On Tuesday morning, U.S. federal health regulators recommended a pause in the use of Johnson & Johnson’s Covid-19 vaccine while they investigated six reports of blood clots in women ages 18 to 48. One has died, and a second is hospitalized in critical condition.
As of Monday, 6.8 million people in the United States had received the vaccine without any other serious adverse reactions reported.
Experts have yet to determine to what extent, if any, the vaccine is responsible for the clots. But the investigation follows actions by European regulators who concluded that a vaccine made by AstraZeneca may also be the cause of a similar, extremely rare clotting disorder.
U.S. and European public health experts have emphasized that for most people, the benefits of the Covid vaccines far outweigh the risks.
recommends that people who have received the Johnson & Johnson vaccine within the past three weeks should contact their doctors if they experience severe headaches, abdominal pain, leg pain or shortness of breath. People should not be concerned about mild headaches and flu-like symptoms in the first few days after vaccination. Those are common, harmless side effects brought on by the immune system’s production of a defense against the coronavirus.
What is a pause?
During clinical trials and after vaccines go into wide use, experts keep track of any medical problems experienced by people who receive them. If an unusually large cluster of cases turns up, regulators may decide to pause a trial or stop the use of a vaccine to investigate further.
Pauses are common, and typically the investigations reveal that the medical problems were a matter of coincidence. If the investigation reveals that a vaccine does pose a risk, regulators may write new guidance about who should or should not receive it.
regulators have said, roughly one in 1,000 people are affected by a blood clot in a vein every year.
But the clotting disorder of concern in the vaccine recipients is much rarer and different from typical blood clots. In addition to clotting in the brain — called cerebral venous sinus thrombosis, or CVST for short — the patients all had a notably low level of platelets, which left them prone to abnormal bleeding.
said the company was aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine. “In addition, we have been reviewing these cases with European health authorities,” the company said in its statement. “We have made the decision to proactively delay the rollout of our vaccine in Europe.”
Is this the same problem linked to the AstraZeneca vaccine in Europe?
At the news conference on Tuesday, Dr. Marks of the F.D.A. said the cases were “very, very similar.”
a number of possible symptoms, including swelling in the leg, persistent abdominal pain, severe and persistent headaches or blurred vision, and tiny blood spots under the skin beyond the area where the injection was given.
But that set of symptoms was so vague that almost immediately, British emergency rooms experienced a surge in patients who were worried that they fit the description.
Nonetheless, German researchers say that such symptoms in vaccine recipients must be followed up. Blood tests can detect the antibodies.
Can the disorder be treated?
Doctors in Germany and Norway have treated patients with blood-thinning drugs to try to stop the growth of the clots, and with intravenous immune globulin, which can help eliminate the misguided antibodies that are causing the problem.
AstraZeneca vaccines. One recipient, a physician in Florida, died from a brain hemorrhage when his platelet levels could not be restored, and others have been hospitalized. U.S. health officials have said that the cases are being investigated, but they have not reported the findings of those reviews and have yet to indicate that there is any link to the vaccines.
Lawyers and securities experts said a multibillion-dollar family office like Archegos could avoid making 13F disclosures, but it would require threading a needle: The firm could have managed money for only Mr. Hwang and his spouse — not other family members, fund employees or his charity, which operated on the same floor of a Midtown Manhattan office building. The firm could also have been able to skip filing a 13F if it sold off enough stocks to fall below the $100 million threshold before the end of each quarter. It also could have requested confidential treatment from the S.E.C. to keep such disclosures private, lawyers and experts said.
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Archegos was set up to make filings to the S.E.C. — it had its own Central Index Key number — but a search for documents returns no results.
The S.E.C. has opened an informal inquiry into Archegos and the spillover effects of its collapse, which caused billions of dollars in losses at banks around the globe. Regulators have declined to comment on the investigation.
Senator Sherrod Brown, chairman of the Senate Banking Committee, sent letters to the half-dozen banks that did business with Archegos — including Credit Suisse, Goldman Sachs and Morgan Stanley — seeking information about their dealings with Mr. Hwang’s firm. That includes information about any transactions that “would be subject to regulatory reporting with the S.E.C.”
