the time it takes them to get vaccinated, while Kroger pays them a $100 bonus.

study, Ms. Dai and her colleagues found that text messages could boost uptake of influenza vaccinations. The most effective texts were framed as reminders to get shots that were already reserved for the patient. They also resembled the kind of communication that patients expect to receive from health care providers.

Jon Bogard, a graduate student at U.C.L.A. who contributed to the study, said that policymakers should proceed with caution on incentives because they can sometimes backfire. One problem is that the campaigns are expensive, he said. Another is that people receiving shots could see a large incentive as a sign that “vaccines are riskier than they in fact are.”

A better alternative, Mr. Bogard said, could be handing out “low-personal-value, high-social-value” objects — like stickers and badges — that tap into a larger sense of “social motivation and accountability.”

There appears to be no shortage of such swag swirling around the world’s hospitals and vaccination clinics.

Hartford, Conn., people receiving shots can pick up an “I got my Covid-19 vaccination” sticker bearing the home team’s mascot, a goat.

If you aren’t satisfied with the vaccine-related style accouterment at your local clinic, there are plenty of options available for purchase online.

One badge — “I got my Fauci ouchi” — pays homage to America’s best-known doctor, Dr. Anthony S. Fauci.

“Thanks, science,” says another.

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The AstraZeneca vaccine protects fully against Covid-19’s worst outcomes, new study shows.

largest known coronavirus outbreaks early in the pandemic, are now eligible for vaccines in at least 26 states, a New York Times survey found.

The expansion of vaccines to food processing workers comes amid rapid widening of eligibility, especially for essential workers at greater risk of contracting the virus. Almost every state is vaccinating some subset of frontline workers, but the list of eligible professions varies widely. In at least six states, food processing workers are eligible in certain counties but not in others.

Meat and poultry processing facilities have largely remained open even as large outbreaks infected thousands of workers and killed dozens in the first months of the pandemic. The virus started to spread rapidly in meatpacking facilities as assembly-line workers stood side by side in tight quarters.

A JBS USA pork production plant in Worthington, Minn., with more than 700 recorded coronavirus cases held a mass vaccination event on Friday. JBS USA, a subsidiary of JBS S.A., a Brazilian company that is the world’s largest meat-processing firm, has offered employees who receive the vaccine $100 incentives.

“There was a lot of skepticism among members, for a lot of different reasons,” said Matt Utecht, who represents the Worthington workers as president of the United Food and Commercial Workers Local 663 union. He said union representatives went to the facility repeatedly in recent months to share information about the vaccine, and signed up about 1,500 of the union’s roughly 1,850 members.

“It’s been a daily grind of educating, talking, communicating,” he said.

The production and distribution of vaccines has been steadily ramping up in the United States. The Centers for Disease Control and Prevention said on Saturday that about 79.4 million people had received at least one dose of a Covid-19 vaccine, including about 43 million people who have been fully vaccinated. About 2.25 million doses are given each day on average, up from less than a million two months ago.

With demand for vaccines still outpacing supply, states have faced competing interests in deciding which groups to prioritize. Eligibility opened to many food processing workers in early March across much of the Midwest, where meatpacking and food production are a major part of the economy and often a source of employment for recent immigrants.

In Kansas, where food processing workers are now eligible for the vaccine, nearly 4,000 reported cases have been tied to outbreaks in meatpacking plants, more than in any other setting except long-term care centers and correctional facilities.

“This is a livelihood that supports a number of immigrant populations,” said Marci Nielsen, the Kansas governor’s chief adviser on Covid-19. “And it was very important for the governor to send out a signal that she wants to keep those families safe and to keep these industries open.”

Bonnie G. Wong and

The AstraZeneca vaccine at a hospital in Milan last week.
Credit…Alessandro Grassani for The New York Times

The coronavirus vaccine developed by AstraZeneca and the University of Oxford 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. However, AstraZeneca did not disclose how many volunteers had developed severe Covid-19 or had to be hospitalized after receiving the placebo, making it difficult to know how statistically powerful those findings are.

