California And COVID-19 Vaccine Rollout: Why Can’t The State Get It Right? – NPR

Beginning in February, CVS will start offering on-site coronavirus vaccinations.

The companys chief medical officer says CVS will be administering vaccines at 272 store locations across 11 states.

The companys goal is to vaccinate 25 million people or more per month.

Vaccinations will also be free, even if the person is uninsured.

CVS recently partnered with the federal government to vaccinate residents and staff at long-term care facilities.

When Dr Integrity Mchechesi visited a bus terminal in Zimbabwe's capital city Harare, people were calling out, asking if anyone needed a negative COVID-19 test certificate.

Such COVID-19 test certificates can be bought for as little as 10 US dollars, or roughly 50 dollars less than an actual COVID test, in Harare, said Mchechesi, a doctor and co-founder of Vaxiglobal, a health-tech start-up focused on immunization verification in Zimbabwe.

Zimbabwe is one of a number of countriesworking on digital solutions to verify who has been vaccinated. Countries like Denmark, Spain and Greece have supported the idea of COVID-19 vaccination passports, and the WHO is working on an international digital vaccination card that will provide a framework with standards for countries to adhere to.

Dr Integrity Mchechesi, co-founder of Vaxiglobal

At the bus terminals in Harare, Mchechesi was researching falsified vaccination certificates. In a survey of yellow fever vaccination certificates, Vaxiglobal found that more than 80 percent of those used at some bus terminals in Harare were falsified.

"We thought that [was] really concerning," said Mchechesi. "It's not like there is any policing that's done, it's actually sold freely."

Focus turns to COVID-19

Now Vaxiglobal has shifted its attention to verifying COVID-19 test certificates. The organization is workingwith the Zimbabwean health ministry to digitize COVID-19 test results to combat the sale of counterfeit certificates.

Healthcare workers enter the results of people's COVID-19 PCR tests into a decentralized database on Vaxiglobal's platform. When they upload the results, a unique QR code is generated for each result and is attached to a certificate that can be printed or stored in Vaxiglobal's app. Border authorities can then instantly verify the certificate.

Vaxiglobal's app allows border officials to see when and where the test was done

"You can imagine, someone can actually be COVID-19 positive and they don't get their test, they just bought that COVID-19 certificate and the border officials assume that the person is COVID negative that's how cases are being transmitted internationally," said Mchechesi.

The number of fake COVID-19 test certificates hasn't been that high because there is some regulation and citizens are concerned for their health, but the fake certificates are still readily available, said Mchechesi. "You can imagine people are obviously tempted to go for that because it's cheaper."

Mchechesi said a COVID-19 PCR test costs between 45 and 60 dollars in Zimbabwe, a country where 34 percent of the population lived under the extreme poverty line of 1.90 dollar a day in 2019, according to the World Bank.

Zimbabwe has not started rolling out COVID-19 vaccines. When it does, Vaxiglobal plans to apply the same technology to verify vaccination certificates.

Travelers have to present their yellow fever vaccination certificate upon entry into certain countries

Setting a standard for vaccination documentation

Currently, yellow fever is the only disease specified in the World Health Organization's (WHO) International Health Regulations (IHR) that requires proof of vaccination for entry to some countries. The yellow fever vaccination certificate is also the only proof of vaccination certified under the IHR.

But "it is a paper card, easy to falsify, anybody can produce that card with a stamp [and] say 'I got a vaccine,'" Bernardo Mariano, WHO's director of digital health innovation, told DW. "We know that every time there is some sort of rule or regulation put in place, some people will try to break it, create false information or a vaccination certificates."

The IHR provide a legal framework that defines countries' rights and obligations when handling public health crises and emergencies that have the potential to cross borders.

While vaccination against COVID-19 is not part of the IHR yet, a country can make a unilateral decision. Some countries already require a negative COVID-19 test to enter, and the next evolution of that will be requiring proof of vaccination, said Mariano.

WHO open to cooperation with private innovators

For a COVID-19 vaccination certificate to become compulsory for travel the world over, it would have to be part of the IHR, and that process would take a long time, Mariano said. But there are other avenues.

"We believe that the discussion is going on now, and there are a number of companies developing and innovating in this space," he added. "And we want to be in the discussion to set standards early on."

One such initiative is the CommonPass, a digital framework for verifying COVID-19 tests and vaccination certificates. Some airlines have already been rolling out the app to passengers on select flights.

A number of organizations approached the WHO with their own individual solutions, and the WHO's role is to set the standard for certificates, Mariano told DW.

Israel is largely suspending its international flights for nearly a week. The flight suspension goes into effect at 00:00 local time on Tuesday (Jan. 26) and will remain in effect until Sunday. The measure is intended to prevent coronavirus strains from entering the country. Up to 40 percent of new cases in Israel are due to the British COVID-19 mutation.

Ten months after the border closure, international tourists can travel to Sri Lanka again. As confirmed by officials on Monday (Jan 18), travelers will be able to re-enter the island from Jan. 21 if they comply with strict security regulations, present a negative PCR test and stay in a quarantine hotel for 14 days.

Despite extended coronavirus restrictions in Italy, as of Monday (Jan 18), museums and exhibitions in some regions will be able to reopen. This rule applies to the so-called Yellow Zones, where the coronavirus infection situation is less tense. Among others, the Archaeological Park in Pompeii is again able to receive visitors because it is located in the yellow region of Campania.

It's snowing in the Alps and the lower German mountain ranges. Despite all appeals, people are drawn outdoors. In many places, the perfect winter sports conditions are leading to kilometer-long traffic jams, overcrowded parking lots and full slopes, like here in Winterberg. Many municipalities can no longer control the rush and are moving to seal off their ski areas.

New Zealand is setting up a "travel bubble" with neighboring Australia. After months of border closures due to the coronavirus pandemic, New Zealand will once again allow tourists from Australia to enter the country without quarantine requirements in the New Year. New Zealanders have been able to travel to Australia again since October without having to go into quarantine.

On Saturday (December 5) the first Aida cruise ship is scheduled to leave for a one-week trip to the Canary Islands. The ship, designed for 3300 passengers, will reportedly be 50 percent full. All passengers will need to provide a negative coronavirus test, no more than 72 hours old. On board, strict hygiene and distancing rules apply, and only guided shore excursions will be possible.

Australian airline Qantas wants to introduce compulsory vaccination for intercontinental flights. "We will require international travelers to be vaccinated before we allow them on board," Qantas CEO Alan Joyce stated. The general terms and conditions would be adjusted accordingly. Whether this will also be a requirement for domestic flights has not yet been decided.

Both cities will launch a 'travel bubble' on November 22, which will allow people to move quarantine free in each direction, their governments announced on Wednesday (Nov 11), in a rare piece of good news for the pandemic-battered tourism industry. A quota of 200 residents from each city will be able to travel on one daily bubble flight to the other.

Machu Picchu, the ancient Inca city in the Peruvian Andes mountains, has reopened almost eight months after it was closed down due to the Covid-19 pandemic. Peruvian authorities organized an Inca ritual to mark the reopening. To allow for distancing, a maximum of 675 tourists per day are allowed to enter the old Inca city. That is less than a third of the normal number allowed.

Rio de Janeiro's famous annual Carnival spectacle will not go ahead in February. Organizers said the spread of the coronavirus in Brazil made it impossible to safely hold parades which with some seven million people celebrating are a cultural mainstay, tourism magnet and, for many, a source of livelihood. Brazil has the second highest death rate in the world after the United States and India.

To curb the spread of the coronavirus pandemic the German government has announced though new measures to start Monday, November 2. The new restrictions effect the travel business as overnight stays in hotels for tourist purposes will be banned, entertainment facilities such as theaters and cinemas will be closed as will bars and restaurants, which will only be allowed to offer take out services.

