Covid News: Biden Announces Vaccine Donation of 17 Million Doses for African Union

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Biden Announces Vaccine Donation to the African Union

President Biden announced the donation of 17 million doses of the Johnson & Johnson vaccine to the African Union, a month after President Uhuru Kenyatta of Kenya publicly pleaded for more equitable vaccine distribution around the world.

We’re continuing our shared fight against Covid. The United States has donated 2.8 million doses of vaccine to Kenya as part of the 50 million doses we’ve donated to the African Union, and I’m proud to announce that today that we’re making an additional, historic one time donation of 17 more million doses of J.&J. vaccine to the A.U. And we’re going to be sending some more of these by the end of the year to Kenya. The United States has done its best to step up in terms of not only helping Kenya, but the African continent in general with regard to access to vaccines. Happy to hear your new announcement of that increase because, as many of you will know as a continent, we are lagging well behind the rest of the world in terms of being able to vaccinate our people. So any additional support, like the president has just mentioned, is greatly welcomed and we look forward to that continued partnership.

President Biden on Thursday announced the donation of millions of coronavirus vaccines to a group of African countries during a meeting with President Uhuru Kenyatta of Kenya, which is contending with the pandemic and an unfolding humanitarian disaster in neighboring Ethiopia.

The Biden administration’s donation of 17 million doses of the Johnson & Johnson vaccine to the African Union came a month after Mr. Kenyatta publicly pleaded for more equitable vaccine distribution around the world. At a meeting of the United Nations General Assembly in New York, the Kenyan president criticized the “asymmetry” of the vaccine supply, a clear reference to countries such as the United States that are administering booster shots instead of donating more vaccines to nations in need.

During Mr. Biden’s first in-person meeting at the White House with a leader of an African country, Mr. Kenyatta thanked him for the donation while also suggesting it was not enough.

“As a continent, we are lagging well behind the rest of the world in terms of being able to vaccinate our people,” Mr. Kenyatta said.

Mr. Biden committed to sending more vaccines to Kenya by the end of the year.

“We’re continuing our shared fight against Covid,” he said before reporters were ushered out of the Oval Office. “We’re going to discuss what more the United States can do together on the Horn of Africa to advance peace and security.”

For Mr. Kenyatta, the meeting was an opportunity to bolster the relationship with the United States as his country suffers from the economic turmoil of the coronavirus pandemic.

The United States wasn’t the only wealthy nation announcing plans to address the world’s vast vaccine inequity this week.

South Korea plans to ship almost 1.6 million doses of AstraZeneca’s coronavirus vaccine to Vietnam and Thailand this week, the foreign ministry announced Tuesday, as the Southeast Asian nations struggle to contain the spread of the virus.

The donation comes as South Korea’s vaccination program has accelerated rapidly, with 70 percent of the population expected to be inoculated by the end of the month.

About 62 percent of South Korea’s total population has been fully vaccinated, according to the Ministry of Health and Welfare, and the nation is expected to ease the most severe restrictions by next month. Thailand has fully vaccinated 33 percent of its population and Vietnam about 17 percent.

About 1.1 million doses will go to Vietnam and 470,000 to Thailand, South Korea’s government said.

South Korea was among the last of the world’s wealthiest nations to start a vaccination program, leading to frustration among citizens who had already spent a year living under restrictions to control the spread of the virus. Eight months later, the country has inoculated more people per capita than the United States, which has secured the largest supply of vaccines in the world.

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F.D.A. Panel Greenlights Moderna Boosters for High-Risk Individuals

A Food and Drug Administration advisory panel recommended a half-dose as a third injection for people 65 and older as well as younger adults at high risk because of their medical conditions or jobs.

“Do available data support the safety and effectiveness of Moderna Covid-19 vaccine for use under EUA as a booster dose, 50 micrograms mRNA-1273, at least six months after completion of a primary series in the following populations: individuals 65 years of age and older, individuals 18 to 64 years of age at high-risk of severe Covid-19 and individuals 18 through 64 years of age, whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of Covid-19, including severe Covid-19?” “We do have a unanimous 19 out of 19 yes votes, and that concludes the voting portion.”

A panel of independent medical experts on Thursday unanimously recommended Moderna booster shots for many of those who had received the company’s coronavirus vaccine, paving the way to sharply expand the number of people eligible for an additional shot in the United States.

The advisory panel to the Food and Drug Administration voted 19 to 0 in favor of emergency authorization of a half-dose booster, at least six months after the second dose. Those eligible for the extra shot would include people over 65 and other adults considered at high risk — the same groups now eligible for a Pfizer-BioNTech booster.

The F.D.A. typically follows the panel’s advice, and should rule within days.

The recommendations come as the nation is seeing a decline in coronavirus cases but still faces nearly 90,000 new infections and roughly 1,800 deaths per day. The Biden administration has cast booster shots as an additional tool in the battle against the pandemic, while acknowledging that controlling the disease’s spread depends upon vaccinating tens of millions of Americans for the first time.

In a speech at the White House on Thursday, President Biden once again sought to rally businesses to support vaccination mandates that he said would help reduce the ranks of the unvaccinated in the United States, calling the number of people who have not gotten even a first shot “unacceptably high.”

More than seven million people in the United States have already obtained booster doses of the Pfizer-BioNTech vaccine, and more than a million have received third doses of Moderna’s, even though only those with immune deficiencies are officially eligible.