A prayer service at the Islamic Center in Sandy, Utah, last year. At least one American mosque is having a popup vaccination event to give members the chance to get two shots before Ramadan begins.
Credit…Francisco Kjolseth/The Salt Lake Tribune, via Associated Press

With Ramadan less than a month away, some Muslim organizations in the United States have begun addressing a critical question: whether the dawn-to-dusk Ramadan fast prohibits Muslims from receiving vaccine injections during daylight hours.

The executive director of the Islamic Society of North America, Basharat Saleem, said that numerous scholars of Islamic law had been consulted on the matter.

“The answer is no,” he said. “It does not break the fast.”

The group joined with dozens of others last year in organizing a National Muslim Task Force on Covid-19, which has taken advisement from Muslim jurists. They were in general agreement, Mr. Saleem said, that getting a Covid-19 vaccine was acceptable during Ramadan or at any other time. A shot “will not invalidate the fast because it has no nutritional value and it is injected into the muscle,” the task force announced, a ruling that in the past has covered flu shots and other vaccinations.

Whether vaccinations are permitted during Ramadan is not only a concern among Muslims, and perhaps not even the chief one; there have been questions around the world as well about the presence of forbidden ingredients, such as pork products, in the vaccines. Some have also expressed misgivings about the Johnson & Johnson vaccine similar to those of some Catholic leaders, given that cells used in its development and production had a remote connection to abortion.

Muslim health care workers, even those who have been publicly urging people to get vaccinated, have acknowledged the ethical difficulties.

“These decisions are a matter of personal conscience,” said Dr. Hasan Shanawani, the president of American Muslim Health Professionals and a practicing pulmonologist in Michigan. But the preservation of life is one of the highest principles in Islam, he said, and given the current scarcity of vaccines in many places, the ethics, to him, were straightforward.

Declining a vaccine means “potentially putting all of us at risk,” said Dr. Shanawani, who has treated hundreds of Covid-19 patients over the past year. “Take the vaccine that’s available to you. God is the most forgiving.” When the present emergency has passed, he added, then a person can be more discriminating about which vaccine to take.

Haaris Ahmad, the president of a large and diverse mosque in the Detroit suburbs, said he had heard all of these concerns. He has assured members of the mosque that scholars are in broad agreement that a vaccination would not break the Ramadan fast, and he has also told people that if the Johnson & Johnson vaccine is the only readily available option, they should take it.

But he also acknowledged that people would rather not have to think about these things, especially during the holiest month of the Muslim calendar. So his mosque is hosting a vaccine clinic next Monday night, which would allow people to get in two doses of the Pfizer-BioNTech vaccine just before Ramadan begins in mid-April. And while the event was initially advertised with general language about vaccines, Mr. Ahmad said, the latest flier includes more explicit guidance about what will not be on offer at the clinic: “NOTE,” it reads, “Not J&J.”

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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.

[yelling; sirens]

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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.

“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.

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 pharmacist preparing a Covid-19 vaccine at the Cherokee Nation Outpatient Health Center in Tahlequah, Okla., this month.
Credit…Shane Brown for The New York Times

The rapid development of Covid-19 vaccines, achieved at record speed and financed by massive public funding in the United States, the European Union and Britain, represents a great triumph of the pandemic. Governments partnered with drugmakers, pouring in billions of dollars to procure raw materials, finance clinical trials and retrofit factories. Billions more were committed to buy the finished product.

But this Western success has created stark inequity. Residents of wealthy and middle-income countries have received about 90 percent of the nearly 400 million vaccines delivered so far. Under current projections, many of the rest will have to wait years.

A growing chorus of health officials and advocacy groups worldwide are calling for Western governments to use aggressive powers — most of them rarely or never used before — to force companies to publish vaccine recipes, share their know-how and ramp up manufacturing.

The prospect of billions of people waiting years to be vaccinated poses a health threat to even the richest countries. One example: In Britain, where the vaccine rollout has been strong, health officials are tracking a virus variant that emerged in South Africa, where vaccine coverage is weak. That variant may be able to blunt the effect of vaccines, meaning even vaccinated people might get sick.

But on March 30, a U.S. patent is expected to be issued on a five-year-old invention in a National Institutes of Health lab that swaps a pair of amino acids in the coronavirus spike protein. This feat of molecular engineering is at the heart of at least five major Covid-19 vaccines, and the United States government will control that patent.

