After a day that many hoped might add clarity to the rollout of Johnson & Johnson’s troubled Covid-19 vaccine, the picture on Thursday is as muddy as ever in the United States.
The “pause” that U.S. health officials put in place on the use of the vaccine might now stay in place for seven to 10 days. It’s a decision with potentially painful consequences that could ripple worldwide.
After considering whether to reinstate the vaccine, a panel of expert advisers to the Centers for Disease Control and Prevention determined on Wednesday that it needed more time to assess a possible link to a rare but serious blood-clotting disorder.
In South Africa, health officials have stopped giving the Johnson & Johnson shot, two months after dropping another vaccine, from AstraZeneca. The European Union said it would not make any more purchases of the Johnson & Johnson vaccine or of AstraZeneca’s, which has raised similar concerns. If the perception takes hold that rich countries are dumping second-rate shots on poorer nations, suspicions about the efficacy of the vaccines could harden, slowing the worldwide rollout of desperately needed doses.
Already, doctors say, the recent pauses have heartened vaccine skeptics and made many others feel duped.
“People, especially those who were vaccinated, felt like they had been tricked in a way — they were asking, ‘How do we get rid of the vaccine in our body?’” said Precious Makiyi, a doctor and behavioral scientist in the Eastern African nation of Malawi, where health workers have been racing to empty their shelves of nearly expired AstraZeneca doses. “We fought so hard with vaccine messaging, but what has happened this past week has brought us back to square zero.”
In developed countries, too, the Johnson & Johnson woes could erode public confidence. The vaccine is considered ideal for rural and underserved communities because it requires only one shot and is easier to store.
“There was enthusiasm about it because it was a one-time thing,” said Jill Ramirez, chief executive of the Latino HealthCare Forum in Austin, Texas. “It was a really good opportunity for people to get the vaccine. But I feel uncomfortable signing people up for it.”
However, “Anytime there’s a disruption,” Ms. Ramirez said, “that throws a wrench into that trust. There’s going to be repercussions.”
As the Biden administration grapples with the fallout over the vaccine, three of its top health officials — Dr. Anthony S. Fauci, Dr. Rochelle Walensky and Dr. David Kessler — were set to testify on Capitol Hill on Thursday morning before a House Select Committee overseeing the government’s coronavirus response.
The officials are likely to face questions about the safety of the vaccine and whether the suspension of its use will hinder the government response.
The C.D.C. advisory group’s emergency meeting on Wednesday was called to review the reports that had led to the pause on the Johnson & Johnson vaccine: Six cases of rare and severe blood clots in the brain in women ages 18 to 48, one of whom died.
All of the women had received the Johnson & Johnson vaccine before developing the clots, although it is unclear whether the vaccine was responsible. More than seven million people have had this shot in the United States. Public health officials and experts have emphasized that for most people, the benefits of the Covid vaccines far outweigh the risks, and that suspending use of some of them may do more harm than good.
The panel on Wednesday also learned of a seventh woman and a man who experienced the rare condition after receiving the Johnson & Johnson vaccine during clinical trials.
Advisory meetings usually end with a vote on whether or how to use a vaccine. But in this case, the members declined to vote after reviewing several options, including whether to limit use of the vaccine to older adults, saying that they did not have enough information to assess the potential risks.
Addressing the panel, Dr. Camille Kotton of Harvard Medical School warned that losing the Johnson & Johnson vaccine even temporarily represented a big blow to efforts to stop the pandemic, especially in underserved communities.
“Putting this vaccine on pause, for those of us that are frontline health care workers, has really been devastating,” she said.
A leading member of Japan’s governing party said on Thursday that the country would consider canceling the Tokyo Olympics if rising coronavirus cases were not brought under control.
But as his comments lit up the internet, he quickly walked them back, issuing a statement saying that he had been speaking hypothetically and that “our party has not changed its support for holding a safe and worry-free Games.”
Yet the comments were the first public indication that the government is considering canceling the Games, in the face of widespread public discontent about their organization and growing concerns about the pandemic. (Polls indicate that more than 70 percent of Japanese believe the Games should be delayed again or called off entirely.)
Infection rates in Japan, although still relatively low, have climbed in recent weeks, raising fears that the country could soon face a “fourth wave” of cases as it prepares for the Games. They are set to begin in late July, a year after they were postponed because of the pandemic.
Speaking to a television news program, Toshihiro Nikai, the secretary general of the governing Liberal Democratic Party and one of the most powerful politicians in Japan, said that “if the situation becomes more difficult, we’ll have to completely cancel” the Olympics, according to local media reports. The interview was prerecorded and has not yet aired.
Hours later, as headlines about his comments were splashed across the news media, Mr. Nikai sought to soften the message with a statement reaffirming his commitment to the Games.
So far, Japan has avoided the worst of the pandemic, recording fewer than 10,000 deaths — an achievement that many attribute to ubiquitous mask-wearing and an effective public health campaign.
But the country has been slow to roll out vaccines, with shots for elderly citizens only beginning earlier this month.