The rules for 13F filings apply to “registered investment advisers and exempt reporting advisers that manage accounts on behalf of others, including advisers to separately managed accounts, private funds, mutual funds, and pension plans.” They must file if they have “discretion” over $100 million or more in securities at the end of a quarter.
Nicolas Morgan, a former S.E.C. lawyer, said a family office could get around the stock reporting requirement in only rare circumstances. It “would be outside the norm” to not file a 13F, said Mr. Morgan, a partner in the white-collar defense practice at Paul Hastings.
After the failure of Archegos, Americans for Financial Reform, an advocacy group, sent a letter to the S.E.C. calling for a review of 13F filings and whether gaps in the disclosure process created the registration exemption for family offices, which control roughly $6 trillion in assets, according to Campden Wealth, which provides research and networking opportunities to wealthy families.
Ant Group, the online finance affiliate of the Chinese e-commerce giant Alibaba, announced a sweeping overhaul of its business on Monday in response to demands from China’s government, which is moving swiftly to curb the power of the country’s internet giants.
Beijing’s campaign has taken the corporate empire of Jack Ma, Alibaba’s billionaire co-founder and Ant’s controlling shareholder, as an early major target. On Saturday, China’s antitrust authority fined Alibaba $2.8 billion for abusing its dominance in digital retail — a record amount for violations of the country’s antimonopoly law.
As part of what both Ant Group and Chinese officials called a “rectification plan,” the company on Monday said it would apply to set up as a financial holding company, which would bring closer supervision and requirements that it hold onto more money that it might otherwise lend or put to profitable use.
Ant also said it would change the way it collects and uses personal information to improve data security and prevent abuse. And it said it would improve corporate governance to better adhere to rules about fair competition.
said in a statement. “Using the rectification as an opportunity, Ant Group will reinforce our commitment to serve consumers, small businesses and the real economy.”
Chinese officials forced Ant to call off its blockbuster initial public offering last November, mere days before its shares had been expected to debut. A month later, regulators ordered Ant to correct what they called a litany of failings in its business, which includes a range of financial services, from payments to credit, that are offered through its Alipay app.
Alipay’s user base of more than 700 million people in China gives Ant huge sway within the country’s financial system.
China first said last September that companies owning two or more financial businesses would have to register as financial holding companies and be subject to increased government oversight. In a news briefing at the time, an official at China’s central bank named Ant as one of several companies that would likely have to restructure under the new rules.
The aim, officials said, is to better monitor systemic risks that have arisen as more nonfinancial companies have “blindly” entered the financial industry.
Two days after Chinese regulators fined the e-commerce giant Alibaba $2.8 billion for placing illegal restrictions on the vendors on its shopping sites, the company said it would lower the fees it charges such merchants and invest in new services for them.
“We will incur additional cost,” Alibaba’s chief executive, Daniel Zhang, said on Monday during a conference call with analysts. “We don’t view this as a one-off cost. We view this as a necessary investment to enable our merchants to have a better operation on our platform.”
The company’s chief financial officer, Maggie Wu, said Alibaba had set aside “billions” of renminbi in additional annual spending to support this initiative but did not offer more specifics. One U.S. dollar is around 6.6 renminbi.
China’s antitrust penalty against Alibaba far exceeds previous fines it has levied for anticompetitive business practices. It reflects the government’s growing concern about internet giants’ ability to tilt the playing field against their rivals and take advantage of their consumers.
In Alibaba’s case, the authorities focused on the company’s practice of blocking vendors from selling their wares on competing sites. Mr. Zhang said on Monday that such exclusivity arrangements previously covered only some digital storefronts operated by big brands on Tmall, Alibaba’s higher-end platform.
Mr. Zhang said Alibaba did not expect the ending of such arrangements to have any “material negative impact” on the company’s business. And Joseph C. Tsai, Alibaba’s executive vice chairman, offered an upbeat assessment of what Beijing’s increasing scrutiny of large digital platforms means for China’s internet industry.