The new patent presents an opportunity — and some argue the last best chance — to exact leverage over the drug companies producing the vaccines and pressure them to expand access to less affluent countries.

Pierluigi Marchionne, a veteran police officer in Rome, directing the light traffic last week in the ordinarily jammed Piazza Venezia.
Credit…Nadia Shira Cohen for The New York Times

ROME — If, as it’s said, all roads lead to Rome, then they intersect at Piazza Venezia, the downtown hub of the Italian capital, watched over by a traffic officer on a pedestal who choreographs streamlined circulation out of automotive chaos.

For many Romans and tourists alike, those traffic controllers are as much a symbol of the Eternal City as are the Colosseum or the Pantheon.

That may explain the media frenzy last week over the return of the pedestal (plus its traffic cop) after a yearlong hiatus while the piazza was being repaved — even though there was not much traffic to direct, because of the widespread lockdown that began last week in hopes of containing a surge in coronavirus cases.

“In this difficult period, I think that it was seen as a sign of something returning to normal,” said Fabio Grillo, 53, who, with 16 years under his belt, is the senior member of the team of four or five municipal police officers who direct traffic from the Piazza Venezia pedestal.

In rain or sleet, or sweltering through Rome’s sultry summers, officers have directed traffic from the Piazza Venezia pedestal near the mouth of the Via del Corso, one of Rome’s main streets, for as long as anyone can remember. And the gestures they make with their white-gloved hands are things that all Italian motorists dutifully memorize for their driver’s tests. (Important note: Two hands straight out with the palms facing motorists is equivalent to a red light.)

“It’s been compared to conducting an orchestra,” Mr. Grillo said.

Apart from regular traffic, Piazza Venezia is also a crossroads that leads to City Hall, the Parliament, Italy’s presidential palace and a national monument where visiting heads of state routinely pay homage — which all contributes to the tangle at the hub.

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:

A vaccination clinic in Mississauga, Ontario, this month. The United States has said it will send millions of doses of AstraZeneca’s Covid-19 vaccine, which it has not yet approved for use, to Canada and Mexico.
Credit…Nathan Denette/The Canadian Press, via Associated Press

To many Canadians, it seemed decidedly unneighborly. Canada’s initial coronavirus vaccination program moved at a stately pace over the winter, while inoculations in the United States raced ahead. But Washington was unwilling to share any of its stockpile of tens of millions of doses of a vaccine it had yet to approve for use by Americans.

Last week, that shifted. After weeks of suggesting that any vaccine diplomacy was well into the future, Jen Psaki, the White House press secretary, said Thursday that the United States was planning to share 1.5 million doses of the AstraZeneca vaccine with Canada and 2.5 million doses with Mexico.

The White House announcement seemed to catch Ottawa officials off guard. Hours passed before Anita Anand, the cabinet minister responsible for buying vaccines, issued a statement that read more like an insurance policy than a note of thanks.

“After numerous discussions with the Biden administration, Canada is in the process of finalizing an exchange agreement,” it read in part.

Ms. Anand and Prime Minister Justin Trudeau had little more to add on Friday afternoon, saying only that the talks were still underway and that the details would come later.

From Ms. Psaki’s remarks, it appears that the United States will officially just be lending Canada and Mexico the vaccines. It is unclear whether they will ultimately have to be replaced in kind or if the loan will be of the forgivable nature. She also said that the United States might soon share surpluses of other vaccines.

Pharmacy technicians filling syringes with vaccine in Portland, Maine, this month.
Credit…Robert F. Bukaty/Associated Press

Melanie Allen, a high school English teacher, was in a bind. She works in one state and lives in another. And both denied her a Covid-19 vaccine.

Ms. Allen, who lives in Chatham, N.H., but works in Maine, said she was told that she was not eligible for a vaccine by officials in both states. Although teachers are now eligible for vaccination in every state, her New Hampshire residency blocked her from receiving the vaccine in Maine, she said.

And in New Hampshire, she was told she is not eligible because she does not teach in the state and, at 45, does not meet the age requirement.

And so, she waited.

On Friday, Ms. Allen finally got her first shot after a health center in Maine decided to vaccinate teachers no matter where they lived.

“Even though the states haven’t officially changed their tune,” she said, “it was heartening to see that the local community was stepping in to make sure the right thing happened.”

