The latest on the coronavirus pandemic and vaccines

A memorial ceremony for the 938 Berks County residents who died from Covid-19 was held at the Reading Hospital in West Reading, Pennsylvania on April 8.

About 618,523 people will have died from coronavirus in the US by August 1, according to the latest forecast from the University of Washington Institute for Health Metrics and Evaluation’s (IHME) influential coronavirus model.

That projection accounts for the scale up of Covid-19 vaccine distribution in the US over the next 90 days and continued spread of the B.1.1.7 virus variant throughout the nation.

An April 1 forecast projected 609,000 deaths by July 1 and warned that continued relaxation of public health measures and increases in mobility could lead to large surges of cases, like those seen in Michigan.

In the worst-case scenario, in which fully vaccinated people return to pre-pandemic levels of mobility, the model predicts 697,573 deaths by August 1. If 95% of the US population wore masks, the projection drops to 604,413 deaths by August 1.

The border between Brazil and Bolivia is seen closed in the Brazilian city of Brasiliia, in Acre state on Friday, April 2nd, 2021.

Bolivia’s border with Brazil will remain closed for one additional week until April 17, so that further Covid-19 infections can be avoided, authorities announced on Friday.

As of Thursday, Bolivia’s health ministry reported a total of 279,207 coronavirus cases and 12,412 deaths.

A nurse loads a syringe with a dose of the Pfizer Covid-19 vaccine at the Blood Bank of Alaska in Anchorage on March 19, 2021.

It’s “highly likely” the US Food and Drug Administration will allow Pfizer’s Covid-19 vaccine to be used in children aged 12 to15, according to the acting chairman of an FDA vaccine advisory committee.

“It’s highly likely, if the data submitted support it,” said Dr. Arnold Monto, a professor of epidemiology at the University of Michigan. Monto is also serving as acting chairman of the Vaccines and Related Biological Products Advisory Committee in their review of Covid-19 vaccines.

“I think it could be done relatively quickly,” he added.

Pfizer applied to the FDA earlier today to expand its emergency use authorization (EUA) or its vaccine to be used in children aged 12 to 15. Currently it is authorized for ages 16 and up.

Monto said the FDA likely won’t ask the committee he chairs to meet to discuss expanding the use of Pfizer’s vaccine down to 12-year-olds.

“They’re not going to have advisories every time they tweak things,” he said.

He couldn’t speculate on how long it would take the FDA to consider Pfizer’s request to amend its EUA.

Moderna and Johnson & Johnson’s Covid-19 vaccines have been authorized for use in people over the age of 18.

People are seen on a queue to access a lottery shop at the Lapa neighborhood during the Covid-19 pandemic in Rio de Janeiro, on April 8.

The Brazilian state of Sao Paulo will be easing some of its coronavirus restrictions starting Monday, the regional government announced Friday.

The level of restrictions will be assessed again on April 18, authorities said. 

The head of the Covid-19 task force in Sao Paulo state, Joao Gabbardo, said the current restrictions have brought the desired results – the reduction of cases and hospitalizations – but a wider opening of activities is out of the question at the moment.

Under the new guidelines, sports events would be able to take place without spectators and restaurants will be open for takeout. The ban on in-person religious ceremonies and a curfew from 8 p.m. to 5 a.m. local time will remain in place.

During the worst of the crisis for Sao Paulo state, intensive care unit occupancy reached 90.5%, according to state health authorities, but on Thursday authorities said it had gone down to 88.6%. 

Also on Friday, the city of Rio de Janeiro announced that it is easing some of its measures too, allowing bars and restaurants to be open until 9 p.m. local. The beaches will remain closed. 

The level of restrictions in Rio city will be assessed again on April 19, authorities said. 

Yesterday, the Brazilian Senate said it will open an inquiry into the government’s handling of the Covid-19 pandemic, as President Jair Bolsonaro continues to avoid lockdown measures despite the country’s mounting death toll.