“The regulators’ communication to the public is very clear that they’re affirming our business model,” Mr. Tsai said. “We feel very comfortable that there’s nothing wrong with the fundamental business model of a platform company. These regulatory actions are undertaken to ensure fair competition in order to benefit the public.”
“We are pleased that we’re able to put this matter behind us,” he said.
China on Saturday said it was imposing a record $2.8 billion fine on the e-commerce titan Alibaba for monopolistic business practices, the government’s toughest action to date in its campaign to regulate the country’s internet giants more closely.
Beijing’s market watchdog began investigating Alibaba in December for potential antitrust violations including preventing merchants from selling their goods on other shopping platforms. On Saturday, the regulator said its investigation had concluded that Alibaba had hindered competition in online retail in China, affected innovation in the internet economy and harmed consumers’ interests.
The fine on Alibaba, one of China’s most valuable private companies, exceeds the $975 million antitrust penalty that the Chinese government imposed on Qualcomm, the American chip giant, in 2015. Even so, it is unlikely to leave a substantial dent on Alibaba’s fortunes. The regulator said the fine represented 4 percent of Alibaba’s domestic sales in 2019. The group reported profits of more than $12 billion in the last three months of 2020 alone.
Alibaba said in a statement that it would accept the penalty “sincerely” and would strengthen its internal systems “to better carry out its social responsibilities.”
proposed updating the country’s antimonopoly law with a new provision for large internet platforms such as Alibaba’s. In November, officials halted the plans of Alibaba’s sister company, the finance-focused Ant Group, to go public and tightened oversight of internet finance.
In December, it opened the antimonopoly investigation into Alibaba — a startling turn in the fortunes of Jack Ma, Alibaba’s co-founder, whom people in China had long held up as an icon of entrepreneurial pluck.
Skepticism about the clout of large internet companies has been on the rise in the United States and Europe, too. Western regulators have repeatedly fined Goliaths such as Google in recent years for various antitrust violations. But such penalties generally have not changed the nature of the companies’ businesses enough to mitigate concerns about their power.
Federal officials have said they still expect enough supply from the two other authorized vaccine manufacturers to be able to fulfill President Biden’s promise of having enough doses for all adults in the country by the end of May.
Nonetheless, states were counting on the Johnson & Johnson vaccine to fill important gaps in vaccination campaigns. Easier to store and transport — the vaccine can be kept at normal refrigeration temperatures for three months — states had begun using it in transformative ways, on homeless populations, migrant workers and college students.
Federal administrators divide vaccine doses nationwide based on each state’s adult population. That means that California will bear the brunt of the reduction: After receiving 572,700 doses of the Johnson & Johnson vaccine this week, it will get only 67,600 next week, according to Centers for Disease Control and Prevention data.
In Texas, the allocation will drop to 46,300 from 392,100. Florida, which received 313,200 shots this week, will get 37,000 next week. Guam, which received 16,900 doses this week, will receive none next week.
In Michigan, Gov. Gretchen Whitmer said Friday that she had urged President Biden to surge Covid-19 vaccines into her state, where a worst-in-the-nation outbreak has filled hospitals and forced some schools to close. “At this point that’s not being deployed, but I am not giving up,” Ms. Whitmer said, describing a Thursday evening call with the president. “Today it’s Michigan and the Midwest. Tomorrow it could be another section of our country.”
Ms. Whitmer, a Democrat whom the president considered as a potential running mate, took pains to praise aspects of Mr. Biden’s coronavirus response at a Friday news conference. But Ms. Whitmer said a rapid influx of shots, particularly the Johnson & Johnson vaccine, was essential to tamping down case numbers even as she resisted additional restrictions on gatherings and businesses.
Jeff Zients, the White House Covid coordinator, said at a news briefing on Friday that the administration does not plan to shift additional vaccine doses to hard-hit states like Michigan, which is slated to get another 17,500 Johnson & Johnson doses next week, an 88 percent drop compared to the nearly 148,000 doses it received this week, according to C.D.C. data.
Two reports published on Friday in a leading medical journal help to explain how AstraZeneca’s Covid vaccine can, in rare cases, cause serious and sometimes fatal blood clots.