The city announced on Monday (Oct.26) that this decision had been made in view of the rapidly increasing number of coronavirus cases. The mayor explained that it was to be assumed that in the near future the Covid-19 traffic light in Nuremberg will change to dark red. "Against this background, we think it would be the wrong signal to go ahead with the annual Christkindlesmarkt Christmas market.

The Canary Islands are no longer on the list of corona risk areas, the Robert Koch Institute announced on Thursday (Oct. 22). The abolition of the travel warning for the Canary Islands should above all please tour operators.For them, the islands off the coast of Africa with their year-round summer climate are one of the most important sources of hope for the winter season.

Starting October 15, some of the Caribbean state have been reopened for international flights, with Havana a notable exception. Every visitor is tested for the coronavirus upon arrival, and a team of doctors is available in every hotel. The German vacation airline Condor plans to offer flights to Cuba's most popular tourist destination, the Varadero peninsula, starting October 31.

Discussions are underway between Australia and low-risk countries across Asia and the Pacific to lift coronavirus travel restrictions, but the government has warned that travel to the US and Europe may not be an option until 2022. From Friday, Australia will open its international borders for the first time since March, allowing visitors from New Zealand to travel to the country quarantine-free.

The cruise industry has decided to make coronavirus testing mandatory for all guests and crew members aboard cruise ships. The Cruise Lines International Association, the worlds largest such organization, announced on October 8 that passengers can only board ships by providing proof of a negative test result. All member shipping companies worldwide must now comply with this rule.

In the wake of significant increases in coronavirus infection figures in Europe, Berlin has announced further EU countries as risk areas for travelers. In addition to Belgium and Iceland, additional areas of France and Great Britain, including all of Northern Ireland and Wales, were also classified as risk areas on September 30.

Thailand is to receive its first foreign vacationers when a flight from China arrives next week, marking the gradual restart of a vital tourism sector battered by coronavirus travel curbs, a senior official said on Tuesday. The first flight will carry some 120 tourists from Guangzhou, flying directly to the resort island of Phuket.

India's most famous building was closed for six months, but since Monday ( September 21) it can be visited again, under strict restrictions. Only 5000 online tickets will be issued per day. There are temperature checks at the entrance. Selfies are allowed, group photos are prohibited. The Taj Mahal is a UNESCO World Heritage Site and is normally visited by 8 million people every year.

The Foreign Ministry has reacted to higher numbers of coronavirus infections on September 16 by issuing further travel warnings, including Vienna and Budapest. The province of North Holland with Amsterdam as well as South Holland with the cities of The Hague and Rotterdam are also affected. New risk areas were also identified in the Czech Republic, Romania, Croatia, France, and Switzerland.

Because of the coronavirus pandemic, the tourism sector has suffered a loss of 460 billion dollars (388 billion euros) from January to June, the World Tourism Organization reported in Madrid. The loss of sales was five times higher than during the international financial and economic crisis of 2009, and the total number of tourists worldwide fell by 65 percent in the first half of the year.

Germanys Foreign Office has warned against unnecessary tourism to Czech capital, Prague, and the Swiss cantons Geneva and Vaud (Vaud). This also applies to the French Mediterranean island of Corsica, the French regions Auvergne-Rhones-Alpes (around Lyon), Nouvelle-Aquitaine (around Bordeaux) and Occitania (around Toulouse) as well as more Croatian Adriatic areas, such as the city of Dubrovnik.

The German government has extended its travel warning for around 160 countries through September 30. The advisory applies to "third countries" i.e. countries that are not members of the EU or associated with the Schengen area. From October 1st, a "differentiated system" will apply, in which individual travel and safety information will be given for each country.

Australia has extended its travel restrictions for a further three months. The borders will remain closed for visitors from abroad until at least December 17. However, the government announced that domestic travel will soon be allowed for residents of the country. An exception will be the state of Victoria, with its metropolis Melbourne, for which a lockdown has been in place since early July.

The German government has extended the travel warning for around 160 countries outside the European Union by two weeks until September 14. A spokeswoman for the German Foreign Ministry explained the move on Wednesday (Aug 26) with rising coronavirus infection rates. "The situation will not relax sufficiently by mid-September to be able to lift the worldwide travel warning," she said.

With 2,500 instead of 6,000 passengers, the MSC Grandiosa left the port of Genoa on August 16. Stops on the seven-day voyage include Naples, Palermo and Valletta. Passengers and crew were tested for coronavirus before boarding, and body temperature is to be checked on a daily basis. Rival cruise company Costa will not be offering Mediterranean cruises again until September.

Germany's health and interior ministries have agreed that all of Spain apart from the Canary Islands is now a high-risk area due to a surge in cases. Spain said it was closing night clubs across the country. Restaurants, bars and similar venues would need to close by 1 a. m. and would not be allowed to take in new guests after midnight.

In the first six months of 2020, 59% fewer tourists came to Berlin than in the previous year. The Statistics Office said on August 10 that 2.7 million guests had visited Berlin, the lowest number since 2004. The slump was even worse for foreign tourists: two thirds stayed away. Since June, the figures have been recovering and are at 30 to 40% of the previous year.

Anyone entering Germany from a high-risk area must take a coronavirus test from August 8, after an order by Health Minister Jens Spahn. Currently, many countries are classified as risk areas, including the United States and Brazil. In the European Union, Luxembourg, the Belgian region of Antwerp and the Spanish regions of Aragon, Catalonia and Navarre were risk areas as of early August.

Norwegian cruise operator Hurtigruten has stopped all cruises on August 3 until further notice after an outbreak of the coronavirus on one of its ships. At least 40 passengers and crew members on the Roald Amundsen tested positive for COVID-19. Meanwhile, German cruise line Aida Cruises has also postponed its planned restart due to the lack of necessary permits.

Despite coronavirus uncertainty, Nepal has reopened Mount Everest for the autumn trekking and climbing season. To boost the struggling tourism sector the government will permit international flights to land in the country from August 17. The Himalayan country shut its borders in March just ahead of the busy spring season when hundreds of mountaineers usually flock to the country.

Concerned over a possible second wave of coronavirus, Amsterdam has requested that tourists not visit the Dutch capital on weekends. Potential day-trippers should come between Monday and Thursday, the city said on July 23. The tourist influx has swelled to such a degree that recommended social distancing of 1.5 meters between people is currently not possible in the city center.

In order to manage tourist throngs amid the pandemic, Bavaria's Economy Minister Hubert Aiwanger is planning a live digital guiding system for visitors. Clogged streets, wild campers and overcrowding on hiking trails in the Alps this brings popular regions such as Lake Tegernsee (photo) to their limits. The live update system is primarily intended to redirect day-trippers to less full areas.

Holiday flights within Europe are on the move again, with passengers sitting close together. According to an opinion poll by the International Air Transport Association (IATA), 62% of those questioned are afraid of being infected by passengers in the next seat. This was identified by IATA as the main reason for the decline in willingness to travel, which is now only 45%.

Author: Andreas Kirchhoff, Susan Bonney-Cox

He likened the WHO's vision to the use of bank cards with the Visa logo on them. The cards belong to different banks but they operate using Visa's payment system.

"You have this trusted ecosystem where hundreds of thousands of banks and millions of merchants in [different] countries can transact in a trusted system," said Mariano. "Basically, [WHO] is a trusted entity that is able to validate that certificate but then we want to ensure that we don't get into the business of producing apps and software."

That way, the companies developing digital solutions can continue their work and sell to governments.

Debate over requiring vaccination for travel

In a letter to the European Commission on January 12, Greek Prime Minister Kyriakos Mitsotakis suggested setting up a common European certificate for people vaccinated against COVID-19.

Vaccination would not be compulsory or a prerequisite for travel, but people who have been vaccinated should be free to travel, Mitsotakis wrote. "It is urgent to adopt a common understanding on how a vaccination certificate should be structured so as to be accepted in all member states."

On January 15, the WHO's Emergency Committee recommended that countries do not require proof of vaccination from incoming travelers based on the still unknown impact of the vaccines on reducing transmission and the limited number of vaccines available.