On Thursday, Brazil recorded over 4,200 new Covid-19 deaths in 24 hours, raising its total toll to more than 345,000 – second only to the United States.

The field hospital in the parking lot of Sunnybrook Hospital in Toronto, Wednesday, March 31.

Canada says its third wave of the pandemic is now more serious than the previous two, as hospitalizations and critical care admissions spike, and the vaccine rollout is unlikely to change things over the next few weeks. 

“The end is definitely in sight but we’re not there yet. This third wave is more serious and we need to hang in there for another few weeks to make sure that we can flatten that curve, drop those numbers down again, to give a chance for vaccines to take hold,” Canadian Prime Minister Justin Trudeau said during a news conference in Ottawa Friday. 

The situation is most serious in Ontario, Canada’s most populous province, where officials say the province is close to its “worst case scenario” projections for the third wave. The province came dangerously close on Friday to shattering a record for a single day increase in cases and has already set a record this week for intensive care unit (ICU) admissions related to Covid-19. 

Ontario imposed a province-wide stay-at-home order Thursday but restrictions have only moderately decreased new infections, despite the fact that cities like Toronto have been in some form of lockdown since late November. 

“I can understand the frustration, the anxiety, the concern that Canadians right across the country are feeling in seeing these numbers rise, I share it. I think we’re all recognizing that we don’t want to be in this third wave but we’re here,” Trudeau said. 

Across the country, Canadian health officials say ICU admissions are up more than 20% in the last week alone as all of Canada’s most populous provinces cope with a third wave more threatening to the healthcare system than the last two. 

“Right now my concern is, the thing to me is the ICUs filling up, not just hospitalizations, because there is an absolute limit to ICU capacity not necessarily because of equipment but because of people,” Dr. Theresa Tam, Canada’s top doctor, said speaking alongside Trudeau during Friday’s news conference.

Although Canada broke a record this week for vaccine doses administered, Tam said the vaccine rollout will not slow the rapid epidemic growth in cases, as more contagious variants spread throughout the country. 

Adams 12 Five Star Schools District RN Tiffany Karschamroon draws a dose from a vial of the Johnson & Johnson Covid-19 vaccine at an event put on by the Thornton Fire Department on March 6, in Thornton, Colorado. 

The US Centers for Disease Control and Prevention are aware of several incidents involving adverse reactions to the Johnson & Johnson Covid-19 vaccine in four states.

In a statement released on Friday, CDC spokesperson Kristen Nordlund told CNN:

Officials in several of those states had previously confirmed to CNN that vaccinations were temporarily paused due to adverse reactions to the Johnson & Johnson vaccine. 

At this time, CDC and FDA “are not recommending health departments stop administering any lots of COVID-19 vaccine,“ the statement says. “CDC has performed vaccine lot analyses and has not found any reason for concern.”

Severe side effects from the vaccine are uncommon, and many people won’t experience any side effects at all.

But the CDC said “some people will have pain or swelling at the injection site or fever, chills, or a headache. These typically don’t last long and are signs that your body is building protection.”

Johnson & Johnson Covid-19 vaccinations at the Cumming Fairgrounds in Georgia are being paused out of an abundance of caution, the Georgia Department of Health and the North Health District announced in a news release on Friday.

On Wednesday, eight people had adverse reactions after being vaccinated, according to a statement from Nancy Nydam, spokesperson for the state’s Department of Health. One person was taken to the hospital for evaluation and the other seven people were monitored on-site and sent home, the release said.

“The reactions were consistent with common reactions in adults being vaccinated with any vaccine, but due to the number of individuals affected, the site stopped the J&J vaccinations to evaluate,” the statement said. In total, there were 425 Johnson & Johnson vaccines administered at that location on Wednesday, and “tens of thousands of J&J doses have been given statewide with no adverse reactions.” 

