Latin America, South and Southeast Asia and Africa will be among the recipients of an initial 25 million excess doses that the Biden administration is sharing this month.WASHINGTON — The White House, besieged with requests from other nations to share its supply of coronavirus vaccine, announced Thursday that it would distribute an initial 25 million doses this month across a “wide range of countries” in Latin America and the Caribbean, South and Southeast Asia, and Africa, as well as the Palestinian territories, war-ravaged Gaza and the West Bank.The doses are the first of a total 80 million that President Biden has pledged to send overseas by the end of this month. Three-quarters of the initial batch will be given to the international vaccine effort known as Covax, officials said at a White House briefing on the pandemic, though administration officials are helping decide where to send them.The rest will be reserved for “immediate needs and to help with surges around the world” and regions dealing with “urgent, present crises,” said Jake Sullivan, the president’s national security adviser, including in India, Ukraine and Iraq as well as the West Bank and Gaza.But the donation is nowhere close to enough. About 11 billion doses are needed to vaccinate 70 percent of the world’s population against the coronavirus, according to estimates from researchers at Duke University. As of last month, the analytics firm Airfinity estimated that 1.7 billion doses had been produced.Thursday’s announcement comes a week before Mr. Biden leaves for Cornwall, England, to meet with the heads of state of the Group of 7 industrialized nations, where the global vaccine supply is certain to be a topic of discussion. Officials said the Biden administration would donate additional doses throughout the summer as they become available.“This is just the beginning,” said Jeffrey Zients, Mr. Biden’s coronavirus response coordinator. “Expect a regular cadence of shipments around the world, across the next several weeks.”While China and Russia have used vaccine donations as an instrument of diplomacy in an effort to extract favors from other nations, Mr. Biden has insisted the United States will not do that — a point that Mr. Sullivan emphasized on Thursday in describing the White House strategy.Nearly two-thirds of U.S. adults have had at least one shot of a coronavirus vaccine, and the rate of new cases and deaths has plummeted, contributing to an overall picture across the country that is “encouraging and uplifting,” Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said on Thursday.But the picture around the world, especially in poorer nations in Africa and Central and South America, where vaccination rates are much lower, is bleak. According to data from Johns Hopkins University, Uruguay, Argentina, Colombia and Paraguay are all awash in new cases; in Colombia, nearly 500 people a day have died of the coronavirus over the past several weeks. A sudden, sharp rise in coronavirus cases in many parts of Africa could amount to a continental third wave, the World Health Organization warned on Thursday.Some African nations have less than 1 percent of their populations partly vaccinated, according to data from the Our World in Data project at the University of Oxford, and the percentages of vaccinated people in Honduras and Guatemala are around 3 percent of the population.Mr. Sullivan said the administration had decided to give priority to “neighbors” of the United States, including countries like Guatemala and Colombia, Peru and Ecuador, while also working with existing regional networks like the African Union to allow local authorities to allocate the vaccines as they see fit.Mr. Biden came into office vowing to restore America’s position as a leader in global health, and he has been under increasing pressure from activists, as well as some business leaders, to do more to address the global vaccine shortage. This year, he said he was reluctant to give away vaccine doses until the United States had enough for its own population, though he promised in March to send a total of four million doses of AstraZeneca’s vaccine to Mexico and Canada.Those doses, it turned out, were made at a Baltimore facility owned by Emergent BioSolutions, where production has since been put on hold after an incident of contamination.Mr. Biden’s pledge to donate 80 million doses this month involves vaccines made by four manufacturers. Besides AstraZeneca, they are Pfizer-BioNTech, Moderna and Johnson & Johnson, the last three of which have received U.S. emergency authorization for their vaccines.The president has made several announcements to help reach his goal. He said last month that his administration would send 20 million doses of the authorized vaccines overseas in June — the first time he had pledged to give away doses that could be used in the United States. Officials said Thursday that the number rose to 25 million because more authorized doses have become available.Mr. Biden also announced last month that he would send one million doses of Johnson & Johnson’s vaccine to South Korea; a plane carrying those doses was expected to take off Thursday evening, Mr. Zients said.And the president has pledged to donate up to 60 million doses of AstraZeneca’s vaccine. But those doses, also made at the Emergent plant, are not authorized for domestic use and cannot be released to other countries until regulators deem them safe. If they are not cleared for release, Mr. Biden would have to agree to donate more of the three vaccines used here to fulfill his 80 million promise.The president has described the vaccine donations as part of an “entirely new effort” to increase vaccine supplies and vastly expand manufacturing capacity, most of it in the United States. To further broaden supply, Mr. Biden recently announced he would support waiving intellectual property protections for coronavirus vaccines. He also put Mr. Zients in charge of developing a global vaccine strategy.But activists say simply donating excess doses and supporting the waiver are not enough. They argue that Mr. Biden must create the conditions for pharmaceutical companies to transfer their intellectual property to vaccine makers overseas, so that other countries can establish their own vaccine manufacturing operations.