Covid-19 Global News: Live Updates on Vaccine Booster Shots

More people in Florida are catching the coronavirus, being hospitalized and dying of Covid-19 now than at any previous point in the pandemic, underscoring the perils of limiting public health measures as the Delta variant rips through the state.

This week, 227 virus deaths were being reported each day in Florida, on average, as of Tuesday, a record for the state and by far the most in the United States right now. The average for new known cases reached 23,314 a day on the weekend, 30 percent higher than the state’s previous peak in January, according to a New York Times database. Across the country, new deaths have climbed to more than 1,000 a day, on average.

And hospitalizations in Florida have almost tripled in the past month, according to federal data, stretching many hospitals to the breaking point. The surge prompted the mayor of Orlando to ask residents to conserve water in order to limit the strain on the city’s supply of liquid oxygen, which is needed both to purify drinking water and to treat Covid-19 patients.

Even as cases continue to surge, with more than 17,200 people hospitalized with the virus across Florida, Gov. Ron DeSantis, a Republican, has held firm on banning vaccine and mask mandates. Several school districts have gone ahead with mask mandates anyway.

Overall, 52 percent of Floridians are fully vaccinated, but the figure is less than 30 percent in some of the state’s hardest-hit counties.

On Monday, dozens of doctors and hospital employees in Palm Beach County gathered for an early morning news conference to beseech the unvaccinated to get shots, emphasizing that the surge was overwhelming the health care system and destroying lives.

“We are exhausted,” said Dr. Rupesh Dharia, an internal medicine specialist. “Our patience and resources are running low.”

A growing proportion of the people inundating hospitals and dying in Florida now are coming from younger segments of the population, particularly those ages 40 to 59, which were less vulnerable in earlier waves of the pandemic. The Delta variant is spreading among younger people, many who thought they were healthy and did not get vaccinated.

Dr. Chirag Patel, the assistant chief medical officer of UF Health Jacksonville, a hospital system in Northeast Florida, said the patients hospitalized with the virus during this latest surge tend to be younger and have fewer other health issues, but are nearly all unvaccinated. Of those who have died, including patients ranging in age from their 20s to their 40s, more than 90 percent were not inoculated, Dr. Patel said.

“We’ve had more patients this time around that have passed away at a younger age with very few if any medical problems,” he said. “They simply come in with Covid, and they don’t make it out of the hospital.”

Two months ago, the number of Covid-19 patients admitted at the system’s two University of Florida hospitals in Jacksonville was down to 14. On Tuesday morning, 188 coronavirus patients were in the hospitals, including 56 in the intensive care units.

One of the hardest parts of his job, Dr. Patel said, is having to tell family members that their unvaccinated loved one had succumbed to the virus. “It’s just such a senseless and preventable way of ultimately dying,” he said.

Lisa Waananen, Alison Saldanha and Sarah Cahalan contributed reporting.

Pfizer and BioNTech said on Wednesday they were now applying to the Food and Drug Administration for supplemental approval of a coronavirus vaccine booster shot for those aged 16 and up, and will submit all their supporting data by the end of this week. The move came as the companies said that a third shot of the vaccine sharply increased the levels of antibodies against the virus.

The companies conducted a study of 306 volunteers who received a booster shot about five to eight months after their second shot. Researchers found that the level of antibodies that block the coronavirus jumped more than three times higher than the level after the second dose.

The side effects of a third injection were about the same as after the initial two doses, the companies said. The underlying data was not included in the news release, nor were the dates or location of the study specified. The companies said they were preparing a scientific publication describing the research.

The news of Pfizer and BioNTech’s booster application came two days after the F.D.A. fully approved their two-dose vaccine for those 16 and older, making it the first to move beyond emergency use status.

Over the past few weeks, federal regulators have been racing to collect and evaluate data on booster shots. If the F.D.A. decides additional shots are safe and effective, the Biden administration has said it wants adults to get a third injection eight months after their second shot of the Pfizer or Moderna vaccines, starting the week of Sept. 20.

Federal health officials said last week that they believe that the potency of the Pfizer-BioNTech and Moderna vaccines wanes over time, raising the risk of infection from the highly contagious Delta variant. While data indicate that the vaccines continue to offer robust protection against hospitalization and severe disease, the officials said they fear that the situation could change without booster shots.