On Friday, the same expert committee will meet to discuss and vote on whether the roughly 15 million people who received the single-dose Johnson & Johnson vaccine should also be eligible for booster doses. Its members are also supposed to discuss a new federal study that suggests those Americans might be better off getting a booster dose of the Moderna or Pfizer-BioNTech vaccines.

If the F.D.A. quickly authorizes Moderna booster doses, and if the Centers for Disease Control and Prevention signs off after a meeting of its own committee of vaccine experts next week, people in the eligible groups could begin seeking out the shots soon after. In addition to people over 65, those groups include younger adults at high risk of severe Covid-19 or serious complications because of medical conditions or their jobs.

To date, more than 103 million people in the United States have been fully vaccinated with Pfizer’s product, more than 69 million with Moderna’s and about 15 million with the Johnson & Johnson shot.

Dr. Patrick Moore, a panel member and virologist at the University of Pittsburgh, said he voted to recommend a Moderna booster based on a “gut feeling, rather than based on really, truly serious data.” Others questioned whether half a dose was the right amount, and whether a Moderna booster would work better if it was given at least eight months after the second shot, instead of six months.

An independent panel of experts advising the Food and Drug Administration voted on Thursday to recommend a booster shot for many recipients of the Moderna coronavirus vaccine, and on Friday to recommend authorizing booster shots of Johnson & Johnson’s one-dose coronavirus vaccine for people 18 years or older, at least two months after the first dose.

So what happens now? There are further steps at the F.D.A., then steps at the Centers for Disease Control and Prevention, and the process ends with the states. Here’s how it breaks down.

The F.D.A.

• The F.D.A., a federal agency of the Department of Health and Human Services that controls and supervises medications and other elements related to public health, takes up the advisory panel’s recommendation, which includes the question of who should be eligible. The advisory panel’s votes are not binding, but the F.D.A. typically follows them.

• Then the F.D.A. itself issues a determination on whether to authorize the boosters and for whom. Such decisions are typically issued within a few days of advisory committee meetings.

The C.D.C.

• An advisory panel to the Centers for Disease Control and Prevention, the United States’ public health agency, reviews the F.D.A.’s decision. Next week, that panel is scheduled to meet and vote on its recommendations regarding boosters.

• The C.D.C. takes up that panel’s recommendations, and the agency’s director, Dr. Rochelle P. Walensky, issues the agency’s guidance on whether boosters should be used and who should be eligible. That guidance is deeply influential for states, doctors, pharmacies and other health care institutions and the general public. As with the process at the F.D.A., the panel’s recommendations are not binding, but the C.D.C. usually follows them.

  However, there was a rare exception last month: When a C.D.C. advisory panel rejected the F.D.A.’s recommendation that frontline workers be included among those eligible for the Pfizer-BioNTech booster, Dr. Walensky overrode her own agency’s advisers and sided with the F.D.A.

The states

State health departments generally follow the recommendations of the C.D.C. In the case of the Pfizer-BioNTech booster, the shots began being administered widely immediately after Dr. Walensky announced the C.D.C.’s guidance to allow them for people over 65, patients in nursing homes and other institutional settings, those with underlying medical conditions, and frontline workers.

The Texas Supreme Court on Thursday temporarily blocked the San Antonio public school district’s requirement that its educators and staff be fully vaccinated against Covid-19. The mandate, which the district announced in August, had been set to take effect on Friday.

In its order, the court said it was not ruling on the underlying claims in the case. Similar issues are at play in lawsuits over local governments’ mask mandates, and the court said it had “not yet had the opportunity to consider the merits of these challenges.”

The dispute over vaccine and mask mandates has played out in court battles for months in Texas, where Republican Gov. Greg Abbott has tried to ban them.

Before the State Supreme Court blocked the San Antonio school district’s vaccine mandate, a lower court had upheld it earlier this month. When the district announced its vaccine mandate in August, it was paired with a mask mandate, but that was blocked by the State Supreme Court days later.

Mr. Abbott issued an executive order this week that prohibits nearly all coronavirus vaccine mandates in Texas, including private companies that had been exempt from earlier orders. That clashed with the plans of several major companies that have significant presences in the state, such as Google and Facebook. American Airlines and Southwest Airlines said they would ignore the Texas order and instead follow federal requirements.

In an attempt to codify Mr. Abbott’s order into law, Republicans in the Texas House of Representatives took up a bill this week that would let workers opt out of vaccine mandates “for reasons of conscience” and sue their employers if they tried to enforce the mandates. The bill also provides exceptions for medical conditions and “acquired immunity against Covid-19 through post-transmission recovery,” though it does not specify how that would be determined.

Some opponents said they worried that the bill would prompt a flood of lawsuits.

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‘We Can’t Let Up Now’: Biden Urges Vigilance Against Virus

President Biden expressed optimism in the fight against the coronavirus amid a drop in new cases, while pleading with unvaccinated Americans to get the shots and rallying support for vaccine mandates.

