Two positive developments this week could potentially expand access to the Pfizer-BioNTech Covid-19 vaccine around the world.
A study in Israel showed that the vaccine is robustly effective after the first shot, echoing what other research has shown for the AstraZeneca vaccine and raising the possibility that regulators in some countries could authorize delaying a second dose instead of giving both on the strict schedule of three weeks apart as tested in clinical trials.
Although regulators in the United States have held fast to the requirement that people receive two doses of the Pfizer-BioNTech vaccine three weeks apart, the British government decided to prioritize giving as many people as possible an initial dose, allowing delays of up to 12 weeks before the second dose. The Israeli study could bolster arguments for emulating that approach in other countries.
The Food and Drug Administration did not immediately comment on whether the new data would affect its recommendations.
Published in The Lancet on Thursday and drawing from a group of 9,100 Israeli health care workers, the study showed that Pfizer’s vaccine was 85 percent effective 15 to 28 days after receiving the first dose. Pfizer and BioNTech’s late-stage clinical trials, which enrolled 44,000 people, showed that the vaccine was 95 percent effective if two doses were given three weeks apart.
(A flurry of recent studies have also suggested that people who have recovered from Covid-19 may not need more than one dose of a vaccine.)
Pfizer and BioNTech also announced on Friday that their vaccine can be stored at standard freezer temperatures for up to two weeks, potentially expanding the number of smaller pharmacies and doctors’ offices that could administer the vaccine, which now must be stored at ultracold temperatures.
In a statement, the companies said they have submitted the new temperature data to the Food and Drug Administration, which would need to sign off on guidance to providers that would allow them to store the vaccines at the new temperatures.
Distribution of the Pfizer-BioNTech vaccine has been complicated by the requirement that it be stored in freezers that keep the vaccines between -112 and -76 degrees Fahrenheit. The vaccines are shipped in a specially designed container that can be used as temporary storage for up to 30 days, if it is refilled with dry ice every five days. The vaccine can also be refrigerated for up to five days in a regular refrigerator, if it has not yet been diluted for use in patients.
A similar vaccine from Moderna, by contrast, can be stored in standard freezers and then in a refrigerator for up to 30 days, which has allowed it to be used more readily at smaller vaccination sites.
The Centers for Disease Control and Prevention said on Thursday about 41 million people have received at least one dose of a Covid-19 vaccine, including about 16.2 million people who have been fully vaccinated.
With vast swaths of the United States pelted by heavy winter storms that brought Covid-19 vaccinations to a near-halt over the past week, health officials say a daunting task has become even more difficult.
But not impossible.
“We’re going to just have to make up for it: namely do double time when this thing clears up,” declared Dr. Anthony S. Fauci, a top pandemic adviser to President Biden.
The brutal winter weather delayed the delivery of hundreds of thousands of doses across the country just as vaccine distribution was beginning to gather steam in the United States. Part of the problems is that the storms affected a FedEx facility in Memphis and a UPS facility in Louisville, Ky. — both vaccine shipping hubs.
Jennifer Psaki, the White House press secretary, said Thursday the Biden administration was working closely with manufacturing and shipping partners to assess weather conditions.
Shipment delays have been reported in California, Colorado, Florida, Illinois, Nevada, New Jersey, New York, Ohio, Oregon, Utah and Washington, among other states, forcing vaccine sites to temporarily shutter and coveted appointments to be rescheduled.
In Texas, where millions of residents lost power during the powerful storm, a delivery of more than 400,000 first doses and 330,000 second doses was delayed. A portion of those shots, roughly 35,000 doses of Pfizer’s vaccine, were sent to North Texas providers on Wednesday, but shipments will continue to depend on safety conditions.
Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said on Thursday that the state was “asking providers that aren’t able to store vaccine due to power outages to transfer it elsewhere or administer it so it doesn’t spoil.”
On Monday, health officials in Texas scrambled to give people more than 5,000 doses after a power outage in a storage facility where they were being kept. But Mr. Van Deusen said that “reports of vaccine spoiling have been minimal.”
The Houston Health Department said on Thursday it would restart vaccinations for second doses this weekend and schedule additional first- and second-dose appointments next week. The Federal Emergency Management Agency said that more than 2,000 vaccine sites were in areas with power outages.