Some public health experts have challenged the plan as premature, saying the available data shows that the vaccines are holding up well against severe disease and hospitalization, including against the Delta variant. Extra shots would be warranted only if the vaccines failed to meet that standard, some have said.

Pfizer executives presented an early look at their booster data on July 23, during their second-quarter earnings call. In a smaller study, they found that antibody levels dropped markedly in the months following a second dose. But those levels jumped back up after a third dose. When researchers expanded their focus to a larger group of subjects, they continued to find a strong effect from the boosters.

Antibodies that can neutralize the coronavirus are only one kind of defense our immune systems use to fight it. The new study did not include details about other defenses provoked by the vaccine, such as immune cells trained to kill infected cells.

The participants in the new booster study were between the ages of 18 and 55. It was not immediately clear why the study did not include older people. Volunteers were followed for a median period of 2.6 months.

Pfizer and BioNTech said that in addition to the F.D.A., they plan to submit their data to regulatory authorities in Europe and other countries.

The administration’s booster plan does not as yet include recipients of Johnson & Johnson’s one-shot vaccine. Johnson & Johnson announced earlier on Wednesday that unlike the studies of Moderna’s and Pfizer’s vaccines, a study of 17 volunteers showed little change in their antibody levels over the course of six months.

But the study also showed that when the volunteers were given a second shot six months after their first, their antibodies against the coronavirus jumped nine times higher than the level after the first dose. Company officials said they are looking forward to discussing a potential booster strategy for their vaccine with federal health officials.

While Pfizer-BioNTech vaccine was fully approved as a two-shot regimen for those 16 and older, adolescents aged 12 to 15 can continue to be vaccinated under the vaccine’s emergency use authorization. Regulators have only authorized a third shot for some people with weakened immune systems.

A booster shot of the Johnson & Johnson vaccine dramatically raises the levels of antibodies against the coronavirus, the company reported on Wednesday.

Johnson & Johnson will submit the data to the Food and Drug Administration, which is evaluating similar studies from Pfizer and Moderna. If authorized by the agency, the Biden administration wants to provide booster shots eight months after vaccination.

The Johnson & Johnson vaccine was absent from the government’s initial booster plan, announced last week. But with the new data, the company hopes to be part of the initial distribution of additional shots, which could happen as early as September.

“We look forward to discussing with public health officials a potential strategy for our Johnson & Johnson Covid-19 vaccine, boosting eight months or longer after the primary single-dose vaccination,” Dr. Mathai Mammen, the global head of Janssen Research & Development at Johnson & Johnson, said in a statement.

In February, the F.D.A. gave emergency authorization to Johnson & Johnson for its one-shot vaccine. A clinical trial carried out last fall and winter showed that a single shot had a 72 percent efficacy in preventing symptomatic Covid-19 among U.S. participants. In the trial, none of the vaccinated volunteers were hospitalized or died.

Johnson & Johnson carried out its clinical trial before the Delta variant became widespread, leaving open the question of how well the vaccine worked against the highly contagious form of the virus. But in a study released earlier this month, South African researchers found that a single shot of the Johnson & Johnson vaccine was up to 95 percent effective against death from the Delta variant, and reduced the risk of hospitalization by 71 percent.

In its new study, Johnson & Johnson tracked 17 volunteers from last year’s clinical trial. Six months after vaccination, their level of antibodies had changed little.

That’s different than the pattern seen with the Moderna and Pfizer-BioNTech vaccines. Those shots initially produce higher levels of antibodies, but their levels then drop over several months.

When volunteers in the Johnson & Johnson trial were given a booster shot at six months, their antibodies against the coronavirus jumped nine times as high as after the first dose.

Studies on the Moderna and Pfizer-BioNTech vaccines found a comparable jump in antibody levels. Because the three vaccines were not tested in a head-to-head comparison, it’s not possible to determine which one provides the biggest boost.

Johnson & Johnson said that it had submitted a manuscript describing the research to the website Medrxiv. It has not been posted there yet.

Noah Weiland contributed reporting.

To help address unequal access to Covid-19 vaccines around the world — an issue that “remains the Achilles’ heel” of the pandemic fight —  the World Health Organization is starting a program to manufacture vaccines in Latin America and the Caribbean, Dr. Carissa Etienne, the director of the Pan American Health Organization, said Wednesday.