Today, I want to provide a brief update on my plan that I announced in early September to accelerate the path out of this pandemic. It’s working. We’re making progress. Nationally, daily cases are down 47 percent. Hospitalizations are down 38 percent over the past six weeks. Over the past two weeks, most of the country has improved as well. Case rates are declining in 39 states and hospital rates are declining in 38 states. We’re down to 66 million, still unacceptably high number, of unvaccinated people from almost 100 million in July. Every day we see more businesses implementing vaccination requirements, and the mounting data shows that they work. Businesses and organizations that are implementing requirements are seeing their vaccination rates rise by an average of 20 percent or more to well over 90 percent — the number of employees vaccinated, We’re headed in the right direction. We have critical work to do, but we can’t let up now. My team and I are doing everything we can, but I’m calling on more businesses to step up. I’m calling on more parents to get their children vaccinated when they are eligible. And I’m asking everyone, everyone who hasn’t gotten vaccinated, please get vaccinated. That’s how we put this pandemic behind us and accelerate our economic recovery.

President Biden pleaded with Americans to remain vigilant against the coronavirus on Thursday, rallying states and private businesses to support vaccine mandates in an effort to avoid a surge in cases.

“We’re headed in the right direction. We have critical work to do and we can’t let up now,” Mr. Biden said in a speech at the White House. “I’m calling on more business to step up. I’m calling on more parents to get their children vaccinated when they are eligible.”

Mr. Biden projected optimism amid a drop in new cases compared to a devastating summer wave that undermined the president’s commitment to overcome the pandemic and curb the harm it has inflicted on the economy and schools.

The United States is now recording roughly 90,000 new infections a day, down more than 40 percent since August. Hospitalizations and deaths are also falling. Nearly 70 percent of adults are fully vaccinated, and many children under 12 are likely to be eligible for their shots in a matter of weeks.

“That’s important, it’s important progress but it’s not — now is not the time to let up,” Mr. Biden said. “We have a lot more to do.”

The president used the moment to issue a warning that the pandemic is not yet over, an effort to avoid the mistake he made last July when he celebrated “independence from the virus” on the Fourth of July. Nearly 2,000 Americans are still dying every day as the country heads into winter.

Mr. Biden, noting “the 66 million, still an unacceptably high number of unvaccinated people,” sought to encourage private businesses to implement vaccine mandates that have become the focus of Republican attacks.

Gov. Greg Abbott of Texas, a Republican, issued an executive order earlier this week barring virtually any coronavirus vaccine mandate in the state. Gov. Ron DeSantis of Florida, also a Republican, threatened to fine localities that mandate vaccines for government employees, complicating the administration’s efforts to curb the pandemic.

“Vaccination requirements should not be another issue that divides us,” Mr. Biden said.

The Occupational Safety and Health Administration earlier this week submitted the initial text of its emergency temporary standard to the Office of Management and Budget. It must undergo a likely weeks-long interagency review process before it is issued to companies, and some business have said they are waiting for the guidance before implementing mandates.

Mr. Biden also spoke about the administration’s plans for distributing booster shots to vulnerable Americans. The Food and Drug Administration has already authorized booster shots for many people who received their second dose of the Pfizer-BioNTech vaccine at least six months ago.

An advisory committee to the F.D.A. voted unanimously to recommend a third dose of the Moderna vaccine for many of the vaccine’s recipients.

“Boosters are free, I’ll say it again, free, available and convenient to get,” Mr. Biden said.

Mr. Biden also said the F.D.A. is still determining whether to authorize a vaccine for children between the age of five and 11, and should reach a decision “in the next few weeks.”

While the number of daily Covid cases in Utah has begun to fall, the state’s hospitals are still overwhelmed and public health leaders are asking residents not to let their guards down.

There were 570 people hospitalized with Covid-19 on Wednesday, nearing the state’s peak in January, when vaccines weren’t yet widely available, according to a New York Times database. Although new coronavirus cases are trending down, the number of Covid patients remains high and is overstretching hospitals in Utah.

That is why public health leaders in a news briefing on Wednesday warned people to remain vigilant and get vaccinated.

“Now is not the time to let your guard down. Covid is not over,” Dr. Russell Vinik, the chief medical officer at the University of Utah Health, said at the news briefing.

The difference between this latest surge and last winter’s is that Utah doesn’t have as many health care workers to treat Covid patients, Dr. Vinik said. Patients who can no longer delay routine care are streaming back into medical facilities. Health care workers across the country are quitting from burnout, while some in Utah have been lured to other states, such as Nebraska and New York, with the promise of extra pay.

Nationally, Covid hospitalizations are trending downward, according to a New York Times database, but cases and hospitalizations have plateaued at high levels in several states in the Mountain West and Upper Midwest.

Hospitalizations in Idaho set a pandemic record on Oct. 2, but are trending slightly downward again. In Wyoming and Montana, hospitalizations have nearly reached peak levels in recent weeks.

The rate of fully vaccinated people in Utah — 52 percent — is lower than the national figure of 57 percent, according to a New York Times database. But the state’s vaccination rate is still far ahead of most of its neighbors, including Idaho and Wyoming.

An Alaska lawmaker who was barred from Alaska Airlines flights after she defied a federal mandate requiring passengers to wear masks disclosed this week that she had tested positive for the coronavirus.

The lawmaker, Lora Reinbold, a Republican state senator who has also been a vocal critic of vaccine mandates, said on Facebook that she had been exhibiting symptoms of Covid-19, the illness caused by the virus.

Her revelation came as Alaska has been grappling with its worst coronavirus surge of the pandemic.

“It’s my turn to battle Covid head on… game on!” Ms. Reinbold wrote on Tuesday. “Who do you think is going to win? When I defeat it, I will tell you my recipe.”

Ms. Reinbold, 57, drew widespread attention in April after a video emerged of her arguing with employees at Juneau International Airport about the mask rule.