Most of the vaccines for New York State, scheduled for delivery between Feb. 12 and Feb. 21, have been delayed as well, Gov. Andrew M. Cuomo said on Thursday night.
In New York City, Mayor Bill de Blasio said at a news conference earlier in the day that “a vast majority of the resupply” the city was expecting for this week had not yet shipped from the factories.
The city has had to hold off on scheduling upward of 35,000 appointments for first vaccine doses because of shipment delays and vaccine shortages. The opening of two new distribution sites was also postponed.
In Los Angeles, the city said that appointments for about 12,500 would be delayed.
Gov. Ron DeSantis of Florida said that while 136,000 Pfizer doses had arrived this week, the state had not received its shipment for the week of 200,000 Moderna doses. He said the shipment could be delayed as late as Monday.
“Because the storms we are seeing in the rest of the country, it’s basically sitting in the FedEx warehouse — and I don’t think they can even get into it because of everything,” Mr. DeSantis said at a news conference, encouraging those who had appointments rescheduled to “hang in there, the doses are going to get here.”
Dr. Fauci, the nation’s top infectious disease expert, called the weather delay “significant.”
“Obviously it’s an issue,” he told MSNBC on Thursday. “It’s been slowed down in some places, going to a grinding halt.”
Dr. Fauci said, “We’re just going to have to make up for it as soon as the weather lifts a bit, the ice melts and we can get the trucks out and the people out.”
As of Thursday, the C.D.C. said that about 41 million people had received at least one dose of a Covid-19 vaccine, including about 16.2 million people who have been fully vaccinated.
An international effort to speed up the manufacture and distribution of coronavirus vaccines around the globe has gotten a boost on two fronts: White House officials said the Biden administration would make good on a U.S. promise to donate $4 billion to the campaign over the next two years and the pharmaceutical company Novavax committed to eventually sell 1.1 billion doses of its vaccine.
President Biden was to make his announcement on Friday during a virtual meeting with other leaders from the Group of 7, where he is also expected to call on other countries to step up their contributions. The $4 billion was approved last year by a Republican-led Senate when President Donald J. Trump was still in office.
Public health experts often say that unless everyone is vaccinated, it is as if no one is vaccinated. One of the officials, who spoke anonymously to preview the president’s announcement, noted that the move to help with efforts abroad to diminish the impact of the pandemic was also in the interest of international security for the United States.
Countries such as India and China are already using the coronavirus vaccine as a diplomatic tool; both are giving away doses to other nations in an effort to expand their global influence. National security experts said the United States should consider doing the same.
But, an official said, the United States will not be able to share vaccines now, while the American vaccination campaign is still continuing to expand.
The international vaccine effort, known as Covax, has been led by the public-private health partnership known as Gavi, the Vaccine Alliance, as well as the Coalition for Epidemic Preparedness Innovations and the World Health Organization. It aims to distribute vaccines that have been deemed safe and effective by the W.H.O., with a special emphasis on low- and middle-income countries.
So far, the United States has pledged more than any other nation, according to the White House. Officials there said the money would be delivered in multiple tranches: an initial donation of $500 million right away, followed shortly by an additional $1.5 billion. The remaining $2 billion will delivered by the end of 2022
The Novavax sale will not come immediately; its vaccine has not yet been approved by a government regulatory authority.
Under a memorandum of understanding between Gavi and Novavax, the company agreed to provide “1.1 billion cumulative doses,” though it did not specify a time frame.
Mr. Biden was not the only G-7 member urging greater contribution to the global vaccination effort. President Emmanuel Macron of France said the United States and Europe should allocate up to 5 percent of their vaccine orders to developing countries.
“We are allowing the idea to take hold that hundreds of millions of vaccines are being given in rich countries and that we are not starting in poor countries,” Mr. Macron said in an interview with the Financial Times.
António Guterres, the United Nations Secretary General, also offered choice words for what he described as a “wildly uneven and unfair” distribution of vaccines. In a high-level meeting of the U.N. Security Council on Wednesday, Mr. Guterres called vaccine equity “the biggest moral test before the global community.”