A country could decide to make vaccination a requirement for entry, but it would be difficult to verify without an internationally recognized standard.

"The challenge is, if there's no entity that sets the standards of what that vaccine means, I can come with any piece of paper and say: 'I have the vaccine,'" Mariano said.

The World Travel and Tourism Council (WTTC), which opposes vaccination requirements for travel, said the step would delay the revival of an already struggling travel and tourism sector that many rely on for income.

GuaveraGuavera, president and CEO of the WTTC, told DW that because it will take a significant amount of time to vaccinate the global population, some people who might want to get vaccinated but hadn't had the chance yet would be discriminated against, "particularly those in less developed countries, or those in less vulnerable age groups."

The WTTC instead supports testing on departure and arrival.

If all goes to plan, the WHO will have developed and defined the vaccination certificate standards and addressed data privacy issues by the end of March, with the standards ready to go by the beginning of April.

Chinas coronavirus vaccines were supposed to deliver a geopolitical win that showcased the countrys scientific prowess and generosity. Instead, in some places, they have set off a backlash.

Officials in Brazil and Turkey have complained that Chinese companies have been slow to ship the doses and ingredients. Disclosures about the Chinese vaccines have been slow and spotty. The few announcements that have trickled out suggest that Chinas vaccines, while considered effective, cannot stop the virus as well as those developed by Pfizer and Moderna, the American drugmakers.

In the Philippines, some lawmakers have criticized the governments decision to buy a vaccine made by a Chinese company, Sinovac. Officials in Malaysia and Singapore, which both ordered doses from Sinovac, have had to reassure their citizens that they would approve a vaccine only if it had been proved safe and effective.

Right now, I would not take any Chinese vaccine, because theres insufficient data, said Bilahari Kausikan, an influential former official at Singapores Ministry of Foreign Affairs. He added that he would consider it only with a proper report.

At least 24 countries, most of them low and middle income, signed deals with the Chinese vaccine companies because they offered access when richer nations had claimed most of the doses made by Pfizer and Moderna. But the delays in getting the Chinese vaccines and the fact that the vaccines are less effective mean that those countries may take longer to vanquish the virus.

Beijing officials who had hoped the vaccines would burnish Chinas global reputation are now on the defensive. State media has started a misinformation campaign against the American vaccines, questioning the safety of the Pfizer and Moderna shots and promoting the Chinese vaccines as a better alternative. It has also distributed online videos that have been shared by the anti-vaccine movement in the United States.

Liu Xin, an anchor with CGTN, the state broadcaster, asked on Twitter why the foreign media had failed to follow up on the deaths of people in Germany who had taken one vaccine though scientists have said the people were already seriously ill. Ms. Lius tweet was shared by Zhao Lijian, a top spokesman at Chinas Foreign Ministry.

George Gao, the head of the Chinese Center for Disease Control and Prevention, has questioned the safety of the American vaccines because their developers used new techniques rather than the traditional method embraced by Chinese makers.

China had hoped its vaccines would prove it had become a scientific and diplomatic powerhouse. It remains on a par with the United States in the number of vaccines approved for emergency use or in late-stage trials. Sinopharm, a state-owned vaccine maker, and Sinovac have said they can produce up to a combined two billion doses this year, making them essential to the global fight against the coronavirus.

Unlike the Pfizer and Moderna vaccines, their doses can be kept at refrigerated temperatures and are more easily transported, making them appealing to the developing world. They have been doled out as aid to countries like Pakistan and the Philippines.

Chinas campaign has been plagued with doubts, however. Many people have memories of the countrys vaccine scandals. Several governments remain angry about Beijings lack of openness about the virus in the early days of the pandemic. Its efforts at the start of last year to distribute masks and protective equipment to the West came under fire amid reports of shoddy quality and the demands by Chinese officials for public thanks.

A YouGov survey this month of roughly 19,000 people in 17 countries and regions showed that most were distrustful of a Covid-19 vaccine made in China. The misinformation campaign surrounding Western vaccines could further undermine its image.

The delays in shipments to places like Brazil and Turkey have been the latest hitch.

In Turkey, the government initially promised that 10 million doses of the Sinovac vaccine would arrive in December. Only three million did in early January, according to Fahrettin Koca, Turkeys health minister. He did not explain the reason for the shortfall, which has been criticized by opposition politicians. The remaining doses finally arrived on Monday, according to Anadolu, Turkeys state-run news agency.

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

Life will return to normal only when society as a wholegains enough protection against the coronavirus. Once countries authorize a vaccine, theyll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But its also possible for people to spread the virus without even knowing theyre infected because they experience only mild symptoms or none at all. Scientists dont yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while theyre not experiencing any cough or other symptoms. Researcherswill be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection wont be any different from ones youve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. Its possible that people may need to plan to take a day off work or school after the second shot. While these experiences arent pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell's enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

In a statement, Chinas Foreign Ministry cited its needs at home, where the coronavirus has re-emerged.

Currently, Chinas domestic vaccine demand is huge, it said. While meeting domestic demand, we are overcoming difficulties, thinking and trying ways to develop international vaccine cooperation with other countries, especially developing countries in different ways, and providing support and assistance according to their needs and within our capacity.

The sporadic outbreaks could also hinder production. Sinovac, which declined to comment, said on Friday online that it was looking for workers for a Beijing-area facility where an outbreak had frightened off potential employees.

Countries like Turkey and Brazil are rolling out their immunization programs with a Sinovac vaccine because Western companies cannot deliver as quickly. But Brazils efforts have been delayed as well. Eduardo Pazuello, the countrys health minister, said China was not acting fast enough with the documents needed to export raw materials to Brazil.

We are making strong moves at the diplomatic level to find where that resistance is and solve the problem, Mr. Pazuello said at a news conference on Jan. 17.

On Wednesday, Rodrigo Maia, Brazils speaker of the house, told reporters that he had met the Chinese ambassador to Brazil, who made it clear that there is no political obstacle, that it was a technical process that was delayed a little.

Other vaccines are beginning to fill the gap. Brazils Health Ministry announced on Thursday that a previously delayed shipment of two million doses of the Oxford-AstraZeneca vaccine would arrive the next day from India.

The world was also caught off guard by the disclosure that the Sinovac vaccine may not be as effective as previously thought. Earlier, officials in Turkey said trials there showed the vaccine had a 91 percent efficacy rate. In Indonesia, it was 68 percent. In Brazil, researchers initially said its efficacy was 78 percent.

Then, on Jan. 12, scientists said it had an efficacy rate of just over 50 percent, once people who experienced mild symptoms were included. That level is a hair above the threshold set by the World Health Organization to consider a vaccine effective. In a news conference last week, Sinovacs chief executive officer, Yin Weidong, reiterated that the vaccine was 100 percent effective in preventing severe cases. He said the lower efficacy rate was a result of the trials focus on health care workers, who had a higher propensity of contracting Covid-19 than the general population.

Jair Bolsonaro, Brazils president and a critic of both China and its Covid-19 vaccines, pounced on the data. On Jan. 13, he mocked the vaccines efficacy rate, asking a supporter: Is that 50 percent good?

To be sure, the Chinese vaccines have a big appeal to many countries. More than 40 countries have expressed an interest in importing Chinese vaccines, according to Chinas Foreign Ministry. Several world leaders, including President Reccep Tayyip Erdogan of Turkey and President Joko Widodo of Indonesia, have gotten a Sinovac vaccine.

But the spotty and inconsistent disclosures about the vaccines remain a problem. Sinopharm has said a vaccine candidate made by its Beijing Institute of Biological Products arm has an efficacy rate of 79 percent, but it did not disclose crucial details. Sinopharm didnt respond to a request for comment.

In Hong Kong, a special administration region of China that has ordered 7.5 million doses of the Sinovac vaccine, officials have not received an application for emergency distribution nor any data from the Chinese company.