The exchange prompted Alaska Airlines to bar Ms. Reinbold from its flights, a decision that was later upheld. As long as the federal mask mandate is in place — it was extended until Jan. 18, 2022 — Ms. Reinbold will be banned from Alaska Airlines flights, the carrier said in an email on Thursday.

Unable to fly from her district to Juneau, the state capital, a journey that could take more than 19 hours by car and ferry, Ms. Reinbold, who represents Eagle River, Alaska, asked last month to be excused from legislative sessions until next year. The Republican-led Senate accepted her request without objection.

A legislative aide for Ms. Reinbold, who previously called the airline’s ban “mask tyranny,” did not immediately respond to a request for comment on Thursday.

In her Facebook post, Ms. Reinbold revealed that she was “blessed” to have obtained ivermectin, a drug typically used to treat parasitic worms in livestock, which she called the “de-covider.”

In August, the Food and Drug Administration warned that ivermectin should not be taken to treat or prevent Covid-19. Demand for the drug has surged, with Fox News promoting the findings of studies about its use against Covid-19.

The lawmaker said that she was taking “lots of vitamins” and quercetin, one of a large class of compounds called flavonols that are found in fruits and vegetables.

“My Vicks steamer has been a God send!” she added.

Speaking on the floor of the Alaska State Senate last month, Ms. Reinbold continued to take a defiant stance against the federal mask mandate.

“The political ban is still in place as long as Biden’s illegitimate mask mandate is in place on private and public transportation,” she said.

In August, the Transportation Security Administration extended a face mask requirement at airports and on airplanes, commuter buses and trains through Jan. 18. Last month it doubled fines for travelers who refuse to wear masks in airports and on commercial airplanes.

The move came amid a surge in airline complaints of unruly passengers and even violent confrontations between travelers and flight attendants, some of which have been precipitated by disputes over wearing masks.

Ms. Reinbold alluded to Alaska’s recent rise in infections and hospitalizations in her Facebook post.

“I plan to keep my promise to stay OUT of the hospital,” she wrote. “Some of them seem like scary places these days.”

In a subsequent Facebook post on Thursday, Ms. Reinbold said that her flulike symptoms — including a fever, muscle aches and a sore throat — were subsiding, but that she still had a mild cough and had not regained all of her energy.

“I believe there is a zero chance of me going to hospital,” she wrote.

After a brutal summer surge, driven by the highly contagious Delta variant, the coronavirus is again in retreat in the United States. Daily reports of new cases have declined by roughly 40 percent since August, and hospitalizations and deaths are falling, too.

The crisis is not over everywhere — the situation in Alaska is particularly dire — but nationally, the trend is clear, and hopes are rising that the worst is finally behind us.

Again.

Over the past two years, the pandemic has crashed over the country in waves, inundating hospitals and then receding, only to return after Americans let their guard down.

It is difficult to tease apart the reasons that the virus ebbs and flows in this way, and harder still to predict the future.

But as winter looms, there are real reasons for optimism. Nearly 70 percent of adults are fully vaccinated, and many children under 12 are likely to be eligible for their shots in a matter of weeks. Federal regulators could soon authorize the first antiviral pill for Covid-19.

“We are definitely, without a doubt, hands-down in a better place this year than we were last year,” said Dr. Nahid Bhadelia, director of the Center for Emerging Infectious Diseases Policy and Research at Boston University.

But the pandemic is not over yet, scientists cautioned. Nearly 2,000 Americans are still dying every day, and another winter surge is plausible. Given how many Americans remain unvaccinated, and how much remains unknown, it is too soon to abandon basic precautions, they said.

“We’ve done this again and again, where we let the foot off the pedal too early,” Dr. Bhadelia said. “It behooves us to be a bit more cautious as we’re trying to get to that finish line.”

It can be hard to keep track of developments on coronavirus vaccine boosters without a scorecard.

The Food and Drug Administration’s panel of expert advisers voted on Thursday to recommend booster shots for many recipients of the Moderna coronavirus vaccine, and on Friday to recommend boosters for recipients of Johnson & Johnson’s vaccine who are ages 18 and older, at least two months after receiving the first dose.

The agency has already authorized booster shots of the other vaccine in use in the United States, from Pfizer-BioNTech, for certain groups who got that vaccine initially. Third doses of the Pfizer-BioNTech and Moderna vaccines also have been authorized for some people with weaker immune systems, who may not have gotten full protection from the original two doses.

All three vaccines initially provide very strong protection against infection, serious illness and death from Covid-19. The impetus for boosters comes from studies suggesting that while that protection remains strong against serious illness and death, it may decline somewhat over time and could allow more breakthrough infections, especially of the highly contagious Delta variant. The decline tends to be most pronounced in older people and those with certain underlying medical conditions.

Here is a rundown of the booster-shot situation for the three vaccines available in the United States.

Pfizer-BioNTech

What you would get: A third full dose, at least six months after your second.

Where it stands in the U.S.: Available now for many people. The F.D.A. has authorized third shots for people over 65, people with certain medical conditions and some others who are at high risk because of where they work or live. (Some immunocompromised people can get a third shot a month after their second.) The agency has put off a decision on whether to authorize boosters for other people.

Where it stands elsewhere: Israel and some other countries are administering Pfizer-BioNTech booster shots widely.