He called on G-7 countries to “create the momentum to mobilize the necessary financial resources” at their Friday meeting.
In states across the country, officials are trying to pry loose millions of doses of coronavirus vaccine that have been sitting in freezers because they were allocated in excess to nursing homes or stockpiled for second doses.
Federal officials estimate that as many as six million doses are unnecessarily stowed away. Freeing them up could increase the number of doses administered by more than 10 percent — significantly stepping up the pace of the nation’s inoculation program at a time when speed is of the essence to save lives, curb disease and head off more contagious variants of the virus.
So far, 56 million shots have been administered in the United States, and only 12 percent of the population have received one or more doses. And the idea that doses are sitting in cold storage while millions of people languish on waiting lists has deeply frustrated government officials.
Part of the problem stems from when the federal vaccination program for long-term-care facilities began late last year. At the time, the Centers for Disease Control and Prevention based allotments on the number of beds, even though occupancy rates are the lowest in years. Then the C.D.C. doubled that allotment to cover staff. But while four-fifths of long-term-care residents agreed to be vaccinated in the first month of the program, 63 percent of staff members refused, the agency reported. More have since agreed, although exactly how many is not clear.
Despite the lack of uptake, the pharmacy chains that administer the program continued tapping their allotments from the federal government. At one point in Virginia, they had used fewer than one in every three doses they had on hand, according to Dr. Danny Avula, the state’s vaccine coordinator.
The New York Times surveyed all 50 states, and found that at least 20 said they had shifted or planned to shift doses that had been set aside for long-term-care facilities.
The get-tough approach has begun to pay off. The gap between the number of doses shipped to states and the number injected into arms is narrowing: More than three-fourths of the doses delivered are now being used, compared with less than half in late January, according to the C.D.C.’s data tracker.
And many doses have been held back for second shots, though the White House has discouraged the practice and is providing three-week projections of supply as reassurance that they will not come up short.
In the few days since indoor dining resumed in New York City, customers appeared to be trickling in, but usually in modest numbers, and interviews with owners, workers and industry experts suggested that many people were still leery of being inside.
Industry experts also say that allowing restaurants to open their doors to patrons at 25 percent capacity is unlikely to significantly reverse the economic damage that the pandemic has inflicted.
Thousands of New York’s 25,000 restaurants, bars and nightclubs have closed for good. Many others are barely holding on. They are way behind on rent, furloughing or laying off workers and making a fraction of their usual revenues.
The restaurant industry, one of the city’s most vital economic pillars, once employed 325,000 people. It has shed more than 140,000 jobs.
A survey by the New York City Hospitality Alliance, an industry group, found that 92 percent of restaurants reported being unable to afford their rent in December, up from 80 percent in June.
“We have been the eye of this crisis,” said Andrew Rigie, the alliance’s executive director. “When Covid-19 hit, we were told to socially distance, but restaurants are where we come together to socialize. Restaurants are part of not only the economic foundation, but also the social and cultural fabric of New York City.”
The return of indoor dining has renewed public health concerns after a post-holiday spike in infection rates across the city, the emergence of new virus variants and limited vaccine supplies.
W. Ian Lipkin, a professor of epidemiology at Columbia University, said he would still be cautious about where he dined indoors, despite having been vaccinated. He said he would choose only restaurants that took appropriate safety measures, including spacing tables at least six feet apart, maintaining adequate air flow, installing high-quality air filters and requiring servers to wear masks and gloves.
Not even the draw of a warm seat in the frigid winter could bring some diners inside.
“I’m still not ready to do indoor dining,” said Jennifer Brehm, 37, a teacher who huddled with her 8-month-old daughter, Cassia, at an outdoor cabana at Queen Bar & Restaurant in Brooklyn, noting that Cassia “can’t wear a mask yet.”
Ms. Brehm said she was concerned about new virus variants and had been following the vaccinate efforts. “Until it seems more under control,” she said of local virus caseload, “I won’t be ready to eat indoors.”
The Vatican has clarified that employees who refuse a coronavirus vaccine will not be punished, after pushback over an internal decree suggesting that those who did not get vaccinated could be dismissed.
Vatican City State said in a statement on Thursday that “alternative solutions” would be found for employees who did not want to be vaccinated.
That came in response to a heated debate over a Feb. 8 directive signed by Cardinal Giuseppe Bertello, the governor of the world’s smallest state. It referred to provisions in a 2011 law for Vatican employees stating that any who refuse preventive health measures can be punished, up to “the interruption of the relationship of employment.”
Pope Francis has said that coronavirus vaccinations are an ethical obligation, and called the refusal to accept them suicidal. Francis, 84, and his predecessor, Benedict VXI, 93, were among the first to be inoculated when Vatican City began its vaccination campaign last month.
The Feb. 8 decree called vaccinating “a responsible decision” for Vatican employees, and said that failure to do so was a risk for others and for public health.
Vatican City has about 5,000 employees, and many live in Italy, where vaccinations are not mandatory.
Cardinal Bertello’s office said on Thursday that its February decree had been issued to protect employees and the working environment “in the case of an event that could set off a public health emergency.” It also said that some jobs — especially those where employees come into contact with the public — might require vaccination. Failure to vaccinate in these cases, it said, would “allow for alternative work solutions for the interested party.”
The note said that the 2011 regulations did not have “a sanctioning or punitive nature” and were instead aimed at “striking a balance between protecting community health and individual freedom of choice.”
Pope Francis has made repeated appeals for the world’s wealthier nations to share vaccines with the most needy and vulnerable.
Maybe it was the bonnets.
Or the gloves that the two women donned, though the temperatures in Orlando, Fla., on Wednesday hovered in the 60s.
In a scene right out of a sitcom, the women went to a coronavirus vaccination site “dressed up as grannies,” said Dr. Raul Pino, the health administrator for Orange County, at a news conference on Thursday. Except they were 34 and 44, not over 65, so despite their get-ups, which included spectacles, they were ineligible to get the shots in Florida.
However, the ruse may have worked before. The women presented valid Centers for Disease Control and Prevention cards indicating that they had already received their first vaccine doses, Dr. Pino said, who did not name them. “I don’t know how they escaped the first time,” he said.
Florida has vaccinated about 42 percent of its more than 4.4 million people 65 and older, according to the state, and health care workers and people with some underlying conditions are also eligible for the shots. It is unclear when the administration of Gov. Ron DeSantis, a Republican, will consider that enough of those populations have been vaccinated to open eligibility more widely.
The state is one of many where vaccines are in high demand because of a lag in shipments from weather delays.
Younger people, teachers, police officers and other essential workers are all clamoring for doses, but Florida has not said which group it will prioritize next.
Agencies administering the shots have had to be “very careful” about people “faking it,” Dr. Pino said. “It’s probably higher than we suspect,” he said, adding that at least one man who was too young for a shot tried to pass himself off as his father, who had the same name.
“Our job as a health department is to vaccinate as many people as possible, as fast as possible,” Dr. Pino said, adding that the state’s Department of Health was following the governor’s priorities, which are based on modified C.D.C. guidelines.
On Wednesday, Health Department staff asked sheriff’s deputies to issue trespass warnings to the bonnet-clad women, whose birth dates did not match those that they had used to register for the vaccines, a spokesperson for the sheriff’s office said.
They were not charged with any wrongdoing. But they did not receive the vaccine.
Air travel has recovered somewhat in recent months, but it remains deeply depressed compared with 2019, and no one knows when business will return to previous levels.
Now and for the next several months at least, airlines are flying whomever they can wherever they can. That often means catering to a small group of people who are undeterred by the pandemic to travel to ski slopes or beaches.
“As a quick strategy, fly where people are,” said Ben Baldanza, a former chief executive of Spirit Airlines, the low-cost carrier. “That’s been a real smart strategy, but that’s not a long-term way for those airlines to make money.”
Such leisure travel offers limited comfort to an industry so thoroughly clobbered. Tourists and people visiting family and friends typically take up most of the seats on planes, but airlines rely disproportionately on revenue from corporate travelers in the front of the cabin.
Before the pandemic, business travel accounted for about 30 percent of trips but 40 to 50 percent of passenger revenue, according to Airlines for America, an industry association. And those customers aren’t expected to return in great numbers anytime soon.
The four largest U.S. airlines — American, Delta, United and Southwest — lost more than $31 billion last year, and the industry over all is shedding more than $150 million each day, according to an estimate from Airlines for America.
The industry spent much of the past year scrimping and saving, trimming older, less efficient planes from their fleets; renegotiating contracts; and encouraging tens of thousands of workers to take buyouts or early retirement packages.
But it hasn’t been enough to offset a drop of nearly two-thirds in air travel as public health experts and the Centers for Disease Control and Prevention continue to discourage travel. Airlines for America does not expect passenger numbers to return to 2019 levels until at least 2023. And airlines might have to wait even longer if the economic recovery falters because of the spread of coronavirus variants or a delay in vaccinations.
Some experts say that corporate travel may never return to peak levels, with many in-person meetings replaced by video conferences and phone calls.
Airlines are more hopeful, perhaps because they rely heavily on corporate travel.
Ed Bastian, Delta’s chief executive, said on a conference call last month that about 40 percent of Delta’s big corporate customers expected their business travel to be fully recovered by 2022, and an additional 11 percent by 2023. Citing the airline’s internal research, he said 7 percent expected that business travel might never be fully restored, while the rest said they were unsure when things would return to previous levels.
American is “very optimistic” that corporate travel will return as vaccines are distributed, Vasu Raja, the airline’s chief revenue officer, told investors and reporters last month. But, he added, “the rate of that is unclear at best.”
BANGKOK — Once again, a Thailand hotel guest who posted complaints online faces the threat of a defamation charge. This time, it centers on the guest’s claim of cockroach legs in his macaroni.
Topp Dunyawit Phadungsaeng, who spent 14 days in coronavirus quarantine at the Ambassador City Jomtien Hotel after arriving last month from San Francisco, had plenty of time on his hands to record complaints about the quality of the food, the lack of cleanliness and the presence of bugs.
On Monday, after checking out, he posted on Facebook about his stay, including 46 photographs and four videos that he took of the hotel, a government-designated quarantine facility. His posts were widely shared, especially a photo of what he said were the legs of a cockroach in his stir-fried meal.
“It turned out to be the worst 14 days of my life,” he said in his post. “Don’t call this quarantine. A forced prison stay looks better than this.”
His complaints were widely picked up by the Thai news media. And a day after his post appeared, the hotel issued a statement calling on a “certain group of people” to stop posting “false information” with the intent of damaging the hotel’s reputation. Otherwise, the hotel said, it had the right to pursue civil and criminal charges “to the utmost.”
Because of the coronavirus, anyone coming to Thailand must spend 14 days in quarantine. The government will cover the cost of some hotels, including the Ambassador City Jomtien, which is near Pattaya city. Guests can pay to stay at higher-end hotels, including some with five stars, that are designated quarantine sites.
Mr. Topp said he regretted not paying for better lodging. Among his complaints were that his room had no Wi-Fi but plenty of mosquitoes and cockroaches. Water dripped from the ceiling, bedsheets were moldy, and he was served food that was sometimes inedible, he said.
“I didn’t expect it to be a luxury five-star hotel,” he wrote. “But have you ever been disappointed despite not having any expectations?”
In September, an American hotel guest was arrested and charged with criminal defamation after posting complaints on TripAdvisor about his stay at the Sea View Koh Chang resort on Koh Chang island.
The guest, Wesley Barnes, eventually made a formal apology in exchange for the hotel’s dropping the charges. But the Sea View’s strategy backfired. It was widely criticized on social media, and TripAdvisor posted a notice warning travelers that the hotel was behind the jailing of a guest for harsh reviews.
A spokesman for the defense ministry, which has a role in overseeing quarantine facilities, said he hoped Mr. Topp and the Ambassador City Jomtien Hotel resolve their difference.
“In this case, it is the right of the reviewer,” said the spokesman, Kongcheep Tantravanich, “but we would also ask for sympathy for the hotel owners.”
To get her coronavirus vaccination last weekend, Frances H. Goldman, 90, went to an extraordinary length: six miles. On foot.