Whether it is because they are not making enough or if they have no plans to send the vaccines to Hong Kong yet, I dont know, said Dr. Lau Chak Sing, who heads a Hong Kong government advisory panel on Covid-19 vaccines.

Data disclosure has also been an issue in the Philippines, which has secured 25 million Sinovac vaccine doses. Risa Hontiveros, an opposition lawmaker, said President Rodrigo Dutertes administration continues to cram their preference for Chinese-made vaccines down the publics throat, without emergency use approval and with inconsistent data.

Leila de Lima, a senator and opposition leader who is in prison, expressed anger that the government was paying $61 a dose, more than double what Sinovacs partner in Indonesia is paying. The presidential palace said that that price was overstated but that it couldnt divulge the real ones because of a confidentiality agreement.

Despite the uncertainty, many people may have little choice.

Ill have my jab, said Kayihan Pala, a member of the Turkey Medical Associations Covid-19 monitoring board. I am waiting my turn, because there is no other option.

Reporting was contributed by Letcia Casado, Tiffany May, Elsie Chen and Jason Gutierrez.

COLUMBUS, Miss (WCBI)- As the coronavirus vaccine is becoming more widely available; there are some things that still turn peoples heads; some believe taking it is the right thing to do while others think differently.

There are many negative and positive outlooks on the vaccine and these folks weigh their opinion about getting the shot and if others should or not.

It was just my way of helping out I mean anything I can do to help stop spread this virus Im going to do it, said Kelly Denton.

I think people are scared too you know what I mean as far as taking it because this is the quickest medicine theyve ever had. A lot of people arent trusting the government a lot of people arent trusting our hospitals even in Columbus, said Shontae Miller.

First and foremost my family; and also Im a small business owner so to protect the health and safety of my clients, said Laura Vernon.

She also weighed in on why others should take the shot.

I certainly think its the most proactive way to try to put an end to this virus, said Vernon.

Science proves it works and I dont want to be on the losing end, said James Lowe

As for his opinion on if people should get it.

Thats up to them I think it should be an individual choice, it shouldnt be mandated, and if they dont want to make it thats up to them, said Lowe

Vaccines are available for essential workers, high-risk adults 65 and older, and healthcare officials.

Californias troubled vaccine rollout is starting to pick up a bit, with data showing 125,000 people being vaccinated a day.

On Monday, Gov. Gavin Newsom announced the state would move to an age-based system for vaccinations in hopes of speeding up and simplifying the process. Currently, residents 65 and older and certain essential workers including educators, food and agricultural workers, and first responders may receive inoculations. Eligibility will shift to a system based on age groups starting in mid-February.

About 55% of the 4.7 million doses sent to California counties and health care providers so far have been administered, according to state data last updated Tuesday. The Biden administration said it is distributing 17% more vaccine next week as states have experienced severe shortages, and promised three weeks notice on vaccine shipments.

San Francisco opened its first mass vaccination site last Friday and said it wants to vaccinate all eligible residents by June, but theres still a long way to go. As of Tuesday, only 3.6% of San Franciscos population had received one dose of the vaccine.

One bottleneck was alleviated last week when California told health care providers it was safe to administer a large batch of Moderna vaccine doses that had been put on hold because of some allergic reactions at a San Diego vaccination site. Those 330,000 doses accounted for one-tenth of the states supply.

Despite the short-term boost, supply problems remain a concern. Meanwhile, the discovery of several new variants of the coronavirus that may spread more easily, including a mutation that took hold in the Bay Area in December, makes it even more urgent to fix the nations troubled vaccination rollout.

Local health departments are responsible for implementing the vaccine rollout, so Bay Area residents will need to check their own countys specific vaccination plans for details. Some counties have request forms that residents can fill out, and others direct people to speific health care providers to make appointments.

Heres what we know so far about when and where Bay Area residents can get their vaccines, plus answers to frequently asked questions. You can also stay up to date on the vaccine rollout across the state and country via The Chronicles Vaccine Tracker, and visit the California Department of Public Health vaccine website for more information.

County-by-county details and links:

San Francisco: The public health department and private providers including UCSF, Kaiser and Sutter helped open the citys first mass vaccination site, at City College, on Friday. Those eligible for a vaccine, such as health care workers and those 75 and older, will be contacted by their provider and invited to the site, which is appointment-only. The city also plans to have two other mass vaccination sites at Moscone Center in SoMa and The SF Market in Bayview up and running by Feb. 1. The health department also plans to administer vaccines at more than a dozen community clinics and at several pop-ups around the city. San Francisco residents can go to www.sf.gov/vaccinenotify and submit contact and eligibility information, and then be notified via email when its their turn to get vaccinated. Residents can also track distribution of vaccines through the citys online dashboard.

Alameda County: The county is currently vaccinating health care workers and residents of long-term care facilities, and will move on to individuals 65 and older and frontline essential workers soon. People can fill out this form to be notified when its their turn. Residents can track distribution of vaccines and learn more about elibility and distribution through the county and health providers through Alameda Countys online dashboard.

Contra Costa County: This online form currently allows health care workers and individuals 65 and older to request vaccination appointments. Residents can track doses administered and other data through the countys online dashboard.

Marin County: The county had started vaccinating some teachers but has changed course to prioritize by age; moving forward, it is vaccinating people 75 and older first. Residents can sign up here to be notified when they are eligible to receive shots. The county is tracking doses administered and other vaccination data on its online dashboard.

Napa County: Health care works, employees and residents of long-term care facilities, and people 65 and older can receive vaccinations in Napa. Those who are eligible can fill out this vaccine interest form to receive notifications and register for a clinic when vaccines are available.

San Mateo: The county is currently vaccinating health care workers and residents of long-term care facilities, and is transitioning to the next phase, residents over age 65, as the supply of vaccines allows. The county says most vaccinations will be given by health care organizations; when they cannot provide direct vaccinations, a county partner will do so. The county lists information about providers booking appointments for eligible residents here.

Santa Clara County: Santa Clara County is currently vaccinating health care workers, with some providers vaccinating people 75 and older. The county provides links to make vaccine appointments for patients of major health care providers. Residents can track distribution of vaccines through the countys online dashboard.

Solano County: The county is currently vaccinating health care workers, residents of long-term care facilities and people over the age of 75. It has provided information for how residents can schedule appointments with the countys various healthcare systems, including who is eligible to go through them. Residents over the age of 65 and those people in Phase 1A, Tier 3 are next in line.

Sonoma County: The county is currently vaccinating health care workers and residents of long-term care facilities. The county will begin including teachers, child care providers, emergency service workers, food and agricultural workers and residents 65 and older in early February. Sonoma has provided phone numbers for major health providers so patients can coordinate directly with their doctors.

Major health care provider information:

Kaiser Permanente: The provider is still vaccinating individuals in Phase 1A. Members 75 and older will be contacted directly via a letter or email with instructions for scheduling an appointment. Supply is still limited for patients 65 and older, but they will be next. Patients are asked not to try to book appointments through their doctors. Those who are not Kaiser members but want to get vaccinated through them can call 866-454-8855, but are warned of of high demand and long wait times.

Stanford Health Care: The health care system can currently schedule appointments for health care workers who work in Alameda, Contra Costa, San Mateo or Santa Clara county, and patients who have received care at Stanford Health Care at least once in the last three years, are 65 or older, and live in Alameda, Contra Costa, San Mateo or Santa Clara county. Members who are eligible can book their appointment through the MyHealth portal online, or by calling 650-498-9000.

Sutter Health: Health care workers and Sutter patients 75 and older are currently being vaccinated. Those who are eligible can book their appointment online through the My Health Online portal, or by calling 844-987-6115 to talk to a scheduler. Callers are warned of high demand and long wait times. Patients should not call their doctors office to schedule vaccine appointments.

John Muir Health: There is no registry or wait list for patients who want a vaccine. John Muir patients will be contacted by group (starting with those 75 and older) through different avenues including MyChart messages, email, text messages and phone calls.