In the last several weeks, newer and more contagious variants of the coronavirus have driven up case counts in major cities, prompting tough restrictions in parts of Tokyo and other municipalities. Experts are concerned that the Olympics, which are expected to welcome thousands of athletes from more than 200 countries, could become a superspreading event.
The government has reiterated that it intends to put on “safe” Games as a symbol of national and global resilience, although in a modified form that bans, among other things, spectators from abroad.
Prime Minister Justin Trudeau of Canada has come under renewed political attacks for the country’s slow vaccination rate, which lags behind the United States’, just as Canada’s daily per capita increase in Covid-19 cases has edged past that of its neighbor for the first time.
The latest wave of coronavirus infections in Canada, driven largely by the B.1.1.7 variant, has strained the capacity of intensive care units in many parts of the country. Children’s hospitals in Toronto and Ottawa, Ontario’s two largest cities, took the unusual step of opening their intensive care beds to adult patients this week.
Restrictions have been reimposed or expanded in many provinces, with a nightly curfew in parts of Quebec.
For a country that had prided itself on its response to the pandemic, the reversal has come as a blow, if a symbolic one. In Canada, the seven-day average of new daily cases is now at 23 for every 100,000 people, compared with 22 in the United States, according to a New York Times database.
Mr. Trudeau was challenged on Wednesday by opponents from both ends of the political spectrum after the health authorities in the Scarborough area of Toronto closed two clinics and canceled 10,000 vaccinations that had been scheduled for this week because of delayed shipments of the Moderna vaccine.
“The Liberal government has failed to secure enough doses and Canadians are angry,” Jagmeet Singh, leader of the center-left New Democratic Party, said in the House of Commons.
“Canadians deserve better,” said Michelle Rempel Garner, a Conservative lawmaker. “There are zoo animals being vaccinated in the United States.” (She may have been referring to apes at the San Diego Zoo that received a coronavirus vaccine last month.)
Mr. Trudeau acknowledged that the situation was deteriorating in some provinces, but he argued that vaccine shipments to Canada had increased substantially in recent weeks. Canada, which relies entirely on imports for its vaccines, has delayed second shots by up to four months to increase the number of people who will have received at least one inoculation.
Mr. Trudeau said that among the Group of 7 countries, Canada ranks third after the United States and Britain for the number of citizens who have been given at least one injection. More than 15 percent of Canadians have received one shot, compared with 37 percent in the United States and 48 percent in Britain.
Yet Canada’s full vaccination rate lags even more. Less than 2 percent of Canadians have been fully vaccinated, compared with 23 percent of Americans and 12 percent of Britons.
Puerto Rico is reporting a sharp rise in new coronavirus cases and hospitalizations amid a lagging vaccine rollout, and officials are worried that a combination of new variants and people neglecting basic pandemic safety measures may be making things worse.
The island is reporting an average of 1,019 new cases a day — a jump from just 211 a month ago, according to a New York Times database. Hospitalizations have spiked 91 percent in the past two weeks, and deaths are on the rise again.
Like much of the United States, Puerto Rico started to report a drop in cases in mid-January, but in the spring it began to reverse course.
At a news briefing on Monday, Puerto Rico’s health secretary, Carlos Mellado, urged people to change their behavior. More than half the cases, he said, had been traced to family activities.
“I think that there’s a citizen responsibility here,” he said in Spanish. “Every person has to empower themselves for their own health.”
Asked whether he would support a lockdown, Mr. Mellado said, “I won’t discount anything.”
Last week, Puerto Rico announced that it would temporarily close schools again, a month after some were allowed to reopen for the first time in a year. Gov. Pedro Pierluisi also issued an executive order that went into effect last week extending Puerto Rico’s overnight curfew, prohibiting certain mass gatherings and ordering commercial businesses and restaurants to close at 9 p.m.
“Faced with an uptick in cases like we’re seeing, my responsibility is to act immediately,” Mr. Pierluisi said.
Mr. Mellado said many people didn’t seem to understand the severity of the situation, noting that more contagious variants may be contributing to the spread of the virus and that even people who have been fully vaccinated shouldn’t flout the safety protocols.
Residents and experts have also expressed concern about the increasing tourism to the island, with many visitors seemingly ignoring virus precautions. Puerto Rican business owners told CNN last month that visitors often didn’t follow mask-wearing rules or respect the curfew. And recent viral videos have highlighted the issue, with one showing dozens of people crowded together, dancing and singing without masks at a popular San Juan plaza.
Puerto Rico has been slow to vaccinate, lagging behind most states and U.S. territories. About 26 percent of residents has received at least one dose of a Covid-19 vaccine, including about 16 percent who are fully vaccinated. Puerto Rico made anyone 16 or older eligible for a vaccine on Monday.
For Puerto Rico, the pandemic has been yet another crisis. The island has also had to contend with a devastating hurricane, a political crisis and a series of earthquakes in recent years. The Biden administration recently announced that it would release $1.3 billion in delayed aid to the territory to protect against future climate disasters and remove restrictions on another $4.9 billion.