“Much of today’s vaccine supply remains in the hands of wealthy nations around the world,” she said. “We must expand regional pharmaceutical production so we can be in the driver’s seat.”

She said her organization, which is part of the W.H.O., was analyzing about 30 proposals to manufacture messenger RNA vaccines — the same type as the Pfizer-BioNTech and Moderna shots — and expects to decide next month which ones to implement.

The “most feasible proposals,” including those that already have guaranteed investment backing, will get priority in an effort to expedite the project, according to Dr. Jarbas Barbosa, the pan-American agency’s assistant director.

The mRNA “vaccines are some of the most effective vaccines against Covid-19, and the technology is highly adaptable, so it has enormous potential to be used against other viruses,” Dr. Etienne said.

Vaccines produced by the program are to be distributed to countries in Latin America and the Caribbean, a region where an average of only 23 percent of the population has been fully vaccinated so far. “In many countries coverage is much lower,” Dr. Etienne said. “Just over 3 percent of people have been vaccinated in Guatemala, and a little over 4 percent in Jamaica.”

Many islands in the Caribbean, including Jamaica, are reporting steep surges in new cases and Haiti’s health system is struggling to care for survivors of the devastating Aug. 14 earthquake that killed more than 2,200 people.

“Logistics and security challenges continue to limit the delivery of supplies, the deployment of personnel to affected areas and the transfer of patients to other hospitals,” Dr. Etienne said.

Mayor Lori Lightfoot of Chicago said on Wednesday that all city employees will have to be fully vaccinated by Oct. 15. The action by the city, the second-largest in the United States to impose such a requirement, came as coronavirus infections continue to spread rapidly across the country.

The policy will apply to more than 30,000 employees, including police officers, firefighters, park employees and sanitation workers. Employees may apply for a medical or religious exemption.

“As cases of Covid-19 continue to rise, we must take every step necessary and at our disposal to keep everyone in our city safe and healthy,” Ms. Lightfoot said in a statement. “Getting vaccinated has been proven to be the best way to achieve that and make it possible to recover from this devastating pandemic. And so, we have decided to join other municipalities and government agencies across the nation, including the U.S. military, who are making this decision to protect the people who are keeping our cities and country moving.”

The Los Angeles City Council passed a similar vaccine mandate last week for the city’s nearly 60,000 municipal workers (the public schools there are not part of the city government). Los Angeles County and the city of Seattle have also adopted mandates.

In New York City, Mayor Bill de Blasio has announced that teachers and other school employees will be required to be vaccinated, and other city employees must either be vaccinated or submit to weekly coronavirus tests.

The Food and Drug Administration granted full approval on Monday to Pfizer-BioNTech’s coronavirus vaccine for people 16 and older, making the vaccine the first to move beyond emergency-use status in the United States.

Ms. Lightfoot, whose administration has had a rocky relationship with major labor unions, is expected to face resistance from their members, particularly in the union representing police officers. She said on Wednesday that her administration was in conversations with labor unions to “create a vaccination policy that is workable, fair and effective.”

The Fraternal Order of Police in Chicago said earlier this week that it opposed a mandate and was awaiting more information from the mayor’s office.

Bob Reiter, the president of the Chicago Federation of Labor, which represents union members in Chicago and Cook County, said that while unions believe in the benefits of vaccination, “we do not believe punitive mandates are the right path to significantly increase vaccine uptake.”

“We believe this announcement may harden opposition to the vaccine, instead of protecting the workers who have sacrificed so much over the past 18 months,” Mr. Reiter said in an email.

Nearly 64 percent of Chicago residents age 12 and older have been fully vaccinated; nationwide, 60 percent of Americans 12 and older have been fully vaccinated.

Mandatory vaccination against the coronavirus for active-duty U.S. service members who have not already gotten shots will begin now, though no hard deadline has been set to complete it, the secretary of defense said in a memo.

Lloyd J. Austin III, the secretary, directed “the secretaries of the military departments to immediately begin full vaccination of all members of the armed forces under D.o.D. authority on active duty or in the Ready Reserve, including the National Guard, who are not fully vaccinated against Covid-19.”