About half of the states have residency requirements for vaccinations, though most allow out-of-state workers to receive a shot if they meet other eligibility conditions, said Jennifer Kates, senior vice president of the Kaiser Family Foundation, a nonprofit focused on national health issues.

Connecticut, for example, allows workers who live in other states to receive the vaccine if they can prove that they work in an approved industry.

States including Florida and New Hampshire limited the rollout of Covid-19 vaccines to residents in hopes of stemming complaints of “vaccine tourism,” where a person could drive across a state line for a shot that they would not be eligible for back home.

Although most states allow nonresident workers to be inoculated, Ms. Kates said people living in one state and working in another might run into snags as they navigate the scheduling process.

“When you have such a patchwork of requirements,” Ms. Kates said, “it’s like a puzzle, and people who really want to get vaccinated are trying to figure how they can get that last piece of the puzzle.”

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.

Restaurants transformed their outdoor dining spaces into areas where people could gather to connect amid isolation.
Credit…Sasha Arutyunova for The New York Times

In the year since the pandemic began, people learned to be together while apart and navigated the pain of feeling apart while together. Screens — small and large — became crucial links to the rest of the world.

Activities and routines that commanded crowds — visiting museums, attending concerts, working out, learning, traveling, partying — ceased or found a new life online. Holidays usually celebrated by family gatherings became fraught with consequences.

Memories of a prepandemic world, where people could stand shoulder to shoulder with faces bare, began to feel like dreams — as did moments of unexpected connection.

Couples in quarantine learned a lot about their significant others. In some instances, these revelations were not happy ones: Lawyers and mediators saw an increase in clients looking to divorce as soon as courts reopened.

In other cases, being confined together made couples stronger. Engagements and pregnancy announcements seemed to pop up constantly on social media. And there were plenty of weddings.

For many of those who were single, dating felt impossible in the early months of the pandemic. Sex toy sales increased. Eventually, emotional and physical needs began to weigh heavy, and people across the country found ways to meet and hook up within the confines of their comfort.

In search of safety, stability and support, adult children moved in with parents and parental figures, sometimes without a fixed departure date. In doing so, they rediscovered one another, and experienced the joys of bonding and the suffocation of constant proximity.

Though some Americans were able to hole up at home, their kitchen tables and couches converted into makeshift offices, others continued to work in public spaces. Delivery drivers dealt with health risks, theft and assault. Airline workers who weren’t furloughed had to confront passengers who refused to wear masks.

But things have opened up, slowly, over the past few months, as cases have fallen and people have become inoculated. Last week, President Biden promised that there would be enough vaccine doses for every American adult by May, and the Centers for Disease Control and Prevention announced that vaccinated people can begin gathering indoors again — a sign that people will soon be finding their way back to one another.

Brittany Marsh, who owns a pharmacy in Little Rock, Ark., administering a Covid-19 vaccine this month. She said the Dr. B service made it easier to distribute leftover doses.
Credit…Rory Doyle for The New York Times

In the hustle to score an elusive vaccine appointment, the leftover dose has become the stuff of pandemic lore.

Extra shots — which must be used within hours once taken out of cold storage — have been doled out to drugstore customers buying midnight snacks, people who are friends with nurses and those who show up at closing time at certain grocery stores and pharmacies. At some larger vaccination sites, the race to use every dose sets off a flurry of end-of-the-day phone calls.

In every case, if the leftover dose does not find an available arm, it must go into the trash.

Now, a New York-based start-up is aiming to add some order to the hunt for leftover doses. Dr. B, as the company is known, is matching vaccine providers who find themselves with extra vaccines to people who are willing to get one at a moment’s notice.

Since the service began last month, more than 500,000 people have submitted a host of personal information to sign up for the service, which is free to join and is also free to providers. Two vaccine sites have begun testing the program, and the company said about 200 other providers had applied to participate.

Dr. B is just one attempt at coordinating the chaotic patchwork of public and private websites that allow eligible people to find vaccine appointments. And while it does not solve the broader structural issues around vaccine distribution, if it scales up the way some hope that it will, it could serve as a model for a better, more equitable way of scheduling vaccinations.