What the science says: The Pfizer-BioNTech vaccine was the first to win full approval in the United States (for those 16 and older), the first to be authorized for some children (those 12 to 15) and the first to be authorized for boosters; the available data on its safety and effectiveness is especially robust. Some studies suggest that the vaccine may decline in effectiveness over time a bit more than the Moderna vaccine.

Moderna

What you would get: A half-dose, at least six months after your second full dose.

Where it stands in the U.S.: An F.D.A. advisory panel voted on Thursday to recommend Moderna boosters for the same population groups who are now eligible for a Pfizer booster. The panel’s vote is nonbinding, but its recommendations are generally followed by the F.D.A. (Some immunocompromised people can receive a full third dose a month after their second.)

Where it stands elsewhere: Some countries are already offering Moderna booster shots or planning to do so soon.

What the science says: Some studies suggest that the Moderna vaccine’s effectiveness declines less than the other two vaccines available in the United States do. That may mean there is less need for Moderna recipients to get boosters. Taking that into account, an F.D.A. staff report took a neutral stance on Moderna’s booster-shot application.

Johnson & Johnson

What you would get: A second dose, at least two months after the initial dose.

Where it stands in the U.S.: The F.D.A. advisory panel unanimously voted on Friday to recommend boosters, even though an F.D.A. staff report found significant shortcomings in the data that the company submitted with its application. The F.D.A. is not required to follow the panel’s suggestions, but it usually does.

Where it stands elsewhere: No country has yet authorized administering second doses of the Johnson & Johnson vaccine.

What the science says: The Johnson & Johnson vaccine gives strong initial protection after one dose, though not as strong as the Pfizer or Moderna two-dose vaccines, so there has long been interest in boosters for Johnson & Johnson recipients.

The Food and Drug Administration’s panel of expert advisers voted on Friday to recommend authorizing booster shots of Johnson & Johnson’s one-dose vaccine for people 18 and older, at least two months after the first dose. The committee also voted on Thursday to recommend booster shots for many recipients of the Moderna coronavirus vaccine.

While the panel’s recommendations are not binding, they are very likely to influence the F.D.A.’s decision — typically issued within a few days after the advisory committee weighs in. If the agency says yes to the boosters, the process moves to the Centers for Disease Control and Prevention.

Who are the experts on the F.D.A.’s Vaccines and Related Biological Products Advisory Committee?

The committee now has 19 voting members who are scientific authorities from a range of fields, including immunology, vaccine safety and virology. Many are medical practitioners.

Dr. Arnold Monto, the acting chair of the committee, is a professor of epidemiology at the University of Michigan School of Public Health.

Here are the other voting members:

• Dr. Archana Chatterjee, a pediatric infectious diseases specialist, is the dean of the Chicago Medical School and vice president for medical affairs at Rosalind Franklin University of Medicine and Science.

• Capt. Amanda Cohn is a doctor and senior official overseeing vaccine policy at the C.D.C.’s National Center for Immunization and Respiratory Diseases.

• Dr. Oveta Fuller is a trained pathologist and an associate professor of microbiology and immunology at University of Michigan Medical School.

• Dr. Hayley Gans is a professor of pediatrics infectious diseases at Stanford University Medical Center.

• Dr. James Hildreth is a professor of medicine and the president and chief executive officer of Meharry Medical College.

• Dr. Randy Hawkins is a practicing physician who specializes in internal medicine and sits on the committee as a consumer representative.

• Dr. Michael Kurilla is a senior official with expertise in infectious diseases and vaccine development at the National Institutes of Health.

• Dr. Jeanette Lee is a professor of biostatistics at the University of Arkansas For Medical Sciences in Little Rock, Ark., and an expert on clinical trials.

• Dr. Ofer Levy is the director of the Precision Vaccines Program at Boston Children’s Hospital, and a professor of pediatrics at Harvard Medical School.

• Dr. H. Cody Meissner is professor of pediatric infectious disease at the Tufts University School of Medicine and Tufts Children’s Hospital in Boston.

• Dr. Patrick Moore is a professor of microbiology and molecular genetics at the University of Pittsburgh.

• Dr. Michael Nelson is a professor of medicine at the University of Virginia in Charlottesville. He is also president of the American Board of Allergy and Immunology.

• Dr. Paul Offit is a professor of pediatrics at Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine.

• Dr. Steven Pergam is an expert on infectious diseases at the Fred Hutchinson Cancer Research Center in Seattle and an associate professor at the University of Washington.

• Dr. Stanley Perlman is professor of microbiology and immunology at the University of Iowa, and a pediatric infectious diseases specialist with expertise in coronaviruses.

• Dr. Eric Rubin is the editor in chief of the New England Journal of Medicine and an expert on infectious diseases at the Harvard T.H. Chan School of Public Health.

• Dr. Mark Sawyer is a professor of pediatrics and a pediatric infectious disease specialist at the University of California, San Diego, and Rady Children’s Hospital in San Diego.

• Dr. Melinda Wharton is the associate director for vaccine policy at the C.D.C.’s National Center for Immunization and Respiratory Diseases.

Kyrie Irving, the N.B.A. star who has been indefinitely barred from practicing or playing with the Brooklyn Nets because of his refusal to get the Covid-19 vaccine, spoke out publicly on Wednesday night for the first time since the team decided to keep him off the court, saying his refusal was a matter of personal freedom.

“You think I really want to lose money?” Irving, who is set to earn about $40 million in salary this season, said on his Instagram feed in a meandering monologue that included incorrect medical information. More than 90 percent of players in the league are vaccinated, a proportion much higher than in the general population of the United States.

