The Palestinian Authority canceled a deal to swap coronavirus vaccine doses with Israel on Friday, citing concerns about the quality of the shots.
Earlier in the day, Israel announced that it would transfer up to 1.4 million nearly-expired doses of Pfizer’s vaccine to the Palestinian territories.
In exchange, the PA would provide Israel with the same number of doses in September or October, after it received a fresh shipment, according to a joint statement from Israeli Prime Minister Naftali Bennett’s office and the nation’s defence and health ministries. (Bennett assumed office on Sunday, replacing longtime Prime Minister Benjamin Netanyahu.)
But almost as soon as the first 90,000 doses arrived from Israel, the PA said it would send them back.
“After the technical teams in the ministry of health examined the first batch of the Pfizer vaccines that were received this evening from Israel, it became clear that the 90,000 doses received do not conform to the specifications contained in the agreement,” Ibrahim Melhem, a PA spokesperson, said at a Friday press conference.
PA Health Minister Mai Alkaila said the doses were supposed to expire in July or August, but the expiration date turned out to be in June, according to Reuters.
“That’s not enough time to use them, so we rejected them,” Alkaila said.
Bennett’s office did not immediately respond to Reuters’ request for comment.
For the past several months, Israelis and Palestinians have witnessed starkly different vaccine rollouts.
Israel has vaccinated a greater share of its population than just about any country so far: around 63% of Israelis have received at least one dose. Many scientists believe that Israel has now reached herd immunity, the threshold beyond which the virus can’t easily pass from person to person.
The nation rolled back the last of its coronavirus restrictions in early June: Businesses can now operate at full capacity, and residents no longer have to show proof that they’ve been vaccinated to enter restaurants, sporting events, or entertainment venues.
Meanwhile, less than 9% of the Palestinian population in the West Bank and Gaza Strip – around 30% of those eligible to get vaccinated – has received at least one vaccine dose, according to Palestinian officials. Many of these doses hail from other countries – including Russia, China, and the United Arab Emirates – as well as COVAX, a global alliance spearheaded by the World Health Organization to vaccinate the world’s poorest nations.
Palestinians in East Jerusalem have access to Israeli health insurance, so they’re eligible to be vaccinated by Israel, but those vaccinations don’t extend to Palestinians in the West Bank and Gaza Strip. As a result, several human-rights organizations have called on Israel to give Palestinians vaccines right away.
“In the Palestinian communities, if they’re not vaccinating as much and then there’s a new strain that comes up that can evade the vaccine protection, then that’s going to be a big issue,” Jorge Alfaro-Murillo, an associate research scientist at the Yale School of Public Health, previously told Insider.
Israel has said that the PA is responsible for its own vaccination campaign. But the nation’s new health minister, Nitzan Horowitz, tweeted Friday that the “important exchange of vaccines” would benefit both sides. That same day, the non-profit organization Physicians for Human Rights Israel called the deal “too little too late.”
Young people who received the Pfizer-BioNTech or Moderna coronavirus vaccines have reported higher-than-usual rates of heart inflammation and swelling, US health officials said on Thursday.
The findings are preliminary and come from a self-reported database of side effects. The Centers for Disease Control and Prevention hasn’t confirmed a link to the vaccines, though researchers are investigating these incidents of heart inflammation, known as myocarditis, and heart swelling, known as pericarditis.
In interviews with Insider on Thursday, cardiologists and infectious-disease specialists said the risk from the vaccine is still tiny compared with the potential damage from getting infected with the coronavirus. Not all experts are convinced there’s a link between the events and the shots.
“It’s not a no-brainer that there’s an association, because the season for getting myocarditis is around now,” Dr. Lorry Rubin, the director of pediatric infectious diseases at Northwell Health’s Cohen Children’s Medical Center, told Insider.
A group of viruses called enteroviruses is the most common cause of myocarditis, Rubin said. Those viruses typically circulate in the summer.
“That’s not the sole cause, but that’s the most common infectious trigger for myocarditis, and that’s more of a seasonal infection,” he said.
All three experts agreed that getting vaccinated, even for young and healthy men and boys, is still the best option.
“You definitely should choose vaccination in that age group because it’s safer than wild-type virus infection,” said Dr. Leslie Cooper, a cardiologist who specializes in myocarditis at the Mayo Clinic.
Early reporting shows more heart side effects than expected
The preliminary data suggests elevated rates of the heart issues among younger vaccinated people, ages 16 to 24. At a Food and Drug Administration advisory meeting on Thursday, CDC officials shared data that included about 12 million doses given to people in this age range. CDC officials said that they would typically expect to see 10 to 102 cases of these heart events in this group but that 275 confirmed cases had been reported.
Most of these cases came after the second dose and were commonly reported in men, according to the preliminary data. The CDC said it was still confirming and investigating these self-reported cases.
The most common symptoms were chest pain and elevated levels of cardiac enzymes. Most of these cases were short-lived; at least 81% of people had already fully recovered from their symptoms, according to the data.
Even if the cases are linked to the vaccine, experts said, the greater risk, by far, is COVID-19.
“We’re talking about an incidence of myocarditis from the vaccine that is 100 times lower than the incidence when you actually get the infection,” Dr. Eliot Peyster, a cardiologist at the University of Pennsylvania, told Insider. “So, yes, it’s probably twice as likely as people who don’t get the vaccine, in a vacuum. But we aren’t in a vacuum. We’re in a pandemic where young people who get the virus get myocarditis in about one in 300 cases.”
The incidence rate among younger people who got the COVID-19 vaccine is still being determined, CDC officials said on Thursday. The agency said it would have more data to present at another meeting next Friday.
A strong immune response to the vaccine could be the culprit
The Pfizer and Moderna shots both use messenger RNA, a new technology that had not been used in a federally approved medicine before the pandemic. Despite its newness, experts said they didn’t think these cases stemmed from something unique to the technology.
Peyster said he would guess it was from a robust inflammatory response to the vaccine, particularly after the second dose.
“Any systemic inflammatory condition – any kind – can generate enough inflammatory stuff where you can actually get a little bit of heart-muscle damage just through systemic inflammation,” he said.
While more than 140 million Americans have been fully vaccinated, the concerns about younger people come as the vaccines start to be used in younger populations. Pfizer’s vaccine was OK’d last month for children as young as 12 years old. Moderna applied for a similar authorization on Thursday.
Not enough shots have been given and tracked in the 12-to-15-year-old population to know whether these heart side effects could be a concern for that age group. Both vaccine developers have said they’re testing their shots in even younger children and infants.
Experts guess that heart side effects will be less common in younger children
Rubin said he didn’t think there was reason for concern among parents deciding whether to get their children vaccinated.
“We don’t know if there’s a causal relationship, and it appears that the rate is low given the millions of people in the 12-to-25-year-old age group who have gotten this vaccine,” he said.
Peyster said he expected that these heart side effects would decrease among the younger ages. Given the history of myocarditis, he said, it’s likely the incidence rate will peak with young adults and adolescents.
The medical experts were unequivocal that the vaccine is clearly the best option overall, for all age groups.
“The evidence says you are much more likely to have heart inflammation from the virus than from the vaccine, even in young, healthy people,” Peyster said. “Therefore, the clear recommendation is vaccine is better than no vaccine.”
Leaders at Sunnyside Community Services, a non-profit center that serves neighborhoods in Queens, New York City, are well aware of the devastating toll COVID-19 has had on their community.
The coronavirus disease had killed more Queens residents than any other borough as of March 2020, when New York City became an epicenter of the pandemic. Queens has the second-highest death rate from COVID-19 among the five boroughs, according to the most recent city data.
In the area of Queens that encompasses Jackson Heights, Elmhurst, and Woodside, 1 in 12 people have had COVID-19 and 1 in 137 have died, according to The New York Times.
At a one-day pop-up vaccine clinic in New York City’s Sunnyside Community Services, workers said community members coming in to get a shot gave them hope about the COVID-19 pandemic’s end, but they will still work hard to ensure no vulnerable member gets left behind.
Jackie Lopez, who leads the COVID Free Queens Coalition at Sunnyside Community Services, told Insider though she feels hopeful about entering a new post-COVID era, she urged federal and state agencies to keep in mind how vulnerable communities have low vaccination rates.
Lopez said she’s heard community members say they can’t get a vaccine because they can’t take days off work if they have side effects. Black and Latino adults have a lower rate of vaccination than the average, according to the University of Minnesota. A volunteer team with the Association of American Medical Colleges said low-income neighborhoods have less access to vaccines, and these residents struggle with navigating the online sign-up processes.
“Our Black and brown communities, our immigrant communities were hit the hardest by the pandemic and we still have work to do to provide accessibility and continue to provide information,” Lopez said.
Inside a pop-up vaccine clinic in one of the hardest hit areas of COVID-19
On May 27, VIP StarNetwork, an on-demand health services company primarily for entertainment industry workers, hosted a one-day pop-up vaccine clinic at Sunnyside Community Services for one day. The May 27 pop-up vaccine site was Sunnyside Community Services’ first, and the organization has scheduled second-dose appointments for June 17.
Johonniuss Chemweno, the CEO of VIP StarNetwork, said the group has been working with the state government to bring pop-up clinics to diverse and low-income communities. VIP StarNetwork, which had been approved as a mass vaccination provider by a federal agency in February, had previously enforced COVID-19 safety protocols for Netflix and Amazon studios.
The pop-up vaccine clinic had a team of more than a dozen nurses ready to help walk-in visitors get a vaccine. The site allowed all adults and people aged 12 to 18 to get a Pfizer, Moderna, or Johnson & Johnson vaccine.
Chemweno told Insider he’s seen an uptick in people under 18 coming into pop-up vaccine sites. The US began inoculating teenagers with the Pfizer vaccine in May.
Recipients were allowed to choose which vaccine they got depending on availability, Chemweno said.
Nada Elrakaivy, a COVID Free Queens Coalition outreach specialist, told Insider many community members have been hesitant about receiving a Johnson & Johnson vaccine after the CDC reported a rare blood clot had been linked to six vaccine recipients. The welcome sign outside the vaccine clinic noted noted that the site had Pfizer vaccines, and two community members asked specifically for the Pfizer vaccine when entering the pop-up site.
Community members entered Sunnyside Community Services and checked-in with Valentina Valencia, an emergency medical technician, and Sofia Mejia, a registered nurse. The two said they had enjoyed “giving back to the community that needs it” through working at with Sunnyside Community services.
After checking in, a nurse administered the vaccine to community members, and recipients had to wait about 15 minutes for observation before leaving.
Elrakaivysaid her group has been giving out free masks to Queens residents on the streets, and providing them with information on how to get a COVID-19 test and vaccine. The COVID Free Queens Coalition took down the names of food vendors, who Elrakaivy said are high-risk due to interacting with many different people daily, and made vaccine appointments for those who were interested.
The team always has a Spanish-speaking person with them to communicate with the area’s Latino community.
“For the most part, every time we ask someone if they got the vaccine, they responded with a yes,” Elrakaivy said. “So Queens is doing pretty well. Better than we expected.”
How Sunnyside Community Services workers are dealing with vaccine hesitancy
Jonah Gensler, the associate executive director of Community Services, told Insider he had been engaging with the community throughout the pandemic.
Prior to the pandemic, Sunnyside Community Services held services for senior citizens, English classes for immigrant residents, and other programs for vulnerable people across Queens. Gensler said the non-profit reached with homebound seniors using their phone numbers gathered at previous Sunnyside Community Services events.
The group set up a food pantry when the pandemic hit to help struggling community members. Community Services has also hosted online town halls to get the word out about COVID-19 safety, Gensler said.
Gensler said a roadblock to getting community members vaccinated has been the hesitancy around getting a vaccine and distrust in the government, especially after wealthier areas got better access to vaccines than communities that had suffered during the height of the pandemic.
“We have heard that some community members say, ‘You know, at the height of this pandemic, when the communities in Elmhurst and Corona and Jackson Heights were suffering the most, we didn’t get all the support we needed,'” Gensler said. “And that does lead to hesitancy.”
But Lopez, the lead organizer of COVID Free Queens Coalition, said Sunnyside Community Services is uniquely positioned to increase interest in vaccines due to its active members.
She said when one community member said they were hesitant about the vaccine at a recent town hall, other community members chimed in to explain why they got the shot. One person took the vaccine to make sure a senior citizen they care for is safe, Lopez said, and one mother said they want to make sure their child is cared for.
“For us, the biggest goal is kind of bringing up those voices and those stories of why people decided to take the vaccine so that other people who are so a little bit more hesitant will be able to make those connections as well,” Lopez said.
Anna Kern, a 33-year-old nurse practitioner in Ferndale, Michigan, didn’t expect to get COVID-19 after being vaccinated. She got her shots in January, but then in April, she tested positive after being exposed to the virus through an unvaccinated coworker. She has had chills, fatigue, and a racing heart ever since.
“You feel lots of guilt – like, what did I do wrong? How could I have been more cautious?” Kern told Insider, adding, “It feels weird to be a statistical anomaly.”
Breakthrough infections – cases of COVID-19 diagnosed at least two weeks after someone is fully vaccinated – are indeed rare. Just 0.01% of vaccinated Americans had developed breakthrough infections as of April 30, according to a recent report from the Centers for Disease Control and Prevention. But the CDC data suggests that women represent a majority of these cases: 63%.
That’s consistent with clinical trial data, which suggests that coronavirus vaccines are slightly less effective among women. Pfizer’s COVID-19 vaccine was found to have a 96.4% efficacy rate in men, but 93.7% in women. Its widely cited 95% efficacy rate is an average of those two results.
Moderna’s vaccine, meanwhile, was found to have a 95.4% efficacy rate in men, but 93.1% in women. And Johnson & Johnson’s shot reduced the risk of moderate to severe COVID-19 by 68.8% in men, but 63.4% in women.
Together, these results are “a bit perplexing,” Sabra Klein, co-director of the Johns Hopkins Center for Women’s Health, Sex, and Gender Research, told Insider.
Normally, women mount stronger immune responses to vaccines than men do, which often leads to greater protection. Scientists suspect that higher levels of estrogen play a role in this, since estrogen stimulates the immune system.
Klein has a theory as to why that same pattern isn’t playing out for the coronavirus vaccines: It’s possible the shots might be less effective against coronavirus variants for women than for men. Five “variants of concern” have caused the majority of breakthrough infections in the US.
Vaccines train the body to recognize the original coronavirus identified in Wuhan, so they might still work well against that strain in women.
“The whole basis of vaccination is to have some memory cells so that, should you get infected with the virus, if it’s even possible to get for you to get infected, you would be asymptomatic as opposed to being symptomatic because your immune system’s already been trained,” Klein said. “So it might be that some of that training and the specificity of that training is greater for females than males.”
There are, of course, other possible explanations. More women than men have been vaccinated so far, and women could be more inclined to seek out COVID-19 tests or report their illness if they’re experiencing breakthrough symptoms. Women also represent the majority of healthcare workers, who are regularly screened for coronavirus infections at work. So it’s possible that the vaccines won’t turn out to be less effective among women after all.
But it’s hard to determine the answer, Klein said, without more data on how each sex is responding to vaccines.
“The biological differences between males and females and how this could be playing out in response to these vaccines has really not received adequate attention,” she said. “I definitely don’t think these kinds of things should be ruled out – and that’s often what happens because it’s easier to think this is reporting bias than something real.”
Age could also influence vaccine efficacy in women
Few real-world studies have examined the effectiveness of coronavirus vaccines among men versus women in great detail, so scientists are hesitant to say whether women are more likely to develop breakthrough infections.
“While the overall percent of reported breakthrough infections was higher in women, we do not know the sex-disaggregated numbers for the severity of these infections,” Vaishali Moulton, an assistant professor of medicine at Beth Israel Deaconess Medical Center, told Insider.
Researchers also don’t know whether vaccine effectiveness is particularly low for women in a certain age bracket.
On average, people who have experienced breakthrough infections are between 40 and 74 years old, the CDC report found. Most women undergo menopause between 40 and 60 – so that could partly explain why vaccine efficacy was lower in that group.
“We know that some of the female immunity definitely declines post-menopausally and is associated with a reduction in estrogen,” Klein said.
Since no mRNA vaccine had been authorized before last year, scientists are also considering whether the platform itself might stimulate different immune responses in each sex.
A new study suggests that men and women may respond differently to the lipid molecules that mRNA vaccines use to deliver coded messages to the body. The researchers found that natural killer cells – a type of immune cell that helps fight off infection – absorbed fewer lipid molecules in female blood samples than in male samples.
Klein said it’s important to explore these sex-based differences quickly, since more breakthrough infections could allow the pandemic to stretch on.
“If we don’t have good efficacy of this vaccine in all people, two things are going to happen,” Klein said. “You’re going to have these breakthrough cases and we are not going to be able to really stop the spread as much as we hope we will. You’re also going to start to lose public trust.”
Vaccine trials have a history of focusing on men
Vaccine trials have a long history of focusing on male participants. US trials weren’t legally required to enroll women until 1993, when Congress passed the National Institutes of Health Revitalization Act.
Prior to that, women were often left out of medical research because doctors and scientists were concerned that experimental drugs could pose a health risk to babies if a woman became pregnant during a study. Researchers also worried that women’s fluctuating hormone levels could complicate trial results. In 1997, the Food and Drug Administration even recommended excluding women of reproductive age – as well as women who were single, used contraception, or whose husbands had gotten a vasectomy – from early-stage drug trials.
In general, today’s clinical trials often prefer to enroll women taking birth control due to similar concerns about pregnancy, Klein said. Many early-stage vaccine trials also default to using exclusively male mice to avoid having to factor in hormonal differences between the sexes. But even when female participants are included in trials, Klein said, there’s no requirement that the results be analyzed separately for men and women.
That often means that women don’t receive the ideal vaccine dose: Women only need half the standard dose of the seasonal flu vaccine, for instance, to generate the same amount of protective immunity as men do. As a result, women are more prone to adverse reactions from drugs or vaccines. A report last year found that women experience adverse drug reactions nearly twice as often as men do.
Some of these issues could be playing out now with coronavirus vaccines.
The vaccines’ early-stage trials included female animals, and human trials enrolled a relatively equal share of men and women. But the trials didn’t separate data for the sexes when it came to side effects, and pregnant women were excluded.
“Whether you’re talking about male-female differences, or you’re talking about pregnancy, a lot of this could have started in preclinical studies in order to just test some of these things,” Klein said. “All too often, the dogma is that biological sex isn’t important in this context.”
Real-life data has also revealed that women tend have more severe side effects after their coronavirus shots than men do. A February report found that roughly 79% of instances of vaccine side effects reported to the CDC came from women, though just 61% of doses were administered to women overall.
Women also represent the majority of people who experience adverse reactions to coronavirus vaccines, including rare blood clots and anaphylaxis (a severe allergic reaction).
Still, biologists like Klein are hopeful that vaccine researchers will begin studying female subjects more closely in the near future.
“If there’s one silver lining of the pandemic for people like myself who work in the broader area of women’s health, it’s that it’s finally making it very clear that women’s health extends beyond our reproductive tract and that we really should be studied and compared with men,” she said.
New York Governor Andrew Cuomo announced Wednesday that 50 teenagers living in the state could win a full scholarship to any state college or university if they get a first shot of the Pfizer-BioNTech vaccine from Thursday.
The “Get a Shot to Make Your Future” prize draw would allow parents of vaccinated 12 to 17-year-olds to add their child’s names to a raffle. State officials would randomly pick ten names every week for five weeks, Cuomo said at a press conference Wednesday.
The scholarship adds to the list of incentives state officials are using to boost vaccine uptake. Last week, Cuomo unveiled a new “Vax and Scratch” program, which would give people $20 scratch-off lottery tickets for a $5 million cash prize. He announced a two-day free pass to any state park for vaccinated New Yorkers on Monday.
Winners of the prize draw would receive up to five years’ worth of funds to cover tuition, books, and room and board for those enrolling in an undergraduate or approved bachelor’s degree program, Cuomo said.
Cuomo said it was open to all vaccinated 12 to 17-year-olds.
New York state also offers the Excelsior Scholarship, which covers tuition costs for students whose parents make $125,000 or less per year.
Cuomo said the state needed to “get creative” to encourage more New Yorkers to get their shot, amid slowing demand.
“Vaccination rates across the state are beginning to slow and our greatest need is with young New Yorkers who make up a large percent of positive cases and have the lowest vaccination percentage in the state,” Cuomo said at the press conference.
As of Wednesday, 46% of New York residents are fully vaccinated against COVID-19, and 55% have received at least one dose, according to a New York Times database.
Scientists expected the vaccine to be effective in young people even before trial results were released – our immune systems get weaker with age, so children and adolescents typically develop strong protection from vaccines. Indeed, Pfizer’s clinical trials showed that the vaccine was 100% effective among 12- to 15-year-olds: Out of more 1,100 adolescents who received the shot, none developed COVID-19.
Moderna, meanwhile, announced on Tuesday that its vaccine was also found to be 100% effective among 12- to 15-year-olds in clinical trials. The immune responses among adolescents appeared comparable to that in adults.
But adolescents seem to develop side effects more frequently after Pfizer’s shot than adults. That’s likely because kids’ immune systems do an excellent job of revving up quickly.
“That feeling of yuckiness and fatigue and fever is your body making a great immune response,” Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Children’s Hospital, told Insider.
The chart below shows the most common side effects among adolescents and young adults (people ages 16 to 25) after Pfizer’s vaccine, depending on the dose.
Fatigue and headaches were more prevalent among adolescents than adults
The most common side effect among adolescents in Pfizer’s trial was injection-site pain: Nearly 91% of 12- to 15-year-olds reported that after either vaccine dose. Fatigue was the second-most common, with 78% reporting the symptom. About 76% reported headaches.
Nearly half of adolescents also reported chills after either dose of Pfizer’s shot, while 42% reported muscle pain. Fever and joint pain weren’t as prevalent, though: 24% and 20% of adolescents reported these side effects, respectively.
In general, almost all of the vaccine’s side effects were more prevalent among adolescents than adults. About 84% of people ages 18 and older who participated in Pfizer’s clinical trials reported injection site pain, while 63% reported fatigue and 55% reported headaches.
Pfizer’s second shot amplifies an existing immune response, so people typically feel more run-down after that dose. That was true overall for both adults and adolescents in clinical trials. Both age groups also saw the side effects stop within a few days.
Clinical trials are studying the vaccines among kids younger than 12
Pfizer’s shot isn’t the first to be distributed to teens – the Food and Drug Administration authorized Moderna’s vaccine for 16- and 17-year olds in December.
Moderna’s chief executive officer, Stéphane Bancel, said in a statement that the company will ask the FDA to authorize its shot for 12- to 15-year-olds in early June. Johnson & Johnson, meanwhile, started testing its single-dose vaccine in adolescents ages 12 to 17 in April.
Moderna and Pfizer are both still testing their vaccines’ safety and efficacy among younger children. Pfizer expects to have data about its shot’s effectiveness among kids ages 2 to 11 by September, followed by data for children ages 6 months to 2 years in November. Moderna could produce similar data for kids between 6 months and 11 years soon after.
Public-health experts widely agree that vaccinating kids could help the US reach herd immunity – the threshold beyond which the virus can’t spread easily from person to person – much faster.
“As you have new children enter the population, they’re going to be susceptible,” Rahul Subramanian, a data scientist at the University of Chicago, told Insider. “When we vaccinate children, it helps us maintain herd immunity.”
This story has been updated with new information. It was originally published on May 19, 2021.
The UK has reported more than 4,000 cases of the variant, which has now spread to 49 countries including the US, according to Global Initiative on Sharing Avian Influenza Data. B.1.1.7, the variant first identified in the UK, remains the most common variant in both countries.
One dose offered far less protection, the Public Health England (PHE) study showed. A single dose of either vaccine was 33% effective against COVID-19 with symptoms caused by B.1.617.2.
The study, which was posted as a preprint Saturday and is yet to be peer-reviewed by other experts, is the first in the world to show that vaccines offer some protection against B.1.617.2, which has mutations that make it highly infectious and potentially able to escape antibodies produced by vaccines.
For comparison, two doses of Pfizer’s vaccine was 93% effective against symptomatic COVID-19 caused by the most common variant in the US, B.1.1.7, and AstraZeneca’s was 66% effective. After one dose, both vaccines were 50% effective against B.1.1.7, the data showed.
Matt Hancock, the UK’s health and social care secretary, said Sunday in a press release that the findings were “groundbreaking” and showed the importance of getting a second dose to secure the “strongest possible protection” against coronavirus variants.
Second shot of Pfizer and AstraZeneca boosted protection
Adam Kucharski, associate professor at the London School of Hygiene and Tropical Medicine, said on Twitter Sunday that “first and foremost” the study was “another reminder that second doses matter.”
The actual amount of protection offered by the vaccines could be more than it seems from the figures, as the PHE researchers did not look at whether the vaccines protected against severe disease caused by variants. COVID-19 vaccines typically offer more protection against these outcomes.
The lower efficacy of AstraZeneca’s vaccine after two doses, compared with Pfizer’s, could be down to the fact that it was mostly given to older people, who have weaker immune responses, the study’s authors said.
The US will send 80 million coronavirus vaccine doses, or 13% of its total supply, abroad by the end of June, President Joe Biden said on Monday. That’s five times more doses than any other country has shared with the world so far.
WHO Director-General Tedros Adhanom Ghebreyesus said last week that wealthy countries had received 83% of the world’s vaccine supply despite making up just 53% of the world’s population. At an event on Monday, Tedros called the situation “vaccine apartheid.”
Biden, too, emphasized the need to share more doses with the world.
“We want to lead the world with our values, with this demonstration of our innovation and ingenuity, and the fundamental decency of the American people,” Biden said at White House briefing on Monday. “Just as in World War II, America was the arsenal of democracy, in the battle against the COVID-19 pandemic, our nation is going to be the arsenal of vaccines for the rest of the world.”
But the US won’t be redistributing doses that might have otherwise gone to eligible Americans.
The US expects to have have enough doses for everyone who’s eligible (people ages 12 and up) within the next six weeks. As of tomorrow, Biden said, 60% of American adults will have already received at least one shot.
The Biden administration’s plan is to allocate 20 million leftover doses of Pfizer, Johnson & Johnson, and Moderna shots to other countries. The US will also donate 60 million AstraZeneca shots – all the AstraZeneca doses the country has produced thus far – overseas.
The Biden administration hasn’t said which countries will receive the new shipments yet, but the US already promised 4 million AstraZeneca doses to Canada and Mexico.
AstraZeneca’s shot is currently being administered in 165 countries. But the US Food and Drug Administration hasn’t authorized the vaccine yet because it’s waiting on the results of a domestic trial, which was delayed for nearly seven weeks in the fall because of an adverse reaction in a UK participant.
The US purchased 300 million doses of AstraZeneca’s shot roughly a year ago as part of its strategy to buy up multiple vaccine candidates before it was known which ones would be effective. By buying lots of different vaccines ahead of time, the logic went, the US would ensure it had doses of an effective vaccine as early as possible.
Before Monday’s announcement, the Biden administration had already pledged to donate the 60 million AstraZeneca doses, but the vaccines still need to pass an FDA safety review before they’re shipped.
The US vaccine rollout is far ahead of other countries
Biden made his announcement at a moment when the US outbreak appears to be turning a corner: For the first time in the pandemic, coronavirus cases are declining in all 50 states. Coronavirus deaths are also at their lowest level since April 2020, Biden said. The CDC reported 415 COVID-19 deaths on Saturday.
But many public-health experts have warned that the US will continue to be vulnerable to future outbreaks if other countries are only vaccinating their populations at low levels. India and Russia, for instance, have vaccinated just around 10% of their populations, while Japan has vaccinated less than 4%.
As long as the coronavirus is spreading, it can mutate – so new variants may continue to arise. Though current vaccines seem to hold up well against existing variants, public-experts worry that a future variant could be far more resistant to vaccine protection.
“We know that America will never be fully safe until the pandemic that’s raging globally is under control,” Biden said on Monday.
Because of this, some experts even think the US should help other countries vaccinate their residents before immunizing its own teenagers.
“To get back to ‘normal,’ we need to immunize our younger people,” Janet Englund, a professor of pediatric infectious diseases at Seattle Children’s Hospital, previously told Insider. But she added that “if we don’t take care of the rest of the world, it’s going to be a temporary fix.”
Companies across the US are joining in the largest-ever vaccination effort by offering employees perks if they receive the two-dose COVID-19 vaccine.
Receiving the vaccine is voluntary, but most companies have strongly encouraged employees get the immunization when it’s their turn. The two-dose vaccines, one from Pfizer and BioNtech and the other from Moderna, were emergency approved in the US in December. Since then, almost 34 million people have received one or more doses, according to data from the Centers for Disease Control and Prevention.
Many states and localities have begun moving from the first phase of vaccinating health care workers and elderly living in long-term care facilities to immunizing front-line workers. With that, some companies are giving workers two to three hours of paid time off per dose received, and others are offering a stipend for employees who voluntarily get the shots when it’s their turn.
Recently, Publix, Petco and AT&T joined the growing list. Here’s the 18 Insider knows about so far:
Know of a company not on this list that’s offering employees time off, pay, or other perks to get vaccinated? Email Natasha, the reporter of this piece, at email@example.com.
Target is offering workers up to four hours of paid time off to get both shots of the vaccine and will pay for Lyft rides up to $15 for employees needing transportation to and from their appointment.
2. Dollar General
The discount chain was the first major retailer to announce an incentive for workers to get vaccinated. Dollar General employees can earn up to four hours of pay for receiving both doses of the COVID-19 vaccine and will receive extra time off if they have an adverse reaction.
Darden Restaurants, which owns Olive Garden, LongHorn Steakhouse, Bahama Breeze, and The Capital Grille, will offer workers four hours of paid time off, two hours per dose, Bloomberg reported. Employees must show proof of their vaccination to earn the time. The company doesn’t require the shots, but strongly encouraged workers to get them.
4. Shake Shack
The burger-and-shake restaurant chain will give workers 3 hours of pay per shot of the two-dose vaccine. Shake Shack didn’t mandate employees receive the vaccine but “strongly encouraged” it.
5. Noodles & Company
Workers will earn up to four hours of paid time off for receiving the vaccine, the company said in a Feb. 10 statement to Insider. The restaurant strongly recommended employees receive the vaccine but did not require it.
The grocer is giving employees a one-time $100 payment for getting the vaccine. On top of that, Kroger said it would give associates an added bonus of a $100 store card and 1,000 fuel points to “thank and reward” workers during the pandemic.
7. Trader Joe’s
The grocery retailer will offer all 50,000 employees two hours of pay per dose and allow for flexible scheduling so workers can make it to appointments.
The app will offer its US and Canada shoppers, who deliver groceries to customers, a $25 stipend to get vaccinated.
The German grocery chain is encouraging workers to get vaccinated by offering its US workers $200 in extra pay if they receive the immunization.
The fast food chain is giving workers four hours of pay for receiving the vaccine. Though getting the shots is not required, the company said it will connect employees with groups that can answer questions on the vaccination, Restaurant Business reported.
The coffee chain is offering workers two hours of pay per dose of the COVID-19 vaccine they receive.
Amtrak is allowing employees to get vaccinated during work hours, and will pay for two hours off if employees provide proof they received the shot. Workers will also be excused with pay for up to 48 hours if they have side effects.
15. JBS USA and Pilgrim’s
The meat-packing company is offering employees a $100 bonus incentive if they receive the vaccine voluntarily.
The pet-supply retailer told Insider it would offer employees a one-time payment of $75 for getting vaccinated. Plus, it will give a $25 donation to the Petco Partner Assistance Fund for each person who receives their shots.
AT&T is giving employees up to four hours of paid time off per dose, adding up to eight hours total for anyone who needs the hours to get the vaccine, a spokesperson said in an email to Insider. The company is also giving workers access to Castlight, a tool to help them find available vaccines in their area based on eligibility.
Publix will give associates a $125 gift card to the store after they get both doses of a COVID-19 vaccine. Workers aren’t required to get the shots at Publix, but they will need to show proof of vaccination. The vaccine is optional, though encouraged, the company said.
19. Walmart and Sam’s Club
Beginning May 18, Walmart and Sam’s Club will give its associates below the store manager level $75 for being fully vaccinated, the companies announced on May 14. Workers are required to show their vaccine card in order to receive this bonus.
In January, Dr. Tedros Adhanom Ghebreyesus, the director-general at the World Health Organization (WHO), warned that the world was on the “brink of a catastrophic moral failure” by not giving enough vaccines to poorer countries. “It is not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries,” he said.
Meanwhile, vaccines remain scarce in low- and middle-income countries and many of the most vulnerable people in those nations haven’t yet received a shot, a WHO spokesperson told Insider. In India, where millions are dying and the virus has mutated, less than 10% of people have had at least one vaccine dose, according to Oxford University’s Our World in Data.
Some experts see this disparity as a moral dilemma. “You don’t need to vaccinate all the way down, say, to your teen population … before you send out vaccine doses to COVAX,” Melinda French Gates, co-chair at the Gates Foundation, said May 9. COVAX is the WHO-backed initiative that aims to get more vaccines to low and middle-income countries.
To get itself – and the world – back to normal, the US needs to both vaccinate its young people and send more shots abroad, some experts told Insider. Others went further, and said that it doesn’t make sense to vaccinate low-risk populations, such as kids, when vulnerable people abroad are at risk abroad.
Fauci: We need to do both
Dr. Anthony Fauci, President Biden’s chief medical advisor, has said that immunizing young people is essential to achieve herd immunity, which is when enough people are vaccinated that the virus can no longer spread from person to person.
But Fauci has also advocated sending doses abroad to curb the virus’ spread.
“[India has] got to get their resources, not only from within, but also from without, and that’s the reason why other countries need to chip in to be able to get either supplies for the Indians to make their own vaccines or to get vaccines donated,” Fauci told ABC News Sunday.
A spokesperson from US President Joe Biden’s administration told Insider that it had committed 60 million AstraZeneca doses to countries in need, once cleared by the Food and Drug Administration (FDA).
Kathleen Neuzil, professor in vaccinology at the University of Maryland School of Medicine, told Insider that vaccinating teens and sending doses abroad via COVAX were not “necessarily mutually exclusive.”
Neuzil said that she’d witnessed more younger people from ethnic minorities and with chronic conditions getting sick with COVID-19 in the US, who needed access to vaccines. But she said a coordinated response was required between nations. “No single country alone can beat this pandemic.”
Dr. Erlinda Ulloa, a pediatrician studying the safety and efficacy of COVID-19 vaccines in kids at the University of California, told Insider that fair vaccine distribution and immunizing teens in the US were separate issues.
Ulloa said that 12 to 15 year-olds should get vaccines if and when it’s recommended. “It’s remarkably safe and effective in this age group,” she said. But from an ethical perspective, if there’s opportunity to support vaccination efforts abroad then the US should do it, Ulloa said.
Getting back to normal
Janet Englund, professor of pediatric infectious diseases at Seattle Children’s Hospital, told Insider that if US teens weren’t immunized the virus would continue to spread in younger age groups. “To get back to ‘normal,’ we need to immunize our younger people,” she said.
“But if we don’t take care of the rest of the world, it’s going to be a temporary fix,” she added. “All these variants will eventually escape our vaccine and the best way to handle that is to vaccinate [the US and the rest of the world].”
Englund said the coronavirus vaccine co-developed by Pfizer and BioNTech – the shot that has been authorized for US teens – might be technically difficult to use in low and middle income countries right now as it requires very cold storage temperatures, although the groups are working on a vaccine that can be stored in a normal fridge. Other vaccines from AstraZeneca and Johnson & Johnson (J&J) could be more useful as they can be stored at normal temperatures already, and J&J’s shot is just one dose, she said.
Prioritize vulnerable adults abroad, two experts say
Russell Viner, professor of adolescent health at University College London, told Insider in a statement that the “key risk” for society was the “diversion of vaccines” to low risk groups while vulnerable adults in other countries remain unvaccinated.
Viner said very few children and teenagers ended up in intensive care with COVID-19 disease, and almost all of these were the same children that are vulnerable to winter viruses every year. It’s difficult to argue that vaccination benefits healthy teens, given our current knowledge, he said.
Viner said there was undoubtedly a very small group of teenagers who were clinically extremely vulnerable and should be vaccinated. Teenagers also play a role in transmission so if they remain unvaccinated they could act as a reservoir of infection, he said.
Adam Finn, professor of paediatrics at the University of Bristol, told Insider in a statement that giving vaccines to adolescents wasn’t a priority, at least for now.
Finn explained that most children who catch coronavirus don’t get seriously ill. “Indeed, most don’t get sick at all,” he said.
Finn said that at this point in the pandemic, when there are global shortages of vaccines, and lots of vulnerable people who haven’t got a shot, the priority was to prevent large epidemic waves, like the one in India.
“Those outbreaks pose a global threat as they drive the evolution of vaccine-resistant variants and their dissemination around the world,” he said.