Scientific teams from Germany and Norway found that people who developed the clots after vaccination had produced antibodies that activated their platelets, a blood component involved in clotting. The new reports add extensive details to what the researchers have already stated publicly about the blood disorder.
Why the rare reaction occurred is not known. Younger people appear more susceptible than older ones, but researchers say no pre-existing health conditions are known to predispose people to the problem, so there is no way to tell if an individual is at high risk.
Reports of the clots have already led a number of countries to limit AstraZeneca’s vaccine to older people, or to stop using it entirely. The cases have dealt a crushing blow to global efforts to halt the pandemic, because the AstraZeneca shot — easy to store and relatively cheap — has been a mainstay of vaccination programs in more than 100 countries.
statement on its website, AstraZeneca said it was “actively collaborating with the regulators to implement these changes to the product information and is already working to understand the individual cases, epidemiology and possible mechanisms that could explain these extremely rare events.”
The two new reports were published by The New England Journal of Medicine. One from Germany describes 11 patients, including nine women ages 22 to 49. Five to 16 days after vaccination, they were found to have one or more clots. Nine had cerebral venous thrombosis, a clot blocking a vein that drains blood from the brain. Some had clots in their lungs, abdomen or other areas. Six of the 11 died, one from a brain hemorrhage.
One patient had pre-existing conditions that affected clotting, but during a news briefing on Friday, Dr. Andreas Greinacher, an author of the report, said those conditions most likely played only a minor role in the disorder that occurred after vaccination.
second report, from Norway, described five patients, one male and four female health care workers ages 32 to 54, who had clots and bleeding from seven to 10 days after receiving the AstraZeneca vaccine. Four had severe clots in the brain, and three died. Severe headaches were among their early symptoms. Like the German patients, all had high levels of antibodies that could activate platelets.
The team from Norway also recommended treatment with intravenous immune globulin. The researchers said the disorder was rare, but “a new phenomenon with devastating effects for otherwise healthy young adults,” and they suggested that it may be more common than previous studies of the AstraZeneca vaccine had indicated.
On Friday, European regulators also said they were reviewing reports of a few blood clot cases that occurred in people who had received the Johnson and Johnson vaccine. In the United States, federal agencies are investigating reports of a different type of unusual blood disorder involving a precipitous drop in platelets that emerged in a few people who had received either the Pfizer-BioNTech or Moderna vaccines.
The annual letter to shareholders by JPMorgan Chase’s chief executive, Jamie Dimon, was published early Wednesday. The letter, which is widely read on Wall Street, is not just an overview of the bank’s business but also covers Mr. Dimon’s thoughts on everything from leadership lessons to public policy prescriptions.
“The U.S. economy will likely boom.” A combination of excess savings, deficit spending, vaccinations and “euphoria around the end of the pandemic,” Mr. Dimon wrote, may create a boom that “could easily run into 2023.” That could justify high stock valuations, but not the price of U.S. debt, given the “huge supply” soon to hit the market. There is a chance that a rise in inflation will be “more than temporary,” he wrote, forcing the Federal Reserve to raise interest rates aggressively. “Rapidly raising rates to offset an overheating economy is a typical cause of a recession,” he wrote, but he hopes for “the Goldilocks scenario” of fast growth, gently increasing inflation and a measured rise in interest rates.
“Banks are playing an increasingly smaller role in the financial system.” Mr. Dimon cited competition from an already large shadow banking system and fintech companies, as well as “Amazon, Apple, Facebook, Google and now Walmart.” He argued that those nonbank competitors should be more strictly regulated; their growth has “partially been made possible” by avoiding banking rules, he wrote. And when it comes to tougher regulation of big banks, he wrote, “the cost to the economy of having fail-safe banks may not be worth it.”
“China’s leaders believe that America is in decline.” The United States has faced tough times before, but today, “the Chinese see an America that is losing ground in technology, infrastructure and education — a nation torn and crippled by politics, as well as racial and income inequality — and a country unable to coordinate government policies (fiscal, monetary, industrial, regulatory) in any coherent way to accomplish national goals,” he wrote. “Unfortunately, recently, there is a lot of truth to this.”