The memo, dated Tuesday, said that only vaccines that have been federally approved will be used. It said the leaders of each branch of the military should “impose ambitious timelines for implementation” and report back regularly on progress, using established systems for mandatory vaccine reporting.

John F. Kirby, a spokesman for the Pentagon, said at a news conference on Wednesday that 68 percent of active-duty troops were already fully vaccinated, including the National Guard and Reserves. He said the Navy was the most-vaccinated branch, with 73 percent of sailors fully inoculated, while the Army was the least, with just 40 percent of soldiers fully vaccinated.

“The secretary has made clear his expectation to the military departments that he wants them to move with some alacrity here, and get the force fully vaccinated as fast as possible,” Mr. Kirby said.

Federal approval for Pfizer-BioNTech’s vaccine for people 16 and older on Monday allowed the military to begin requiring Covid vaccinations. The other two vaccines now in use in the United States — made by Moderna and Johnson & Johnson — only have emergency use authorizations from the Food and Drug Administration.

“Mandatory vaccinations are familiar to all Service members, and mission critical inoculation is almost as old as the U.S. military itself,” Mr. Austin said. “Our administration of safe, effective Covid-19 vaccines has produced admirable results to date, and I know the Department of Defense will come together to finish the job, with urgency, professionalism and compassion.”

Over the months when vaccination was voluntary for the 1.4 million active-duty members of the military, a current of resistance developed among younger members.

Now that it will be mandatory, Mr. Kirby said, service members who refuse vaccination and lack a valid medical or religious exemption will be offered a chance to discuss the vaccine with a physician and with their commander, which would ideally address the service member’s concerns, before facing discipline.

“It’s a lawful order, and it’s our expectation that troops will obey lawful orders,” Mr. Kirby said. “And we also expect that commanders will have plenty of other tools available to them to get their vaccination rates up, and to get these individuals to make the right decision, short of having to use disciplinary action.”

The Pfizer-BioNTech Covid-19 vaccine is associated with an increased risk of myocarditis, an inflammation of the heart muscle, a large new study from Israel confirms. But the side effect remains rare, and Covid-19 is more likely to cause myocarditis than the vaccine is, scientists reported on Wednesday.

The research, which is based on the electronic health records of about two million people who are 16 or older, provides a comprehensive look at the real-world incidence of various adverse events after both vaccination and infection with the coronavirus.

In addition to myocarditis, the Pfizer vaccine was also associated with an increased risk of swollen lymph nodes, appendicitis and shingles, although all three side effects remained uncommon in the study. Coronavirus infection was not associated with these side effects, but it did increase the odds of several potentially serious cardiovascular problems, including heart attacks and blood clots.

“Coronavirus is very dangerous, and it’s very dangerous to the human body in many ways,” said Ben Reis, a co-author of the new study and the director of the predictive medicine group at the Boston Children’s Hospital Computational Health Informatics Program.

He added, “If the reason that someone so far has been hesitating to get the vaccine is fear of this very rare and usually not very serious adverse event called myocarditis, well, this study shows that that very same adverse event is actually associated with a higher risk if you’re not vaccinated and you get infected.”

The data arrived in the middle of an intense discussion among federal regulators about the risks of myocarditis and pericarditis, which is inflammation of the lining around the heart, in younger recipients of both the Pfizer-BioNTech and the Moderna vaccines.

Experts studying the origins of the coronavirus for the World Health Organization warned on Wednesday that the inquiry had “stalled” and that further delays could make it impossible to recover crucial evidence about the beginning of the pandemic.

“The window is rapidly closing on the biological feasibility of conducting the critical trace-back of people and animals inside and outside China,” the experts wrote in an editorial in the journal Nature. Several studies of blood samples and wildlife farms in China were urgently needed to understand how Covid-19 emerged, they said.

Amid a rancorous debate about whether a laboratory incident could have started the pandemic, the editorial amounted to a defense of the team’s work and an appeal for follow-up studies. A separate report by American intelligence agencies into the pandemic’s origins was delivered to President Biden on Tuesday, but did not offer any new answers about whether the virus emerged from a lab or in a natural spillover from animals to humans.

The international expert team, sent to Wuhan, China, in January as part of a joint inquiry by the World Health Organization and China, has faced criticism for publishing a report in March that said a leak of the coronavirus from a lab, while possible, was “extremely unlikely.”