“Ultimately, patients need this vaccine, and there’s providers who need help getting it to the people of priority,” Cyrus Massoumi, a tech entrepreneur and founder of Dr. B, said in an interview. “That’s my motivation.”

Mr. Massoumi said he was financing the project out of his own pocket and had no plans to collect revenue. The company is named after his grandfather, who was nicknamed Dr. Bubba and became a doctor during the 1918 influenza pandemic.

The service suffers, however, from some of the same barriers that have marred vaccination efforts so far. Although signing up is simple, doing so requires an internet connection as well as ready access to a cellphone. Because of the last-minute nature of leftover doses, participants must have flexible schedules and access to transportation.

“It’s still heavily internet dependent, so it will depend on who hears about it,” said Arthur Caplan, a medical ethicist at New York University’s Grossman School of Medicine. “It seems he’s trying to solve a problem and do some good, but I’m sad that governments — counties, cities, national organizations — didn’t prepare for this and then didn’t react more quickly to give advice and guidance.”

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China’s Dr. Fauci, Dr. Zhang Wenhong, Urges Restraint in Fighting Covid-19

China has imposed some of the toughest lockdowns in the world to stop Covid-19. One city sealed apartment doors, leaving residents with dwindling food and medicine. One village tied a local to a tree after he left home to buy cigarettes. Beijing forced people to leave their pets behind when they went into quarantine.

Few officials spoke up against the excesses, given the central government’s obsession with its anti-coronavirus campaign. That hasn’t stopped Dr. Zhang Wenhong.

Dr. Zhang, an infectious-disease specialist and perhaps China’s most trusted voice on Covid-19, has spoken out publicly against excessive lockdowns, though he hasn’t criticized individual cities. Fighting the pandemic, he likes to say, is like “catching mice in a china shop.”

“We hope that our pandemic prevention measures won’t affect public life too much,” Dr. Zhang wrote on Jan. 24, after a second wave of infections prompted tough clampdowns.

video a few days later, “life would be too hard.”

Dr. Zhang may be China’s closest analogue to Dr. Anthony S. Fauci, the American infectious-disease specialist who became the public face of stopping the coronavirus amid the chaos of the Trump administration. A consummate technocrat, Dr. Zhang comes across as neither political nor ideological. Yet, by offering his expert opinions straight, he pushes back against the authoritarian instinct in a system that often overreacts with draconian measures.

A top academic at Fudan University in Shanghai and a member of the Communist Party, Dr. Zhang led Shanghai’s expert panel on Covid-19, giving him considerable authority over the city’s response.

propaganda, conspiracy theories and crude nationalism.

viewed more than 860 million times on his department’s official WeChat account alone.

Maintaining a high profile in China often requires discretion. Late last year, Jack Ma, the technology billionaire, publicly criticized regulators. The authorities quickly swooped down on his business empire.

Dr. Zhang doesn’t challenge the government, but neither does he always toe the official line. Late last year, some Chinese officials pointed to findings that the virus had been found on the packaging of imported food, suggesting that the coronavirus may have been brought to China from overseas. Dr. Zhang has told his audience not to worry about it: “The chance of catching the virus from imported goods,” he said, “is lower than dying in a plane crash.”

“I’m not going to hide the information because I’m worried that I could say something wrong and cause some controversies,” he said over the summer. “We always share what we know.”

responded that protein helps build the immune system.

Still, he has kept a high profile without drawing major ire from the government or sustained criticism from the nationalists. Some of that stems from China’s pride in quickly containing the coronavirus. Dr. Zhang, who played a role in that, has won a number of awards from official groups.

In watching his speeches, I found another key to his sustained appeal. In his impromptu speech at a national teaching award ceremony in September, he said the essence of education is acknowledging human dignity. Mr. Zhang appeals to the humanity of his audience and, by admitting his own foibles, shows the authorities and the public that he is merely human, too.

In one speech, he mentioned that some victims of avian flu had caught it from taking care of their infected loved ones, and that female patients were more likely to infect their doting mothers than their absent husbands. “At that moment,” he told the audience, “I lost faith in romantic love.”

said, “I would have worked on my deltoid.”

interview last June, a reporter asked him whether anybody had reminded him to be mindful of his status as an expert and the head of an expert government panel.