“Peter Maybarduk, the director of Public Citizen’s Access to Medicines program, called Thursday for the administration to invest $25 billion in “urgent public vaccine manufacturing at sites worldwide” to make eight billion doses of vaccine using mRNA technology within a year, and to “share those vaccine recipes with the world.”Asked recently whether the United States was prepared to do that, Andrew Slavitt, a senior health adviser to the president, sidestepped the question, saying only that the United States would “play a leadership role” but still needed “global partners across the world.”On Thursday, Mr. Zients said the United States was lifting the Defense Production Act’s “priority rating” for three vaccine makers — AstraZeneca, Novavax and Sanofi — that do not make coronavirus vaccines authorized for U.S. use. The shift means that companies in the United States that supply the vaccine makers will be able to “make their own decisions on which orders to fulfill first,” Mr. Zients said.That could free up supplies for foreign vaccine makers, allowing other countries to ramp up their own programs.Abdi Latif Dahir

The president pushed up his target date by two weeks, matching the timetable already being put in place by many states.WASHINGTON — President Biden on Tuesday moved up by two weeks, to April 19, his deadline for states to make every American adult eligible for coronavirus vaccination, following the lead of states around the country that are already meeting that timetable.Mr. Biden’s announcement came as Americans and their elected officials were grappling with competing and seemingly contradictory forces. The pace of vaccinations is accelerating, but worrisome new variants are spreading. The death rate is declining, but caseloads and hospitalizations are on the rise.California officials announced on Tuesday that they plan to lift all coronavirus restrictions on June 15, provided there are enough Covid-19 vaccines available for anyone age 16 or older and hospitalizations remain low and stable. Other states are already lifting restrictions, but Mr. Biden, in remarks at the White House, warned against throwing off the guardrails too soon.“The virus is spreading because we have too many people who, seeing the end in sight, think we’re at the finish line already,” the president said. “But let me be deadly earnest with you: We aren’t at the finish line. We still have a lot of work to do. We’re still in a life-and-death race against this virus.”The president also reiterated and made explicit his pledge to give surplus vaccine to other countries, once he is certain there is enough for people in the United States.Not quite a month ago, Mr. Biden set a deadline of May 1 for states to open up vaccination to all adults. A week after that, he said that by April 19, 90 percent of adults would be eligible for a shot and would be able to get one within five miles of their home.Since then, nearly every state in the nation has accelerated its vaccination program, and the vast majority are now meeting or coming in ahead of the April 19 target. On Tuesday, Oregon said those 16 or older will be eligible for vaccination on April 19.At least 530 new coronavirus deaths and 76,624 new cases were reported in the United States on Monday, according to a New York Times database. Over the past week, there has been an average of 64,855 new cases per day, an increase of 20 percent from the average two weeks earlier.That has put the country in a tenuous situation, with public health officials, including Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, pleading with governors not to lift restrictions and with citizens to continue to follow social distancing guidelines, wear masks and take other public health precautions. Last week, Dr. Walensky said she felt a sense of “impending doom” from a potential fourth surge of the pandemic.But in California, cases have been declining since hitting a peak early this year, with the state now averaging around 2,700 new cases a day, the lowest figure since June. The C.D.C. said that, as of Tuesday, 35 percent of the state’s total population had received at least one vaccine shot, and 18 percent were fully vaccinated.“With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California’s economy,” Gov. Gavin Newsom, a Democrat, said in a statement. “We can now begin planning for our lives post-pandemic.”Many public health experts say that the nation is in a race between the vaccines and the variants and that, for the moment at least, the vaccines appear to have the upper hand. But public health officials are worried that future iterations of the virus may be more resistant.At the same time, they are watching an uptick in cases among young people, particularly those ages 18 to 24. Dr. Walensky told reporters on Monday that the C.D.C. was working with states to investigate outbreaks in young people that she said may be related to extracurricular activities or sports.Mr. Biden spoke on Tuesday after visiting a vaccination clinic at the Virginia Theological Seminary in Alexandria, Va., which is working with community health centers to offer inoculations. Making the rounds of the makeshift clinic, he showed flashes of his old self — the sunny retail politician who likes to get close to people, with a pat on the arm or a squeeze on the shoulder.“He’s gonna be hard — he’s got so much muscle mass there,” the president joked to a nurse as he squeezed the shoulder of a muscular man who was about to get his shot. “I tell you what, I could have been an All-American if I had those.”But his lightness belied the seriousness of the message he would later deliver at the White House. There, he marked a milestone: Since Mr. Biden has been in office, more than 150 million Covid-19 shots have been administered to Americans, which puts the nation on track to reach his goal of 200 million shots by his 100th day in office, at the end of this month.“We’ve vaccinated more people than any other nation on Earth,” the president said. “The vaccines have proven to be safe and effective. That should give us real hope.”But, he added, “we can’t let it make us complacent.”Jill Cowan