Immediately after the report’s release, Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general, said that the study had not adequately assessed the possibility of a lab leak.

Virologists have leaned toward the theory that infected animals spread the virus to people. In the editorial published on Wednesday, the expert team reiterated calls to test the blood of workers on wildlife farms that supplied animals to Wuhan markets, to see if they carried antibodies indicating past coronavirus infections. The team also recommended screening more farmed wildlife or livestock that could have been infected. (The editorial also notes, somewhat pessimistically, that many Chinese wildlife farms have been closed and their animals killed since the pandemic emerged, making evidence of early spillover from animals to humans hard to come by.)

The team pointed to a recent report showing that markets in Wuhan had sold live animals susceptible to the virus, including palm civets and raccoon dogs, in the two years before the pandemic began, and argued that the weight of evidence behind a natural spillover was greater than that for a lab leak.

Marion Koopmans, a Dutch virologist and co-author of the editorial, described it in an interview as a “cry for urgency.”

“We were getting a little concerned that there really is virtually no debate about the bulk of the recommendations that are not related to the lab hypothesis, and of course there’s a lot of discussion of the lab story, particularly coming from the U.S.,” she said. “Our concern is that because of that emphasis, the rest doesn’t get any more attention.”

To identify the first cases of the virus, Dr. Koopmans said, scientists also needed to examine blood specimens from late 2019 before they are thrown away. The expert team received assurances on its visit to Wuhan that blood banks there would keep samples beyond the usual two-year period, she said, but has still not received access to them.

The Chinese government has stopped cooperating with investigations by the W.H.O., making it difficult to assess any theories about the virus’s origins.

Michael Ryan, a W.H.O. official, criticized China at a news conference on Wednesday for pushing unproven ideas suggesting that the coronavirus escaped from an American military lab.

“It is slightly contradictory if colleagues in China are saying that the lab leak hypothesis is unfounded in the context of China, but we now need to go and do laboratory investigations in other countries for leaks there,” Dr. Ryan said.

He said, however, that Chinese scientists had reported beginning some of the follow-up studies recommended by the international expert team.

The editorial on Wednesday also raised concerns about delays at the W.H.O. The organization said this month that it would form an advisory group to study the emergence of new pathogens, and that the group would support inquiries into the coronavirus. The editorial warned that this new layer of bureaucracy “runs the risk of adding several months of delay.”

Dr. Tedros, the organization’s director-general, said on Wednesday that establishing the advisory group “will not delay the progress of the studies into the origins of SARS-CoV-2.”

The W.H.O. said that it was already working to verify studies into the earliest known cases outside China.

Reports of new coronavirus cases around the world are showing signs of flattening, even though they are still rising rapidly in the United States, the World Health Organization said in its latest weekly assessment.

In the week ended Aug. 22, the W.H.O. said, some 4.5 million new cases were reported worldwide, about the same as the week before, and the rate now “seems to be stable” after two months of sustained growth.

“It is stable at a very high level,” Dr. Tedros Adhanom Ghebreyesus, the director general of the organization, said at a news briefing. “As long as this virus is circulating anywhere, it’s a threat everywhere.”

Deaths reported from Covid-19 were also similar to the previous week, at 68,000 overall, though they continued to rise in Europe and the Americas, the W.H.O. said.

The United States reported the most new cases and deaths of any country, and a 15 percent increase in cases from the week before, the W.H.O. noted, as the Delta variant spread rapidly and politicians sparred over whether to reintroduce mitigation measures. The country recorded 6,712 deaths for the week, an increase of 58 percent from the previous week.

Cases are also rising fairly rapidly in Britain, which recorded 219,919 new cases for the week, an 11 percent increase, the W.H.O. said. Iran and India each reported more new cases than Britain did, but their figures and those of Brazil, another major locus of the pandemic, fell last week.

Japan, host to the Olympic Games and now the Paralympic Games, reported the fastest case growth — its 149,057 new cases for the week represented an increase of 34 percent from the week before. Some Southeast Asian countries, particularly Malaysia and the Philippines, also reported significant increases in cases, while Thailand and the Philippines reported sharp increases in deaths.

So far, the W.H.O. said, about 211 million people around the world have had confirmed coronavirus infections since the start of the pandemic, and just over 4.4 million people are recorded as dying from Covid-19.