St. Joseph Health: The system is still vaccinating health care workers and residents of long-term care facilities. When eligibility expands, St. Joseph patients will be directly contacted to schedule an appointment and dont need to reach out.

Dignity Health: Several locations are offering vaccinations in California to eligible patients, and those interested asked to check with their closest clinic locations for information. Dignity Health Medical Group Sequoia has started vaccinating patients 75 and older in San Mateo. Eligible patients will receive a call or email and be prompted to schedule an appointment through the PropMod system. Patients are asked not to call at this time. The Saint Francis/St. Mary's location in San Francisco is still vaccinating health care workers and residents of long-term care facilities, so no further updates are availble at this time.

With the states shift to an age-based vaccination system beginning in mid-February, the timeline has changed, moving away from prioritization based on workplace risk. Currently, health care workers and residents of long-term care facilities are being vaccinated. Some counties have begun vaccinating individuals 75 and older. Residents 65 and older and essential workers including educators, food and agricultural workers, and first responders are also eligible.

Starting in mid-February, the state will shift to the age-based system that starts with the oldest individuals first and makes its way down to younger age groups.

Phase 1C previously included individuals ages 16 to 64 who were at risk of developing severe illness due to the coronavirus, but it is unclear how and whether those people will still be prioritized in the new system.

Currently, two vaccines have been approved in the U.S. and are available, made by Pfizer and Moderna. The Pfizer vaccine is recommended for individuals 16 and older, and the Moderna vaccine for people 18 and older. No COVID-19 vaccines are approved yet for children because the initial trials included only adults, and a CDC report found that coronavirus symptoms are generally milder in children than adults.

Health care workers are being notified by their workplaces and most are getting vaccinated by their employers or health care providers. Free vaccines are being administered to residents and staff in long-term care settings by CVS and Walgreens.

Individuals in later phases will be able to get their shots from their primary care providers, pharmacies and some people may be able to go through their employers. In addition to the sites open or planned in San Francisco, state and local officials have announced the opening of several mass vaccination sites in Sacramento, Los Angeles and San Diego.

Some sites are currently opening in the Bay Area, but initially only to priority groups. Counties anticipate in the next few weeks to open up the sites to the broader public.

Kellie Hwang is a San Francisco Chronicle staff writer. Email: kellie.hwang@sfchronicle.com Twitter: @KellieHwang

Where is it being manufactured?

While there are some doses coming from Europe in the very first instance, the majority will be provided from the UK supply chain.

In an exclusive report on Jan 16, The Telegraph shared plans for a new 158m super-factory, which would produce 70m doses of an emergency vaccine on British soil- enough to vaccinate the entire nation against new coronavirus strains within four months. The factory will open later this year.

The MHRA has recommended the over 18s should receive two doses to be administered with an interval of between four and 12 weeks.

The Government announced on Dec 30 that it was delaying the second dose of every vaccine in order to reach as many people as possible in the first round of vaccinations.

Both the Oxford vaccine and the Pfizer/BioNTech jabwill be given to people as one shot, followed by another up to 12 weeks later, in order to extend some protection to as many people as possible as quickly as possible.

This is not without controversy, however.

The government's Joint Committee on Vaccination and Immunisation (JCVI) says unpublished data suggests the Oxford-AstraZeneca vaccine is still effective with doses 12 weeks apart - but Pfizer has said it has tested its vaccine's efficacy only when the two doses were given up to 21 days apart.

The World Health Organization has recommended a gap of four weeks between doses - to be extended only in exceptional circumstances to six weeks.

In a further bid to accelerate vaccination, Boris Johnson has announced that 24-hour vaccine centres will be opened "as soon as we can, with the the head of NHS England confirming on Jan 17 that several hospitals will trial 24/7 vaccine centres within the next ten days.

Matt Hancock, however, told BBC Breakfast a 24/7 approach was unlikely to be "the major factor" in hitting the mid-February target, but he was"absolutely" behind it "if it helps speed things up".

Sources in Whitehall have said that plans are in place to pilot a 24-hour vaccination centre to test demand. This comes as manufacturing companies have told ministers that they will not yet be able to produce enough vaccines should 24-hour roll out be introduced across the country.

Supplying vaccinations overnight will speed up the rollout, and allow the Government to reach their goal of vaccinating 32 million people- 60 per cent of the UK adult population by Spring-which was announced on Jan 11.

There have been concerns that a Covid-19 vaccine will not work as well on elderly people, much like the annual flu jab.

However, data from the Oxford/AstraZeneca trial suggests there have been "similar" immune responses among younger and older adults.

The results show that the vaccine is better tolerated in older people compared with younger adults, and produces a similar immune response in old and young adults.

Pregnant women and breastfeeding mothers have now been given the green light to take either the Oxford and Pfizercoronavirus vaccines following an appropriate case-by-case risk evaluation with their healthcare practitioner.

This is a reversal of previous advice which was put in place as precautionary measure.

Traditionally pregnant women are not included in clinical trials, but following a review the MHRA are recommending pregnant women be given the opportunity to receive the vaccine as as there is no evidence they would be at risk.

Dr June Raine, chief executive of the MHRA, said: "Our advice to date has been that given that in initial lack of evidence on a precautionary basis, use of a vaccine wasn't recommended in pregnancy and women with breastfeeding should not be given the vaccine.

"But now that we have reviewed further data that has become available, the Commission on Human medicines has advised that the vaccine can be considered for use in pregnancy when the potential benefits outweigh the risks following an individual discussion with every woman."

The rollout of the Pfizer vaccine was temporarily halted forthose who are known to suffer from severe allergic reactionsfollowing a handful of adverse events in the initial distribution of the vaccine.

There were some concerns that this would also apply to the Oxford jab.

However, following a review,the UK regulatory body has recommended both the Pfizer and Oxford vaccine are safe to administer to those with food or medicine allergies.

Only those who have a known history of reacting to vaccines in the past should proceed with caution.

Sir Munir Pirmohamed, clinical pharmacologist and geneticist, and chairmanof Commission on Human Medicine Expert Working Group, said. "We've come to the recommendation people with a known history of reacting to any specific ingredients of vaccine should not have it. But people with allergies to other medicines or food can have the vaccine."

Dr June Raine added that "at least 800,000 in the UK, probably a million and a half in the US" have already received the Pfizer vaccine.

There has been"no additional concerns and this gives us further assurance that the risk of anaphylaxis can be managed through standard clinical guidance and an observation period following vaccination of at least 15 minutes."

The Oxford vaccine rollout beganon Jan 4.

Mr Johnson haspledged thatthe NHS is committed to offering a vaccinationto everyone in the top four priority groups by Feb15.

To helpwith meeting this target there arealready 595 GP-led sites providing vaccines with a further 180 coming on stream, he said. There are also 107 hospital sites with a further 100 to come.

Furthermore, on Jan 7, The Ministry of Defence revealed it has prepared a "reserve" taskforce of 1,500 members of the Armed Forces who are ready to work at jab centres, should the vaccinators fall ill, and extra staff are required.

The plan comes after the NHS made a formal request to the Civil Authority (Maca) convention via the Military Aid, for 133 members army personnel to take part in the vaccination programme. The workers began their training on Jan 4, and would start administering vaccines from Jan 11.

It just makes common sense that it likely would be more effective.

Dr. Anthony Fauci says two masks are better than one.

It just makes common sense that it likely would be more effective, Fauci, the director of the National Institute of Allergy and Infectious Diseases, told NBCs Today Show this week. Thats the reason why you see people either double masking or doing a version of an N95.

The U.S. Centers for Disease Control and Prevention has not issued official guidance on double masking. It did not advocate wearing face coverings until April 3 last year to help prevent the wearer from spreading coronavirus, but since then health professionals say it also helps prevent the wearer from being infected.

A mask is like an obstacle course for particles to get through, Linsey Marr, an expert in virus transmission and a professor of civil and environmental engineering at Virginia Tech, told AARP. A second mask increases the chance that the particle will be trapped before it gets through.

As of Tuesday, 99.9 million people worldwide had contracted COVID-19 and more than 2.1 million people had died. The U.S. had 25.3 million cases and 421,890 fatalities, according to data aggregated by Johns Hopkins University.

Fauci recently said that he expects more people will be able to get vaccines by April to help prevent the spread of COVID-19. I would expect by the time we get to April, it will be what we call open season on vaccines, Fauci told NPR. Everyone will be able to get a vaccine. So I think by the end of the summer, if we get 70% to 85% of the population vaccinated and get a good herd immunity, I think by the fall we could start to approach some form of normality.

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U.S. President Joe Biden last week signed a mask mandate for all federal workers and anyone on federal property. They should, the mandate said, all wear masks, maintain physical distance, and adhere to other public health measures, as provided in CDC guidelines.

Fauci told NPR, We want to get it to 1 million vaccinations per day. The idea about having everyone for at least 100 days at least wear a mask. Everyone uniformly, so we dont have disparities where some people are adhering to public-health measures, and others are not.

Dispatches From a Pandemic:Its 2:30 a.m. in Wyoming: Youre holding a smartphone to let a husband say goodbye to his wife via FaceTime after 60 years of marriage

Pfizer PFE, +0.08% and German partner BioNTech SE BNTX, -3.91% have said that a final analysis of their vaccine candidate showed 95% efficacy. Meanwhile,Moderna MRNA, +3.35% said itsvaccine candidate was about 94% effective.

BioNTech and Pfizer said an in vitro study found that their COVID-19 vaccine neutralizes the two new highly infectious variants that have emerged in the U.K. and South Africa. The results were published on the preprint service bioRxiv and have not yet been peer-reviewed.

A vaccine candidate from AstraZeneca AZN, +0.80% and the University of Oxford is safe and effective and showed an average efficacy of 70% in a pooled analysis of interim data, according to a recently published peer-reviewed study.

Heres what you need to know:The Brazil P.1 variant is thought to be more contagious but it is unclear if it causes more severe illness.Credit...Jim Mone/Associated Press

A case of a more contagious coronavirus variant first found in Brazil has been confirmed in Minnesota, the states department of health said in a statement on Monday. It is the first confirmed case of the variant in the United States.

The case was identified in a Minnesota resident who had recently traveled to Brazil, the department said, which could suggest that the variant may not yet be widely circulating.

It was only a matter of time before the variant was detected in the United States, said Dr. Anthony S. Fauci, a Covid adviser to President Biden. With the world travel that you have, and the degree of transmissibility efficiency, its not surprising, he said.

The variant, known as B.1.1.28.1 or P.1, shares many mutations with one first identified in South Africa. The Moderna and Pfizer vaccines still protect from the variant circulating in South Africa, the companies have said, but they are slightly less effective. They are expected to perform similarly against the variant identified in Brazil.

The variant identified in Britain is more transmissible, but just as susceptible to vaccines as the original form of the virus. But the variants in Brazil and South Africa have additional mutations that may help elude the vaccines. The amount of concern that I have between the U.K. variant, and the South African/Brazilian is much, much different, Dr. Fauci said.

The variant identified in Britain has been confirmed in 22 states, and the variant found in South Africa has not yet been confirmed in the United States.

The P.1 variant is also thought to be more contagious but it is unclear if it causes more severe illness. The Minnesota Department of Health identified it through its variant surveillance program, which collects 50 random samples from laboratories in the state each week. Minnesota has one of the lowest daily caseloads relative to its population in the country, following a surge in the fall.

The person with the confirmed case is a resident of the Minneapolis-St. Paul metropolitan area, the department said. The patient became ill during the first week of January and the specimen was collected Jan. 9, it said.

Investigators from the health department had spoken with the person after the test was positive for Covid-19, and the person had traveled to Brazil before becoming ill. The person was told to isolate and have household members quarantine. Health officials are conducting additional interviews with the person to learn more about the illness, travel and close contacts.

The United States is flying blind, scientists have warned, as the country navigates the spread of the new variants without a large-scale, nationwide system for checking virus genomes for new mutations. Instead, the work of discovering the variants has fallen to a patchwork of academic, state and commercial laboratories.

Scientists say that a national surveillance program would be able to determine just how widespread the new variant is and help contain emerging hot spots, extending the crucial window of time in which vulnerable people across the country could get vaccinated.

The daily U.S. coronavirus caseload and number of hospitalized patients have fallen recent days, but the introduction of the variants into the country threatens to undermine that progress. The weekly average of new cases per day in the United States was down 33 percent on Sunday since two weeks prior, as states like California start to get a hold on their outbreaks.

California officials on Monday announced that they were lifting severe coronavirus restrictions on large portions of the state, allowing outdoor dining and personal care businesses to resume limited operations.

But the virus has for weeks been raging in Arizona, as well as South Carolina and Rhode Island. New York now has the fifth-worst outbreak in the country, though daily deaths from the virus are far from the levels seen there in the spring.

President Bidens press secretary said on Monday that he would extend the Trump administrations ban on travel by noncitizens into the United States from Brazil, along with similar restrictions on Britain and 27 other European countries, where other variants have been identified. It also added South Africa to the list.

Concern over the variants spread led to discussions in Europe of restricting nonessential travel. Proposing the new restrictions, Ursula von der Leyen, the president of the European Commission, the executive arm of the European Union, tweeted that the new variants had led us to take difficult but necessary decisions.

In Britain, Prime Minister Boris Johnson was expected to announce an extension and tightening of lockdown rules in England this week amid growing concern.

Experts point to Britain as a model for what the U.S. could do to monitor the variants. British researchers sequence the genome that is, the complete genetic material in a coronavirus from up to 10 percent of new positive samples.

Even if the U.S. sequenced just 1 percent of genomes from across the country, or about 2,000 new samples a day, that would shine a bright light on the new variant, as well as other variants that may emerge.

Hours after California public health officials abruptly lifted a strict order to stay at home that had been in place for weeks, Gov. Gavin Newsom defended the decision, saying that the states models showed pressure on intensive care units easing significantly in the next month.

By Feb. 21, the state reported, intensive care unit capacity is projected to reach 30.3 percent across California, with 33.3 percent of intensive care unit space available in Southern California, 22.3 percent in the San Joaquin Valley and 25 percent in the Bay Area.

State officials, Mr. Newsom said, rushed to lift restrictions as quickly as possible once the numbers indicated it would be safe.

We did a lot of comprehensive outreach, and were pleased to move in this direction, he said in a news conference on Monday.

He described accusations that he was making pandemic response decisions based on political considerations as complete, utter nonsense.

The governor has faced mounting political pressure from a recall effort, and experts have said that the regional reopenings and the vaccination effort are crucial tests for his administration.

Mr. Newsom highlighted that Californias overall positivity rate recently compared favorably to those of Texas and Arizona. And he emphasized that reporting delays had contributed to what he described as misconceptions about the speed of Californias vaccine rollout.

Were just getting going, Mr. Newsom said. California, he said, is like a massive ship: It takes a little time to shift course, but when it shifts course, it builds tremendous momentum.

The governor also clarified the states vaccine prioritization: Along with health care workers and anyone 65 and older, the state will prioritize emergency medical workers, food and agricultural workers, and teachers and other school staff.

After that, he said, the state will transition to age-based eligibility, and will focus on getting vaccines to communities suffering disproportionately.

But the problem, experts have said in recent weeks, is that the implementation of such detailed plans rests on county public health departments, and the details have differed community by community.

On Monday morning, California officials announced that they were lifting severe coronavirus restrictions on huge swaths of the state. The decision would allow restaurants in those areas to reopen for outdoor dining, and would let hair salons and other personal care businesses resume limited operations.

However, local officials can still opt to keep restrictions in place, based on conditions in individual communities.

Effective immediately, state officials said, they were ending regional stay-at-home orders, which banned gatherings of any size and required residents to stay home except for essential work. The orders came into force when intensive-care units in the region were projected to become dangerously full.