It was too snowy to drive at 8 a.m. on Sunday when Ms. Goldman took out her hiking poles, dusted off her snow boots and started out from her home in the Seattle neighborhood of View Ridge. She made her way to the Burke-Gilman Trail on the edge of the city, where she then wended her way alongside a set of old railroad tracks, heading south. Then she traversed the residential streets of Laurelhurst to reach the Seattle Children’s Hospital.
It was a quiet walk, Ms. Goldman said. People were scarce. She caught glimpses of Lake Washington through falling snow. It would have been more difficult, she said, had she not gotten a bad hip replaced last year.
At the hospital, about three miles and an hour from home, she got the jab. Then she bundled up again and walked back the way she had come.
It was an extraordinary effort — but that was not the extent of it. Ms. Goldman, who became eligible for a vaccine last month, had already tried everything she could think of to secure an appointment. She had made repeated phone calls and fruitless visits to the websites of local pharmacies, hospitals and government health departments. She enlisted a daughter in New York and a friend in Arizona to help her find an appointment.
Finally, on Friday, a visit to the Seattle Children’s Hospital website yielded results.
“Lo and behold, a whole list of times popped up,” she said in a phone interview on Wednesday. “I couldn’t believe my eyes. I went and got my glasses to make sure I was seeing it right.”
Then came the snow, which would ultimately drop more than 10 inches, in one of Seattle’s snowiest weekends on record. Wary of driving on hilly, unplowed roads, Ms. Goldman decided to go to the hospital on foot. She took a test walk part of the way on Saturday to get a sense of how long the trip might take.
And on Sunday, she trekked all the way to the hospital to get her vaccine.
“I hope that it will inspire people to get their shots,” she said. “I think it’s important for the whole country.”
The rollout in Washington State, like many around the country, has been complicated by failures of technology, shortfalls in equity and a persistent imbalance of supply and demand. State officials have struggled to set up the infrastructure necessary to schedule and vaccinate the millions of people who are already eligible.
Ms. Goldman is scheduled to receive her second dose of the vaccine next month. She plans to drive.
Israel has raced ahead with the fastest Covid-19 vaccination campaign in the world, inoculating nearly half its population with at least one dose. Now its success is making it a case study in setting rules for a partially vaccinated society — raising thorny questions about rights, obligations and the greater good.
Prime Minister Benjamin Netanyahu’s cabinet voted this week to open shopping malls and museums to the public, subject to social distancing rules and mandatory masking. For the first time in many months, gyms, cultural and sports events, hotels and swimming pools will also reopen, but only for some.
Under a new “Green Badge” system that functions as both a carrot and a stick, the government is making leisure activities accessible only to people who are fully vaccinated or recovered starting from Sunday. Two weeks later, restaurants, event halls and conferences will be allowed to operate under those rules. Customers and attendees will have to carry a certificate of vaccination with a QR code.
Israel is one of the first countries grappling in real time with a host of legal, moral and ethical questions as it tries to balance the steps toward resuming public life with sensitive issues such as public safety, discrimination, free choice and privacy.
“Getting vaccinated is a moral duty. It is part of our mutual responsibility,” said the health minister, Yuli Edelstein. He also has a new mantra: “Whoever does not get vaccinated will be left behind.”
Four million Israelis — nearly half the population of nine million — have received at least one dose of the Pfizer vaccine, and more than 2.6 million have gotten a second dose. But about two million eligible citizens aged 16 or over have not sought vaccines. The average number of new daily infections is hovering around 4,000.
Israel’s central government — eager to bring the country out of its third national lockdown without setting off a new wave of infections — was spurred into action by local initiatives. Chafing under the country’s lockdown regulations, an indoor shopping mall in the working-class Tel Aviv suburb of Bat Yam threw its doors open last week for customers who could prove that they had been vaccinated or had recovered from Covid-19.
In Karmiel, the mayor made a similar decision to open his city in the northern Galilee region for business. Other mayors want to bar unvaccinated teachers from classrooms while some hoteliers threatened unvaccinated employees with dismissal.
Mr. Edelstein, the health minister, said on Thursday that vaccination would not be compulsory in Israel. But his ministry is now proposing legislation that would oblige unvaccinated employees whose work involves contact with the public to be tested for the virus every two days. And he is promoting a bill that would allow the ministry to identify unvaccinated people to the local authorities.