HONG KONG — Political opposition has been quashed. Free speech has been stifled. The independent court system may be next.
But while Hong Kong’s top leaders take a tougher line on the city of more than seven million people, they are courting a crucial constituency: the rich. Top officials are preparing a new tax break and other sweeteners to portray Hong Kong as the premier place in Asia to make money, despite the Chinese Communist Party’s increasingly autocratic rule.
So far, the pitch is working. Cambridge Associates, a $30 billion investment fund, said in March it planned to open an office in the city. Investment managers have set up more than a hundred new companies in recent months. The Wall Street banks Goldman Sachs, Citigroup, Bank of America and Morgan Stanley are increasing their Hong Kong staffing.
“Hong Kong is second only to New York as the world’s billionaire city,” said Paul Chan, Hong Kong’s financial secretary, at an online gathering of finance executives this year.
erupted two years ago. At the same time, it is trying to charm the city’s financial class to keep it from moving to another business-friendly place like Singapore.
“It is a one-party state, but they are pragmatic and they don’t want to hurt business,” Fred Hu, a former chairman of Goldman’s Greater China business, said of Chinese officials.
For apolitical financial types, the changes will have little impact, said Mr. Hu, who is also the founder of the private equity firm Primavera Capital Group. “If you’re a banker or a trader, you may have political views, but you’re not a political activist,” he said.
flowed out of local Hong Kong bank accounts and into jurisdictions like Singapore.
Tensions run taut inside Hong Kong’s gleaming office towers. Even executives who are sympathetic to the government have declined to speak publicly for fear of getting caught in the political crossfire between Beijing and world capitals like Washington and London. Hong Kong’s tough rules on movement in the pandemic may also spark some expatriates to leave in the summer once school ends.
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For now, however, financial firms are doubling down on Hong Kong. Neal Horwitz, an executive recruiter in Singapore, said finance was likely to remain in Hong Kong “until the ship goes down.”
carried interest, which is typically earned by private equity investors and hedge funds. Officials had discussed the plan for years but didn’t introduce a bill until February, and it could pass in the coming months through the city’s Beijing-dominated legislature.
sparked criticism elsewhere, including in the United States. But Hong Kong fears a financial exodus without such benefits, said Maurice Tse, a finance professor at Hong Kong University’s business school.
“To keep these people around we have to give a tax benefit,” he said.
Hong Kong has also proposed a program, Wealth Management Connect, that would give mainland residents in the southern region known as the Greater Bay Area the ability to invest in Hong Kong-based hedge funds and investment firms. Officials have boasted that it would give foreign firms access to 72 million people. Hong Kong and mainland Chinese officials signed an agreement in February to start a pilot program at an unspecified time.
Pandemic travel restrictions have slowed the proposal’s momentum, said King Au, the executive director of Hong Kong’s Financial Services Development Council, but it remains a top priority.
“I want to highlight how important the China market is to global investors,” Mr. Au said.
Mainland money has already helped Hong Kong look more attractive. Chinese firms largely fueled a record $52 billion haul for companies that sold new shares on the Hong Kong Stock Exchange last year, according to Dealogic, a data provider. New offerings this year have already raised $16 billion, including $5.4 billion for Kuaishou, which operates a Chinese video app. The record start has been helped in part by Chinese companies that have been pressured by Washington to avoid raising money in the United States.
triple its hires across China, and a spokeswoman said a Hong Kong staff increase was part of that. Bank of America is adding more people in Hong Kong, while Citi has said it will hire as many as 1,700 people in Hong Kong this year alone.
hew to the party line. Still, it is considering moving some of its top executives to Hong Kong, because it will be “important to be closer to growth opportunities,” Noel Quinn, HSBC’s chief executive, said in February.
Investment funds are flocking to Hong Kong, too, after officials in August lowered regulatory barriers to setting up legal structures similar to those used in low-tax, opaque jurisdictions like the Cayman Islands and Bermuda. Government data shows that 154 funds have been registered since then.