“People are smart,” he responded. “They know whether you’re telling them truth or lies.”

When he gets public accolades, he often uses the occasion to highlight his causes, like more funding for infectious-disease research and for increasing the public awareness of tuberculosis and hepatitis B, two of the most common infectious diseases in China.

He also talks about people who deserved more attention, like the women among the pandemic responders whose role has often taken a back seat to the men’s in the media. “Men are on camera more,” he said at a forum on the subject, “but women did more work.”

Then he turned to the female medical workers, and bowed.

View Source

China’s Dr. Fauci Urges Restraint in Fighting Covid-19

China has imposed some of the toughest lockdowns in the world to stop Covid-19. One city sealed apartment doors, leaving residents with dwindling food and medicine. One village tied a local to a tree after he left home to buy cigarettes. Beijing forced people to leave their pets behind when they went into quarantine.

Few officials spoke up against the excesses, given the central government’s obsession with its anti-coronavirus campaign. That hasn’t stopped Dr. Zhang Wenhong.

Dr. Zhang, an infectious-disease specialist and perhaps China’s most trusted voice on Covid-19, has spoken out publicly against excessive lockdowns, though he hasn’t criticized individual cities. Fighting the pandemic, he likes to say, is like “catching mice in a china shop.”

“We hope that our pandemic prevention measures won’t affect public life too much,” Dr. Zhang wrote on Jan. 24, after a second wave of infections prompted tough clampdowns.

video a few days later, “life would be too hard.”

Dr. Zhang may be China’s closest analogue to Dr. Anthony S. Fauci, the American infectious-disease specialist who became the public face of stopping the coronavirus amid the chaos of the Trump administration. A consummate technocrat, Dr. Zhang comes across as neither political nor ideological. Yet, by offering his expert opinions straight, he pushes back against the authoritarian instinct in a system that often overreacts with draconian measures.

A top academic at Fudan University in Shanghai and a member of the Communist Party, Dr. Zhang led Shanghai’s expert panel on Covid-19, giving him considerable authority over the city’s response.

propaganda, conspiracy theories and crude nationalism.

viewed more than 860 million times on his department’s official WeChat account alone.

Maintaining a high profile in China often requires discretion. Late last year, Jack Ma, the technology billionaire, publicly criticized regulators. The authorities quickly swooped down on his business empire.

Dr. Zhang doesn’t challenge the government, but neither does he always toe the official line. Late last year, some Chinese officials pointed to findings that the virus had been found on the packaging of imported food, suggesting that the coronavirus may have been brought to China from overseas. Dr. Zhang has told his audience not to worry about it: “The chance of catching the virus from imported goods,” he said, “is lower than dying in a plane crash.”

“I’m not going to hide the information because I’m worried that I could say something wrong and cause some controversies,” he said over the summer. “We always share what we know.”

responded that protein helps build the immune system.

Still, he has kept a high profile without drawing major ire from the government or sustained criticism from the nationalists. Some of that stems from China’s pride in quickly containing the coronavirus. Dr. Zhang, who played a role in that, has won a number of awards from official groups.

In watching his speeches, I found another key to his sustained appeal. In his impromptu speech at a national teaching award ceremony in September, he said the essence of education is acknowledging human dignity. Mr. Zhang appeals to the humanity of his audience and, by admitting his own foibles, shows the authorities and the public that he is merely human, too.

In one speech, he mentioned that some victims of avian flu had caught it from taking care of their infected loved ones, and that female patients were more likely to infect their doting mothers than their absent husbands. “At that moment,” he told the audience, “I lost faith in romantic love.”

said, “I would have worked on my deltoid.”

interview last June, a reporter asked him whether anybody had reminded him to be mindful of his status as an expert and the head of an expert government panel.

“People are smart,” he responded. “They know whether you’re telling them truth or lies.”

When he gets public accolades, he often uses the occasion to highlight his causes, like more funding for infectious-disease research and for increasing the public awareness of tuberculosis and hepatitis B, two of the most common infectious diseases in China.

He also talks about people who deserved more attention, like the women among the pandemic responders whose role has often taken a back seat to the men’s in the media. “Men are on camera more,” he said at a forum on the subject, “but women did more work.”

Then he turned to the female medical workers, and bowed.

View Source