“You think I really want to give up on my dream to go after a championship?” Irving, 29, said. “You think I really just want to give up my job? You think I really want to sit at home?”

On Tuesday, the Nets said they had barred Irving from playing until he becomes “eligible to be a full participant.” New York City requires most teenagers and adults to have at least one vaccination shot to enter facilities such as sports arenas, and Irving has not practiced with the Nets in Brooklyn. Irving joined the Nets in 2019 as they built a team of superstars that includes Kevin Durant and James Harden.

Irving asked that his decision to remain unvaccinated be respected and said that he has no plans to retire. He couched his refusal to get vaccinated in his opposition to mandates, saying nobody should be “forced” to do it.

Irving falsely claimed his decision to remain unvaccinated does not harm other people. The highly contagious Delta variant has quickly spread in areas with low vaccination rates. And hospitals in those areas have been overrun with unvaccinated patients, leaving few beds and staff members to treat other patients.

By the time vaccines for the coronavirus were introduced late last year, the pandemic had taken two of Lucenia Williams Dunn’s close friends. Still, Ms. Dunn, the former mayor of Tuskegee, contemplated for months whether to be inoculated.

It was a complicated consideration, framed by the government’s botched response to the pandemic, its disproportionate toll on Black communities and an infamous 40-year government experiment for which her hometown is often associated.

“I thought about the vaccine most every day,” said Ms. Dunn, 78, who finally walked into a pharmacy this summer and rolled up her sleeve for a shot, convinced after weighing with her family and doctor the possible consequences of remaining unvaccinated.

“What people need to understand is some of the hesitancy is rooted in a horrible history, and for some, it’s truly a process of asking the right questions to get to a place of getting the vaccine.”

In the first months after the vaccine rollout, Black Americans were far less likely than white Americans to be vaccinated. In addition to the difficulty of obtaining shots in their communities, their hesitancy was fueled by a powerful combination of general mistrust of the government and medical institutions, and misinformation over the safety and efficacy of the vaccines.

But a wave of pro-vaccine campaigns and a surge of virus hospitalizations and deaths this summer, mostly among the unvaccinated and caused by the highly contagious Delta variant, have narrowed the gap, experts say. So, too, have the Food and Drug Administration’s full approval of a vaccine and new employer mandates. A steadfast resistance to vaccines in some white communities may also have contributed to the lessening disparity.

Coronaviruses discovered in Laotian bats are surprisingly adept at infecting human cells, showing that such deadly features can indeed evolve outside of a lab, according to a new study.

Virus experts are buzzing about the discovery, which came after scientists traveled to Laos in the summer of 2020 to catch bats that might harbor close cousins of the Covid-19 pathogen.

In the dead of night, they used mist nets and canvas traps to snag the animals as they emerged from nearby caves, gathered samples of saliva, urine and feces, and then released the bats back into the darkness.

The fecal samples turned out to contain coronaviruses, which the scientists studied in high-security biosafety labs, using specialized protective gear and air filters.

Three of the Laos coronaviruses were unusual: They carried a molecular hook on their surface that was very similar to the hook on the virus that causes Covid-19, known as SARS-CoV-2. Like SARS-CoV-2, the bat viruses’ hook allowed them to latch onto human cells.

“It is even better than early strains of SARS-CoV-2,” said Marc Eloit, a virologist at the Pasteur Institute in Paris who led the study, referring to how well the hook on the Laos coronaviruses bound to human cells. The study was posted online last month and has not yet been published in a scientific journal.

Some experts suspect that these SARS-CoV-2-like viruses may already be infecting people from time to time, causing only mild and limited outbreaks. But under the right circumstances, the pathogens could give rise to a Covid-19-like pandemic, they say.

The findings have significant implications for the charged debate over Covid’s origins, experts say. Some people have speculated that SARS-CoV-2’s impressive ability to infect human cells could not have evolved through a natural spillover from an animal. But the new findings seem to suggest otherwise.

“That really puts to bed any notion that this virus had to have been concocted, or somehow manipulated in a lab, to be so good at infecting humans,” said Michael Worobey, a University of Arizona virologist who was not involved in the Laotian bat study.

Fall has traditionally been a fat time for businesses in New York’s North Country, as Canadian visitors flood into the region to celebrate holidays like Canadian Thanksgiving, taking in dazzling displays of foliage and feasting on big sales at local retailers.

That influx has been stymied at the border for much of the last two years by strict controls implemented because of the coronavirus. On Wednesday, however, businesses all along the state’s northern border were celebrating the news that in November, fully vaccinated Canadians would again be allowed into the United States via the two nations’ heavily trafficked land crossings.

“A simple ‘Yahoo!’ seems to be the right answer,” said Kristy Kennedy, the vice president of marketing and tourism for the North Country Chamber of Commerce, in Plattsburgh, about 25 miles south of Quebec. “We could not be happier.”

That sentiment spread across the state to Niagara Falls and other western New York towns and cities, where the border restrictions — and burdensome rules for American travel to Canada — had crippled usually robust business relationships as well as personal ones, separating some extended families for a year or longer.

Walgreens Boots Alliance administered coronavirus vaccinations at a higher-than-expected rate, delivering 13.5 million vaccinations in the three months that ended in September, which helped bolster its sales, the company reported on Thursday.

The company also announced that it would invest an additional $5.2 billion into VillageMD, a venture that aims to reach underserved communities, to support its rollout of at least 600 primary care practices at Walgreens in the United States.

Shares of Walgreens Boots Alliance jumped by more than 8 percent after the announcement.

The company reported that same-store sales grew 8.9 percent in its fiscal fourth quarter compared with the same period last year. Health and wellness sales increased 14 percent, strengthened by at-home coronavirus tests and cold and flu products.

“Comparable U.S. pharmacy and retail sales both saw robust growth, and recovery continued in our U.K. business as Covid-19 restrictions eased in the quarter,” Rosalind Brewer, the chief executive of Walgreens Boots Alliance, said in a statement.

Net profit jumped 68 percent in the quarter to $627 million; it was $373 million a year earlier. The company also benefited from digital tools that eased curbside and drive-through pickup, leading to 100 percent growth in revenue for the fourth quarter compared with last year.

Walgreens is one of the largest among dozens of grocery and drugstore chains that are giving vaccines allocated by states and via the federal pharmacy vaccination program. The company brings in revenue from the vaccine administration fees paid by government and private payers as well as from purchases made by shoppers coming in for vaccines.

The company requires people to create a Walgreens account to search online for a vaccine appointment, which helped increase membership in its MyWalgreens program to 85 million members from 75 million members in the previous quarter.

But it faced also complaints in the quarter from customers and the Centers for Disease Control and Prevention about the timing of a second dose of the vaccine developed by Pfizer and BioNTech. Walgreens had been scheduling second doses for that shot four weeks apart, but agreed to follow guidance from federal health officials, who recommend a three-week gap.

Deaths from tuberculosis, the world’s biggest infectious disease killer until the Covid-19 pandemic arrived, have increased for the first time in more than a decade, totaling more than 1.5 million people in 2020. That trend is expected to worsen in 2021 and 2022, according to a report released on Thursday by the World Health Organization.

The report confirmed the warnings from the W.H.O. and other global health organizations that the Covid-19 pandemic would reverse years of progress against other infectious diseases, including TB, H.I.V. and malaria.

“This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, said in a statement.

Reported diagnoses of TB also dropped sharply, to 5.8 million cases in 2020 from 7.1 million in 2019, suggesting that many more cases than before are going undiagnosed and untreated — a trend that is likely to have a long-term effect on TB deaths. And only 2.8 million people were given preventive treatment for TB in 2020, a 21 percent decrease from 2019.

In many poor countries, health care workers, funds and testing equipment that would normally be dedicated to TB were redirected to cope with Covid-19, according to the W.H.O. report. Lockdowns and disruptions in supply chains also interrupted access to treatment and care.

At the same time, global funding for TB has fallen to $5.3 billion from $5.8 billion, less than half of what’s needed, according to the W.H.O. report.

There were some glimmers of good news amid the sobering statistics. In the Russian Federation, the incidence of TB fell by 6 percent a year between 2010 and 2020, and the W.H.O. European Region overall exceeded the 2020 goal with a decrease of 25 percent.

Official statistics on coronavirus cases in Africa give the impression that the continent has avoided the worst of the pandemic. But in a continent where most deaths are not formally registered and many countries are struggling to vaccinate their people, the great majority of coronavirus cases — an estimated six out of seven — are going undetected, according to Dr. Matshidiso Moeti, the Africa director at the World Health Organization.

Speaking at a news briefing on Thursday, Dr. Moeti said the W.H.O. estimated that about 59 million people in Africa had been infected with the coronavirus from the beginning of the pandemic through Oct. 10. Only somewhat more than 8 million cases have been officially recorded.

“Now is the time to go on the offensive against Covid-19, and work with local communities to break transmission chains and stop wider outbreaks from happening,” Dr. Moeti said.

The W.H.O.’s analysis was derived from a coronavirus calculator developed by Resolve to Save Lives, a global public health organization that focuses on cardiovascular disease and on preventing epidemics. The calculator estimates infections based on the number of reported cases and deaths and “an infection fatality rate grounded in population-based studies,” according to a statement by the W.H.O.

Africa remains the continent with the lowest vaccination rates. In nearly half of the African countries that have received Covid-19 vaccines, only 2 percent of the population or less has been fully vaccinated, according to the W.H.O.

In a meeting at the White House, President Biden told President Uhuru Kenyatta of Kenya that the United States would donate more than 17 million doses of Johnson & Johnson’s vaccine to the African Union.

Those doses and earlier shipments to the African Union represent more than half of the Johnson & Johnson doses that the U.S. has bought so far for domestic use, the White House said in a statement.

“Along with the 50 million doses already sent to Africa, and the Pfizer vaccine, which continues to ship several times a week to the continent, these doses will help close the vaccine equity gap,” the statement said.

With limited testing available in many countries, Dr. Moeti said, communities in Africa often were “flying blind,” with asymptomatic people passing on the virus without being aware that they have it.

In a bid to curb transmission, she announced a community-based initiative to enhance coronavirus testing in eight countries: Burundi, Ivory Coast, Republic of Congo, Democratic Republic of Congo, Guinea-Bissau, Mozambique, Senegal and Zambia. The initiative includes wider use of antigen detection, a relatively inexpensive type of test that yields results in around 15 minutes, and a “ring-based” strategy of voluntary testing for anyone living within 100 meters of a positive case.