Such orders had been in effect for Southern California, a huge region encompassing Los Angeles, Orange County and San Diego, as well as for the San Joaquin Valley and the Bay Area. Counties in those regions will now return to a tiered system of rules tied to the prevalence of the virus in each county.

The news came on the heels of a weekend of mixed signals from the state about its strategy to curb the rampant spread of the virus.

While Californias overall case numbers have been declining, hospitals in Southern California are still overwhelmed, and experts worry that new variants of the virus including one that researchers recently found in more than half of test samples in Los Angeles could threaten progress.

In the Bay Area, available intensive care capacity had risen to 23.4 percent as of Sunday, according to the state. The stay-at-home order for the region was triggered when the figure fell below 15 percent.

The Sacramento region has just 11.9 percent of its intensive care capacity free, but it was allowed to exit its strict regional order more than a week ago.

The San Francisco Chronicle reported on Saturday that officials in the region were hopeful that the Bay Area order would be lifted soon, but the states department of public health said on Sunday that, based on its projections, the region was not eligible.

Mr. Newsom has repeatedly said that the states reopening would be guided by transparent data. But The Associated Press reported that Mr. Newsoms administration has refused to disclose key figures.

Even after President Biden announced a national strategy for controlling the pandemic, which experts have said was desperately needed, there are still hurdles in the national vaccination program. In California, those hurdles have contributed to continuing chaos, with eligibility rules differing county by county.

The state set up a promised website to help people find vaccination appointments. But its still described as a pilot site.

President Biden, under pressure from an anxious public to speed up the pace of Covid-19 vaccinations, said Monday that he is now aiming for the United States to administer 1.5 million doses a day a goal that the nation already appears on track to meet.

The president made his comments just hours after he banned travel by noncitizens into the United States from South Africa because of concern about a coronavirus variant spreading in that country, and moved to extend similar bans imposed by his predecessor on travel from Brazil, Britain and 27 European countries. Those bans had been set to expire on Tuesday.

Mr. Biden has vowed to get 100 million Covid-19 shots in the arms of the American people by his 100th day in office. Because two doses are required, and some Americans have already been vaccinated, his promise would cover about 67 million Americans. To realize it, the United States would have to administer one million shots a day.

The pace of vaccinations is already picking up, and the United States already seems to be vaccinating well over a million people per day, according to a New York Times analysis of data from the federal Centers for Disease Control and Prevention. The current average is about 1.2 million over the past six days.

With frustration rising across the country over vaccine supply shortages and canceled appointments, Mr. Biden has drawn criticism for not setting his sights higher. Last week, he expressed exasperation Cmon, man! at a reporter who suggested his 100 million shot promise was not ambitious enough. On Monday, he appeared to revise it.

I think that with the grace of God and good will of a neighbor and creek not rising, we may get it to 1.5 million a day rather than one million a day, the president said. But we have to meet that goal of one million a day.

Mr. Bidens comments came as the United States has recorded 25 million coronavirus cases a staggering tally that the nation reached Saturday afternoon, according to a New York Times database. That works out to about one in every 13 people in the country, or about 7.6 percent of the population a number that experts say is almost surely lower than the true number of infections.

The move comes as officials in the new Biden administration are trying to get their hands around a fast-changing pandemic, with public health officials racing to vaccinate the public and to expand the supply of vaccine as more contagious variants of the coronavirus spread.

Dr. Anthony S. Fauci, the governments leading infectious disease specialist, said at the White House last week that were following very carefully the variant of the virus in South Africa because it appears to be more highly contagious.

The variant first discovered in South Africa has not yet reached the United States, but it has been reported in more than two dozen countries.

The first U.S. case of the variant found in Brazil was confirmed in Minnesota, health officials there said on Monday. The variant, known as B.1.1.28.1 or P.1, shares many mutations with the one first identified in South Africa.

On Monday, Moderna said its vaccine was effective against new variants of the coronavirus that have emerged in Britain and South Africa. But the immune response is slightly weaker against the variant discovered in South Africa, and so the company is developing a new form of the vaccine that could be used as a booster shot against it.

And Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, offered a blunt assessment of the vaccination campaign on Sunday, predicting that supply would not increase until late March.

Federal health officials and corporate executives agree that it will be impossible to increase the immediate supply of vaccines before April because of a lack of manufacturing capacity. A third vaccine maker, Johnson & Johnson, is expected to report the results of its clinical trial soon; if approved, that vaccine would also help shore up production.

As the coronavirus assumes contagious new forms around the world, two drug makers reported on Monday that their vaccines, while still effective, offer less protection against one variant. That new information is causing the drug makers to begin revising plans to turn back an evolving pathogen that has killed more than two million people.

The news from Moderna and Pfizer-BioNTech underscored a realization by scientists that the virus is changing more quickly than once thought, and may well continue to develop in ways that help it elude the vaccines being deployed worldwide.

The announcements arrived even as President Biden is banning travel to the United States from South Africa, in hopes of stanching the spread of one variant. And Merck, a leading drug company, on Monday abandoned two experimental coronavirus vaccines altogether, saying they did not produce a strong enough immune response against the original version of the virus.

Moderna and Pfizer-BioNTech both said their vaccines were effective against new variants of the coronavirus discovered in Britain and South Africa. But they are slightly less protective against the variant in South Africa, which may be more adept at dodging antibodies in the bloodstream.

The vaccines are the only ones authorized for emergency use in the United States.

As a precaution, Moderna has begun developing a new form of its vaccine that could be used as a booster shot against the variant in South Africa. Were doing it today to be ahead of the curve, should we need to, Dr. Tal Zaks, Modernas chief medical officer, said in an interview. I think of it as an insurance policy.

Moderna said it also planned to begin testing whether giving patients a third shot of its original vaccine as a booster could help fend off newly emerging forms of the virus.

Dr. Ugur Sahin, the chief executive of BioNTech, said in an interview on Monday that his company was talking to regulators around the world about what types of clinical trials and safety reviews would be required to authorize a new version of the Pfizer-BioNTech vaccine that would be better able to head off the variant in South Africa.

Studies showing decreased levels of antibodies against a new variant do not mean a vaccine is proportionately less effective, Dr. Sahin said.

BioNTech could develop an adjusted vaccine against the variants in about six weeks, he said. The Food and Drug Administration has not commented on what its policy will be for authorizing vaccines that have been updated to work better against new variants.

But some scientists said that the adjusted vaccines should not have to go through the same level of scrutiny, including extensive clinical trials, that the original versions did. The influenza vaccine is updated each year to account for new strains without an extensive approval process.

The whole point of this is a rapid response to an emerging situation, said John Moore, a virologist at Weill Cornell Medicine in New York.

Dr. Sahin said a similar booster shot eventually might be necessary to stop Covid-19. The vaccines reduced efficacy may also mean that more people would need to get the shots before the population achieves herd immunity.

Scientists had predicted that the coronavirus would evolve and might acquire new mutations that would thwart vaccines, but few researchers expected it to happen so soon. Part of the problem is the sheer ubiquity of the pathogen.

Merck announced on Monday that it was abandoning a pair of Covid-19 vaccines in clinical trials.

The news came as a disappointment at a time when the United States and other countries are struggling to accelerate their sluggish vaccination campaigns and new coronavirus variants threaten to bring surges over the next few months.

The two projects are the second and third vaccines to be abandoned in clinical trials. The University of Queensland in Australia abandoned its own effort in December. Sanofi and other vaccine makers have paused some projects after getting disappointing initial results but are now regrouping to move forward.

Merck was slower than other companies to get into the Covid-19 vaccine race. In June, it acquired the Austrian firm Themis Bioscience to develop a vaccine originally designed at Institut Pasteur, based on a weakened measles virus. Researchers began a Phase 1 trial in August. In a second effort, Merck partnered with IAVI, a nonprofit scientific organization that develops vaccines and treatments, on another vaccine. For that one, they used the same design that they successfully employed to make a vaccine for Ebola.