The extraordinary move came just days after officials learned the plant had ruined 15 million doses of Johnson & Johnson’s coronavirus vaccine.WASHINGTON — The Biden administration on Saturday put Johnson & Johnson in charge of a troubled Baltimore manufacturing plant that ruined 15 million doses of the Johnson & Johnson coronavirus vaccine and moved to stop the plant from making another vaccine by AstraZeneca, senior federal health officials said.The extraordinary move by the Department of Health and Human Services came just days after officials had learned that Emergent BioSolutions, a contract manufacturer that has been making both the Johnson & Johnson and the AstraZeneca vaccines, mixed up ingredients from the two, which led regulators to delay authorization of the plant’s production lines.By moving the AstraZeneca vaccine out, two senior federal health officials said, the plant can be solely devoted to the Johnson & Johnson single-dose vaccine and avoid future mishaps.The Department of Health and Human Services directed Johnson & Johnson to install a new leadership team to oversee all aspects of production and manufacturing at the Emergent Baltimore plant, the officials said. The company said in a statement that it was “assuming full responsibility” for the vaccine made at the Emergent plant.With President Biden making an aggressive push to have enough doses to cover every adult by the end of May, federal officials are worried that the mix-up will erode public confidence in Covid-19 vaccines. The AstraZeneca vaccine in particular has generated safety concerns; Germany, France and other European nations briefly suspended its use after reports of rare brain blood clots in some vaccine recipients.The ingredient mix-up, and Saturday’s move by the administration, is a significant setback and a public relations debacle for Emergent, a Maryland-based biotech company that has built a profitable business by teaming up with the federal government, primarily by selling its anthrax vaccines to the Strategic National Stockpile.A spokesman for Emergent declined to comment, except to say that the company would continue making AstraZeneca doses until it received a contract modification from the federal government.Unlike Johnson & Johnson, AstraZeneca does not yet have emergency authorization from the Food and Drug Administration for its vaccine. With three federally authorized vaccines (the other two are by Pfizer-BioNTech and Moderna), it is not clear whether the AstraZeneca vaccine, which has had a troubled history with regulators, could even be cleared in time to meet U.S. needs.However, one of the federal officials said the Department of Health and Human Services was discussing working with AstraZeneca to adapt its vaccine to combat new coronavirus variants. AstraZeneca said in a statement that it would work with the Biden administration to find a new site to manufacture its vaccine.So far, none of the Johnson & Johnson doses made by Emergent have been released by the F.D.A. for distribution. Officials have said it may take weeks to sort out whether other batches of vaccine were contaminated and for F.D.A. inspectors to determine whether the Emergent plant can be cleared to release any doses that it has made.The acting F.D.A. commissioner, Dr. Janet Woodcock, said in a statement on Saturday that the agency “takes its responsibility for helping to ensure the quality of manufacturing of vaccines and other medical products for use during this pandemic very seriously.”But she made it clear that the ultimate responsibility would rest with Johnson & Johnson, saying: “It is important to note that even when companies use contract manufacturing organizations, it is ultimately the responsibility of the company that holds the emergency use authorization to ensure that the quality standards of the FDA are met.”In another arrangement brokered by the Biden administration last month, Johnson & Johnson is now working with Merck, one of the world’s biggest vaccine manufacturers. Officials said Merck would help with management of the Baltimore plant.Emergent’s Baltimore plant is one of two that are federally designated as “Centers for Innovation in Advanced Development and Manufacturing” and were built with taxpayer support. Last June, the government paid Emergent $628 million to reserve space there as part of Operation Warp Speed, the Trump administration’s fast-track initiative to develop coronavirus vaccines.Johnson & Johnson and AstraZeneca both contracted with Emergent to use the space. Both vaccines are so-called live viral-vector vaccines, meaning they use a modified, harmless version of a different virus as a vector, or carrier, to deliver instructions to the body’s immune system. The Johnson & Johnson vaccine is administered in one dose, AstraZeneca’s in two doses.Experts in vaccine manufacturing said that in the past, the F.D.A. had a rule to prevent such mishaps by not allowing a plant to make two live viral vector vaccines, because of the potential for mix-ups and contamination.Last month, Mr. Biden canceled a visit to Emergent’s Baltimore plant, and his spokeswoman announced that the administration would conduct an audit of the Strategic National Stockpile, the nation’s emergency medical reserve. Both actions came after a New York Times investigation into how the company had gained outsize influence over the repository.

#masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Actin November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021Updated 8:30 p.m. ETWASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak

#masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Actin November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021Updated 8:30 p.m. ETWASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak