U.S. Vaccinations Slow, Even as Caseloads Remain High

The average number of daily vaccine doses administered in the U.S. has fallen to its lowest level since March 31. Here’s the latest pandemic news.,

LiveUpdated April 25, 2021, 9:43 a.m. ETApril 25, 2021, 9:43 a.m. ET

A fire at a Baghdad hospital treating Covid patients kills dozens. The U.S. is under pressure to allow exports of vaccine components that India needs.

A pop-up Covid-19 vaccination center in Newark on Friday. The United States is vaccinating fewer people on a daily basis than earlier this month, though coronavirus cases remain stubbornly high.
A pop-up Covid-19 vaccination center in Newark on Friday. The United States is vaccinating fewer people on a daily basis than earlier this month, though coronavirus cases remain stubbornly high.Credit…James Estrin/The New York Times

Vaccination rates are falling in the United States, despite the spread of highly contagious virus variants that are fueling the country’s alarmingly high caseload.

More than 50,000 new U.S. cases were reported on Saturday, and case rates are similar to those of the second wave last summer. But the average number of vaccine doses being administered each day, which rose for months and peaked at 3.38 million, has now fallen to 2.86 million, its lowest level since March 31, according to data from the Centers for Disease Control and Prevention.

The vaccination rate stopped climbing on April 13, when federal health officials recommended pausing the use of Johnson & Johnson’s vaccine to allow researchers to examine a rare blood-clotting disorder that emerged in six recipients. The Food and Drug Administration lifted the pause on Friday, opting to add a warning about the risk to vaccine labeling.

Experts aren’t sure why vaccination rates have begun falling, or whether vaccine hesitancy, an issue before the Johnson & Johnson pause, is entirely to blame. They suggest the issue is more complicated. Many Americans who were eager and able to be vaccinated have now been inoculated, experts believe, and among the unvaccinated, some are totally opposed while others would get a vaccine if it were more accessible to them.

Whatever the reason for the slowdown in vaccinations, it could delay the arrival of herd immunity, the point at which the coronavirus cannot spread easily because it cannot find enough vulnerable people to infect. The longer that takes, the more time there is for dangerous variants to arise and possibly evade vaccines.

Elected leaders and public health officials are left struggling to tailor their messages, and their tactics, to persuade not only the vaccine hesitant but also the indifferent. As mass vaccination sites begin to close, more patients could get vaccinated by their own doctors, with whom people are most at ease — a shift that would require the Biden administration to distribute the vaccines in much smaller shipments to many more providers.

Resuming use of the single-shot Johnson & Johnson vaccine should help with hard-to-reach populations like Americans in remote communities, migrants and older people who may have difficulty leaving their homes.

White House and state health officials are calling the next phase of the vaccination campaign “the ground game,” and are likening it to a get-out-the-vote effort.

“We’re entering a new phase” in the country’s vaccination effort, said Dr. Mark McClellan, former commissioner of the Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University. “In most parts of the country now, there are unfilled vaccination appointments available.”

People who were clamoring for a vaccine have been inoculated, including those who were willing to schedule appointments and wait in long lines at mass vaccination sites, he said.

“Now, it’s more about bringing vaccines to the people who want them but haven’t been able to easily reach the existing sites,” Dr. McClellan said. Walk-in availability, which New York City allowed at city-run sites starting on Friday, could also help vaccinate more people, he said.

Dr. Ashish Jha, the dean of the Brown University School of Public Health, cautioned that it would be “hugely problematic” to broadly denounce those who had yet to get a vaccine — because of indifference or inconvenience — as “resisters.” He said on National Public Radio last week that “there are lots of people who are perfectly happy to get a vaccine but aren’t desperate for it — aren’t convinced that they need it badly.”

Rupali J. Limaye, a professor who studies vaccine behavior at Johns Hopkins Bloomberg School of Public Health, said as vaccinations continued, some might think: “If these other people are vaccinated, why do I need to get it?” but added, “We still need those people to get it to reach herd immunity.”

With temperatures getting warmer, many states have already eased social-distancing measures, and some have even appeared to return to normal activity, alarming officials. Dr. Anthony S. Fauci, the nation’s top infectious disease expert, has said that restrictions should remain in place until there are fewer than 10,000 new cases a day — a number that the United States will not reach by Aug. 1, according to projections from the Institute for Health Metrics and Evaluation at the University of Washington.

“It will feel over in the summer,” said Ali H. Mokdad, a professor of health metrics sciences at the institute. “But somebody like me who works in public health will feel like swimming upstream, telling people in the summer we are not out of danger.”

United States > United StatesOn Apr. 24 14-day change
New cases 50,575 -12%
New deaths 725 -1%
World > WorldOn Apr. 24 14-day change
New cases 403,538 +17%
New deaths 8,837 +3%

U.S. vaccinations >

Where states are reporting vaccines given

Fully vaccinated

At least one dose

Other trackers:

The body of a Covid-19 victim being carried at a crematorium in New Delhi on Friday.
The body of a Covid-19 victim being carried at a crematorium in New Delhi on Friday.Credit…Atul Loke for The New York Times

Biden administration officials are coming under increasing pressure to lift restrictions on exports of supplies that vaccine makers in India say they need to expand production amid a devastating surge in Covid-19 deaths there and falling demand in the United States.

Funeral pyres have lit up the night sky in the worst affected cities, and the country has set a global record of 350,000 new infections a day, which experts say could be a vast undercount.

The State Department spokesman, Ned Price, said in response to questions about the export ban that “the United States first and foremost is engaged in an ambitious and effective and, so far, successful effort to vaccinate the American people.”

The export restrictions fall under the Defense Production Act, which former President Donald J. Trump invoked in the early days of the pandemic and President Biden has used since February to increase vaccine production in the United States.

Mr. Price’s comments came on Thursday, the same day Mr. Biden organized a global climate summit with world leaders, which included India’s prime minister, Narendra Modi.

India, the world’s most-populous democracy, is a vital U.S. partner, especially at a time when relations with China are at a low point.

“It’s of course not only in our interest to see Americans vaccinated,” Mr. Price went on to say. “It’s in the interests of the rest of the world to see Americans vaccinated.”

That did not go down well in India.

“By stockpiling vaccines & blocking the export of crucial raw materials needed for vaccine production, the United States is undermining the strategic Indo-US partnership,” Milind Deora, a politician from Mumbai, one of the hardest-hit cities, wrote on Twitter.

India has also restricted the export of its domestically produced vaccines to meet Indian demand. That could halt the nascent vaccination campaign in Africa, which has 17 percent of the world’s people and relies on vaccines produced in India.

In the United States, county health departments that couldn’t keep up with vaccine demand a month ago have started closing some of their mass vaccination sites because they lack customers (some counties are declining vaccine shipments).

The seven-day U.S. average of vaccinations has declined somewhat in recent days, to 2.86 million doses daily as of Saturday, from a high point of 3.38 million last week, according to a New York Times analysis of data from the Centers for Disease Control and Prevention.

At a news conference on Friday, Jeffrey D. Zients, the White House’s Covid-19 response coordinator, acknowledged that the pace of vaccinations nationally would ebb. “We expect daily vaccination rates will moderate and fluctuate,” he said.

The aftermath of a fire at a hospital in Baghdad on Sunday.
The aftermath of a fire at a hospital in Baghdad on Sunday.Credit…Murtaja Lateef/EPA, via Shutterstock

A fire sparked by an exploding oxygen cylinder killed at least 82 people, many of them Covid-19 patients, at a Baghdad hospital late Saturday, the latest example of the pandemic’s devastating impact on a country riddled with corruption, mismanagement and a legacy of decrepit infrastructure.

The hospital, a facility dedicated to Covid-19 patients in one of Baghdad’s poorer neighborhoods, had no smoke detectors, sprinkler system or fire hoses, said Maj. Gen. Khadhim Bohan, the head of Iraq’s civil defense forces. The fire spread quickly because of flammable material used in false ceilings in the intensive care ward, he said.

“There were no smoke detectors,” General Bohan said. “If there had been smoke detectors, the situation would have been totally different.”

At least 110 people were injured.

Prime Minister Mustafa al-Khadimi called the fire a crime and ordered an investigation within 24 hours into possible negligence at the hospital, the Ibn al-Khatib.

Fans filled the stadium as the band Six60 performed at Eden Park in Auckland, New Zealand, on Saturday.
Fans filled the stadium as the band Six60 performed at Eden Park in Auckland, New Zealand, on Saturday.Credit…David Rowland/Associated Press

AUCKLAND, New Zealand — More than 50,000 fans packed into Eden Park stadium, New Zealand’s largest, on Saturday night for what is believed to be the largest live in-person concert since the pandemic began.

Through a combination of swift lockdowns and border closures, New Zealand has all but eliminated the coronavirus, with 2,600 cases and 26 deaths reported since the start of the pandemic, according to a New York Times database.

Masks are rarely worn, and there are no social-distancing requirements in place. Instead, people are encouraged to scan in on the country’s tracking and tracing system, and hand sanitizer is widely available.

“Next time they tell you it’s impossible, show them this,” Six60, the New Zealand band headlining the concert, wrote in a comment on an aerial photograph of the crowd, posted to its Instagram account.

The event sold out in a matter of weeks. Featuring pyrotechnics and a Maori kapa haka group, it was the first time a musical act had been permitted to headline an event at Eden Park.

While hard-hit countries like Spain, which last month held an experimental indoor concert for 5,000 fans, test out safe ways to resurrect live music in a post-Covid environment, venues in New Zealand have been operating much as they did before the pandemic.

Less than 3 percent of New Zealand’s population has received a dose of a vaccine, according to a New York Times database, and audience members are not required to present proof of inoculation or a negative virus test.

Large live music events are also being organized in other places that have been able to curb the spread of the virus. In Taiwan, the singer-songwriter Eric Chou played sold-out events last year at Taipei Arena, with tickets capped at 10,000 people. In China, over 4,000 live concerts were held during the first week of October for the country’s National Day celebrations.

Perhaps the greatest change for New Zealand is the lack of international performers. With the border closed to almost everyone but citizens and some essential workers, performing artists have had to apply for special permission to enter the country, then spend two weeks quarantining in hotels. The Australian children’s entertainment group The Wiggles and a tribute act to the band Queen have been among those granted special entry visas for entry.

New Zealanders have instead embraced local acts. A national tour by the singer-songwriter Marlon Williams sold out in New Zealand’s largest cities. The singer Benee, who gained fame from TikTok and hails from Auckland, headlined the annual music festival Rhythm and Vines near the city of Gisborne, which attracted 23,000 attendees.

A new trans-Tasman travel corridor, which permits quarantine-free travel between Australia and New Zealand, began last week, opening the way for the Australian singer-songwriter Courtney Barnett to announce a 10-date tour in July.

People waiting to get vaccinated in New Orleans this month.
People waiting to get vaccinated in New Orleans this month.Credit…Emily Kask for The New York Times

More than five million Americans, or nearly 8 percent of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccination campaign.

Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, local health officials are confronting a new challenge of ensuring that those who do get inoculated are doing so fully.

The reasons vary for why people are missing their second shots. In interviews, some said they feared the side effects, including flulike symptoms, which were more common and stronger after the second dose. Others said they felt that they were sufficiently protected with a single shot.

Those attitudes were expected, but another hurdle has been surprisingly prevalent. A number of vaccine providers have canceled second-dose appointments because they ran out of supply or didn’t have the right brand in stock.

Walgreens, one of the biggest vaccine providers, sent some people who got a first shot of the Pfizer or Moderna vaccine to get their second doses at pharmacies that had only the other vaccine on hand.

Several Walgreens customers said in interviews that they scrambled, in some cases with help from pharmacy staff members, to find somewhere to get the correct second dose. Others, presumably, simply gave up.

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