Merck and IAVI were awarded $38 million for their vaccine research, but neither of Mercks projects earned the lavish support that Operation Warp Speed showered on other efforts from companies such as Moderna and Johnson & Johnson. In its announcement, Merck said that both vaccines looked safe in early clinical trials. But neither produced a strong response from the immune system. They decided that it was not worth going forward with large-scale trials that would demonstrate whether the vaccines protected people from Covid-19.

We are grateful to our collaborators who worked with us on these vaccine candidates and to the volunteers in the trials, Dr. Dean Y. Li, the president of Merck Research Laboratories, said in a statement.

Merck will instead focus its Covid-19 efforts on an experimental antiviral drug known as molnupiravir, in partnership with Ridgeback Biotherapeutics. Originally designed for influenza, it has shown promising effects in studies on animals and in early clinical trials. The trial is set to finish by May, although preliminary results could come out as early as March.

IAVI said it would continue searching for Covid-19 vaccines. Our scientists will continue to evaluate other candidates to see if other routes of administration or changes to the construct could lead to improved immune response, said Karie Youngdahl, senior director and head of global communications at IAVI.

President Biden will ban travel by noncitizens into the United States from South Africa because of concern about a coronavirus variant spreading in that country, and will extend similar bans imposed by his predecessor on travel from Brazil, 27 European countries and Britain, his press secretary said on Monday.

The move comes as officials in the new Biden administration are trying to get their hands around a fast-changing pandemic, with public health officials racing to vaccinate the public and to expand the supply of vaccine as more contagious variants of the coronavirus spread.

Mr. Bidens travel ban is a presidential proclamation, not an executive order; typically, proclamations govern the acts of individuals, while executive orders are directives to federal agencies. It will go into effect Saturday and apply to non-U.S. citizens who have spent time in South Africa in the last 14 days. The new policy, which was earlier reported by Reuters, will not affect U.S. citizens or permanent residents, officials said.

On his last full day in office, President Donald Trump tried to eliminate the Covid-19-related ban on travel from Brazil, Britain and much of Europe, saying it was no longer necessary. Jen Psaki, now the White House press secretary, said at the time that ending the ban was the wrong thing to do; on Monday, she announced during her regular briefing that it would remain intact.

With the pandemic worsening and more contagious variants spreading, this isnt the time to be lifting restrictions on international travel, she said.

Ms. Psaki also said the Biden administration intended to hold regular public health briefings three times a week, beginning on Wednesday. She said Mr. Biden would be briefed regularly on the pandemic, adding, I suspect far more regularly than the past president.

The first confirmed case of the Brazilian variant in the United States has been identified in Minnesota, the states health department said on Monday. It was found in a Minnesota resident who had recently traveled to Brazil.

The variant now spreading in South Africa has not yet reached the United States, but it has been reported in more than two dozen countries.

In addition to the travel bans, Mr. Biden issued an executive order last week requiring that all international travelers present negative coronavirus tests before leaving for the United States. The move extended a requirement by the Centers for Disease Control and Prevention that was issued by the Trump administration but set to expire on Tuesday.

A White House official said Sunday that the C.D.C. would not issue waivers from that policy as some airlines had requested.

Mayor Bill de Blasio of New York City announced on Monday that the openings of planned mass coronavirus vaccination sites at Yankee Stadium and Citi Field would be postponed because of the low supply of doses available.

We want to get those to be full-blown, 24-hour operations, Mr. de Blasio said at a news conference, but we dont have the vaccine.

The site at Citi Field had been set to open this week, while plans for the one in the Bronx were still being developed. Another site at the Empire Outlets on Staten Island was initially scheduled to open last week, but will also be postponed, the mayor said.

The city had a total of 19,032 first doses in inventory on Monday morning, Mr. de Blasio said, and expected to receive just under 108,000 doses this week. But he continued to warn that figure was not nearly enough to keep up with the pace at which New Yorkers were being inoculated: If the supply was greater, the mayor said, New York City would be on pace to administer roughly 500,000 doses per week.

Instead, he said many inoculation appointments would continue to be canceled or rescheduled as they were last week.

Jen Psaki, the White House press secretary, said the Biden administration was reviewing state and local officials capacity to administer vaccines as it considered how to bolster the vaccination effort. She noted that mass vaccination sites, like football fields, could be quite efficient.

Infrastructure is pivotal, she said. Its not just about the science.

Some public health experts have worried that the limited supply could undermine goals of state and city officials to prioritize communities hard hit by the virus Black and Latino people and low-income New Yorkers in the vaccine rollout.

The state has not released demographic information on the distribution, but Mr. de Blasio said on Monday that data would come this week, adding that its part of making sure that we act to address the disparities that have pervaded the Covid experience.

The crunch in supply came as Gov. Andrew M. Cuomo said that a statewide spike in cases and hospitalizations in recent weeks, fueled by holiday gatherings, appeared to be ebbing.

While 46 ZIP codes in New York City have seven-day average positive test rates of over 10 percent, according to city data on Monday, and other areas like Long Island are still struggling with higher hospitalization rates, Mr. Cuomo said there was a downward trend in cases statewide. He said on Monday there were 8,730 hospitalizations in New York, down from more than 9,000 more than a week ago.

KNOXVILLE, Tenn. (WATE) Knoxville based biotechnology firm Integrity Laboratories is launching what it calls a game changer for COVID-19 testing and treatment.

The new technology is called AmpliteCt, which is a viral load indicator. The viral load is essentially how much of the virus is in a patients system.

When someone gets tested for COVID-19, doctors only know if the patient is positive or negative.

According to Christian Clevenger, CEO of Integrity Laboratories, with AmpliteCt, doctors will also find out the viral load of their patient.

Integrity Laboratories has played a large role locally and nationally for speedy and efficient COVID-19 testing.

Clevenger said his team wanted to take testing through the firms emergency use authorization platform a step further, so the results are more beneficial.

So getting a clinician, really you know, the positive, but then the ability to really look inside that positive and determine, OK, where is this patient in the process of loading up the virus, and more importantly, have they reached the point where theyre beginning to shed this virus, Clevenger said.

He said knowing what the viral load in someones COVID-19 test will be able to help doctors treat patients properly and efficiently.

You dont want to waste your convalescent plasma if you have a patient that is a low or maybe an intermediate level of viral load, Clevenger said.

Clevenger said AmpliteCt will also be able to determine if a patient is contagious or not.

I think one of the biggest advantages of the AmpliteCt product is, it gives (doctors) visibility to whether the patient is shedding the virus or whether the virus is multiplying, Clevenger said.

This is how it works: AmpliteCt is achieved through an automated, quantitative methodology that categorizes the concentration of viral genetic material in a patient specimen. The AmpliteCt algorithm leverages several key data points, including cycle threshold (Ct), to accurately stratify COVID-19 positive patients within low, moderate, or high infection designations.

Doctors are given a report that indicates on a graph whether the patient has a low, moderate or high viral load.

Clevenger said doctors will be able to tell at what point a patient is in their COVID-19 process by taking Integrity Laboratories COVID-19 test which AmpliteCt will be included multiple times over a period of several days.

If you go into a clinicians office and you feel really poorly, and they take a test and you show up as a high viral load, theyll probably monitor you, take good care of you and then bring you back for a test a few days later. Well, if youre a moderate viral load at that point, then the clinician knows that youre shedding that virus, Clevenger said.

Clevenger said AmpliteCt will be a game changer for treating COVID-19 because the new technology will be able to offer doctors a clearer answer to the question of whats next?

Thats going to mean better outcomes for our community, for the people that live around us; its going to be better outcomes regionally, and its all going to help clinicians to be able to figure out how we treat these patients when theyre in here with different viral loads, Clevenger said.

AmpliteCt will be available to healthcare providers partnering with Integrity Laboratories starting Feb. 3.

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