Dr. Moeti said coronavirus cases appeared to be trending “downward or plateauing” in most African countries, though some were still reporting increases, including Angola, Gabon, and Cameroon. In Rwanda, which had enforced one of the continent’s strictest lockdowns, bars resumed normal operations in late September after being closed for 18 months.

Several African countries are also dealing with outbreaks of other infectious diseases, including the deadly Ebola virus. Ivory Coast confirmed its first Ebola case in almost 30 years in August, and the Democratic Republic of Congo has since reported two fatal cases of Ebola, Dr. Moeti said. Guinea had an outbreak early in the year.

Countries in Latin America and the Caribbean desperately need to increase investment in the health sector, so that the sector can become a motor toward economic recovery from the Covid-19 pandemic, two United Nations agencies reported on Thursday.

“We don’t see a trade-off between health and the economy,” Alicia Bárcena, the head of the Economic Commission for Latin America and the Caribbean, said at a news conference. “The pandemic has already shown us that investment in health is necessary for sustainable growth.” Ms. Bárcena added, “Without health, there can be no sustainable economic recovery.”

On average, Latin American and Caribbean countries spend 3.8 percent of their gross domestic product on health, significantly lower than the 6 percent share the World Health Organization recommends, according to a new joint report by the commission and the Pan American Health Organization, which is part of the W.H.O.

That shortfall in spending contributes to a shortage of health professionals, with only 20 physicians available for every 10,000 people, far fewer than the 30 recommended by the W.H.O.

Dr. Carissa F. Etienne, P.A.H.O.’s director, said that “structural weaknesses of the region’s health systems” affected the region’s ability to respond to the pandemic and left the region short of resources to handle other health issues.

“It is time to transform Latin America and the Caribbean’s health systems,” she said.

Though the region is home to about 8 percent of the world’s population, it has accounted for 30 percent of worldwide deaths attributed to the coronavirus — more than 1.5 million so far.

Many countries in the region have had difficulty immunizing their populations; on average, only 39 percent of people in Latin America and the Caribbean are fully vaccinated, the agencies’ report said.

The pandemic has brought into focus the region’s dependence on imported vaccines and medicines, highlighting the need to increase local manufacturing capacity, they said.

The economic effects of the pandemic have been devastating in Latin America and the Caribbean. Taken together, the region’s economies contracted more sharply in 2020 than in any other year since 1900. The region’s economy is expected to expand by 5.9 percent this year, but even that big a rebound will not be enough to restore output to 2019 levels.

Unemployment, poverty and inequality have all soared, as women in particular dropped out or were pushed out of the work force.

“In addition to giving rise to an alarming public health situation in the countries of Latin America and the Caribbean, the pandemic has also revealed the weaknesses of the economic, social and environmental aspects of the region’s development model,” the agencies said in the report.

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F.D.A. Panel Endorses J.&J. Covid-19 Vaccine Boosters

A Food and Drug Administration advisory panel recommended authorizing booster shots of Johnson & Johnson’s one-dose coronavirus vaccine for people 18 years or older, at least two months after the first dose.

“Today, we are seeking authorization for use of Janssen’s Ad26 Covid vaccine as a homologous booster in those individuals who were previously vaccinated with the single dose.” “Do available data support the safety and effectiveness of Janssen’s Covid-19 vaccine for use under EUA as a booster dose in individuals 18 years of age and older, at least two months after a single dose primary vaccination?” “We do have 19 out of 19 unanimous yes votes for this question. Thank you.”

WASHINGTON — A key federal advisory committee voted unanimously Friday to recommend Johnson & Johnson booster shots, most likely clearing the way for all 15 million people who got the company’s one-dose coronavirus vaccine to receive a second shot.

If the Food and Drug Administration and the Centers for Disease Control and Prevention accept the recommendation, as expected, boosters could be offered by late next week. But many committee members made clear that they believed Johnson & Johnson recipients might benefit from the option of a booster of the Pfizer-BioNTech or Moderna vaccine, something a top F.D.A. official said the agency was considering.

With a series of votes over the past month to recommend boosters for all three coronavirus vaccines used in the United States, the panel set aside significant divisions and skepticism about whether extra shots are needed and edged ever closer to the goal that President Biden laid out in August when he called for boosters for all adults.

Well over 100 million fully vaccinated people will be eligible for boosters if the F.D.A. and C.D.C. endorse the committee’s latest recommendations, even though some scientists say that the evidence supporting boosters remains weak and that it would have been wiser to focus on reaching the unvaccinated, including abroad.

See How Vaccinations Are Going in Your County and State

See where doses have gone, and who is eligible for a shot in each state.

Johnson & Johnson’s vaccine took a beating at Friday’s session, as did the F.D.A. for pushing for a decision without verifying all of the data that the company had submitted.

But the panel members appeared swayed by the argument that it would be unfair to deny Johnson & Johnson recipients an additional shot after endorsing boosters for recipients of the other two vaccines, especially in the face of evidence that Johnson & Johnson offers the weakest protection of the three.

“There is a public health imperative here, because what we’re seeing is that this is a group with overall lower efficacy than we have seen with the mRNA vaccines,” said Dr. Arnold Monto, the committee’s acting chairman and a professor of epidemiology at the University of Michigan School of Public Health. “So there is some urgency there to do something.”

In its second successive day of discussion on boosters, the group wavered on whether it would be wise to soon offer extra shots to younger recipients of the Pfizer and Moderna vaccines.