Xi Jinping, China’s top leader, and Li Zhanshu, the Communist Party’s No. 3 official, at one point owned Hong Kong property, according to a trail that can be traced partly through public records.
While officials have welcomed business, they have made clear to the financial and business worlds that they will brook no dissent. In March, Han Zheng, a Chinese vice premier, praised the stock market’s performance and the finance sector in a meeting with a political advisory group but made its limits clear.
“The signal to the business community is very simple,” said Michael Tien, a former Hong Kong lawmaker and businessman who attended the closed-door session. “Stay out of politics.”
LONDON — For months, European countries have seesawed between craving and rebuffing AstraZeneca’s vaccine, with the shot’s fortunes rising and falling on spats over supply and on questions over the efficacy of the vaccine itself.
But few concerns have proved as disruptive to the rollout of the world’s workhorse vaccine in Europe as reports of very rare blood clots in some recipients. Many countries responded by halting the shot’s use, only to start giving it again after an all-clear from regulators at the European Medicines Agency, and then stopped inoculations a second time in certain age groups after doctors became more concerned about the clots.
On Tuesday, those concerns were reinforced yet again when a top vaccines official at the European Medicines Agency said that the vaccine was linked to extremely rare, though sometimes fatal, blood clots in a small number of recipients. It was the first indication from an international regulatory body that the clots may be a real, if very unusual, side effect of the shot.
Regulators now appear to be considering issuing their first formal warnings about the potential side effects — not only in continental Europe, which has long been wary of the shot for political and scientific reasons, but also in Britain, the birthplace of the AstraZeneca vaccine and long its biggest champion, where new data have sown concerns as well.
speedy inoculation program,have also insisted that the vaccine’s benefits far outweighed the risks. They and the company cited a lack of evidence in Britain that the clotting events were any more common than would be expected among people who had never been given AstraZeneca’s vaccine.
But the evidence changed last week when Britain reported 30 cases of the rare blood clots, 25 more than previously. This week, a prominent scientific adviser to the British government said there was “increasing evidence” of the clots being associated with the vaccine.
regulators reported 30 cases of the rare blood clots combined with low platelets among 18 million people given the AstraZeneca vaccine. That translated to roughly one case in 600,000 recipients of the vaccine.
European countries’ divergent approaches to the vaccine stem from a number of factors, including the supply of vaccines and severity of the pandemic. Marco Cavaleri, the official at the European Medicines Agency who spoke about the link between the vaccine and blood clots, said on Tuesday that those factors would likely continue to dictate how countries used the shot.
Beyond those factors, countries also took very different approaches to managing risk, scientists said. Countries that have continued using the shot were more focused on securing the overall health of their citizens. Others were more preoccupied with minimizing the risk to any single person.
“The attitude here is more, ‘Get me out of the pandemic,’” said Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London, referring to the British approach. In continental Europe, she said, “There seems to be a much higher emphasis on individual safety in the population.”
Adriano Mannino, a philosopher at the University of Munich and director of the Solon Center for Policy Innovation in Germany, said that the collective benefits of the vaccine dominated thinking in Britain, while Germans were more concerned with the risk of an injection going wrong in individual cases. That reflected, partly, Germany’s history with the Nazis, who conducted lethal experiments on people.
“In many areas where law has to regulate ethically delicate and potentially dangerous things,” he said, “the German state has tended to go for tough restrictions.”
Nevertheless, Germans over 60 — the age group still being given AstraZeneca’s vaccine — flooded hotlines to book appointments and stood in line for hours in recent days as eligibility restrictions for their age group were relaxed.
In the northeastern city of Wismar, several hundred people waited for up to five hours on Tuesday in a driving wind and mix of rain and snow to receive the shot.
“I wish there had been better weather,” Kerstin Weiss, the head of the district authority in the northeastern region, told public broadcaster NDR. “But honestly, this is a sign that people are willing to be vaccinated with AstraZeneca.”
Benjamin Mueller reported from London and Melissa Eddy from Berlin. Monika Pronczuk and Emma Bubola contributed reporting.