Georgia is at least the third state to evaluate incidents with the Johnson & Johnson vaccine. North Carolina and Colorado also paused vaccinations earlier this week due to adverse reactions. Nydam said Iowa is also “evaluating incidents,” related to the Johnson & Johnson vaccine. CNN is reaching out to the Iowa Department of Health about the vaccine.

Remember: It’s relatively common to experience side effects from any of the three vaccines available in the US – about 10% to 15% of volunteers in vaccine trials developed “quite noticeable side effects,” Moncef Slaoui, former Operation Warp Speed Chief scientific adviser, said late last year. 

Severe side effects, like allergic reactions, are far less common. 

CNN Health has reached out to the Centers for Disease Control and Prevention about these incidents.

A nurse prepares the Pfizer Covid-19 vaccine a public housing project pop-up site targeting vulnerable communities in Los Angeles, California on March 10.

Pfizer requested an amendment to its emergency use authorization of its Covid-19 vaccine, to expand its use in people ages 12 to 15 in the United States.

Currently, the vaccine is authorized for emergency use by the US Food and Drug Administration in people aged 16 and up. 

The other two Covid-19 vaccines – made by Moderna and Johnson & Johnson – are currently authorized for emergency use in people age 18 and older.

In a photo provided by the Michigan Office of the Governor, Gov. Gretchen Whitmer addresses the state during a speech, Friday, March 19, in Lansing, Mich.

Despite vaccination efforts, Michigan remains “unquestionably a national hot spot right now” for Covid-19, Michigan Gov. Gretchen Whitmer said.

Michigan has not seen this high of a positivity rate since the first surge last spring despite conducting many more tests now, an official with the Michigan Department of Health and Human Services said.

The positivity rate increased to 18%, which is four times what health officials saw last February, according to Khaldun

Hospitalizations are also increasing. At least 15.2% of hospital beds across the state are being used to care for Covid-19 patients, Khaldun said. Hospitals are evaluating and implementing their surge plans, including considerations of canceling elective surgeries, Khaldun stated.

The number of cases and patients doubled in the last two weeks at Spectrum Health and continue to climb each day, according to Spectrum Health CEO Tina Decker. The more contagious B.1.1.7 variant is believed to have contributed to the surge, Decker explained.

Gov. Whitmer proposed various efforts to double down on increasing case numbers.

The governor urged high schools specifically to voluntarily go remote for two weeks following spring break. Youth sports have also been encouraged to suspend practices and games during this two-week period, Whitmer added.

Over 56 pop-up testing sites have opened on school campuses across the state and are now offering post-spring break testing, Khaldun said. She urged those who have recently traveled or have plans to travel to get tested.

Whitmer and Khaldun both advised people to avoid indoor dining. Instead, they should choose to get takeout to support local businesses.

“To be very clear, these are not orders, mandates, or requirements. A year in, we all know what works, and this has to be a team effort. We have to do this together. Lives depend on it,” Whitmer stated during the press conference.

Even those who have already received the vaccine should mask up, wash hands, and socially distance, the governor emphasized.

Over 5.1 million doses of the Covid-19 vaccine, meanwhile, have been administered to over 3.1 million people in Michigan, Whitmer said.

This marks a new milestone for the state. Nearly 40% of residents have been vaccinated in less than four months, and the rate continues to speed up, Whitmer said. Michigan administered 1 million doses, to surpass the 5 million mark, in less than two weeks, according to the governor.

CNN’s Miguel Marquez contributed reporting to this post.

Doses containing AstraZeneca vaccine are seen at a drive-in vaccination centre in Schwelm, western Germany, on April 7.

Doctors have published new details on a handful of people who, after receiving AstraZeneca’s Covid-19 vaccine, developed what they describe as a rare immune response that caused blood clots and low platelets.

In two reports published Friday, an analysis of 16 patients in Germany, Austria and Norway describe a number of clots in “unusual sites” like the brain and abdomen. These events occurred roughly a week or two after receiving the vaccine, and some of these cases resulted in death. 

Both reports in the New England Journal of Medicine suggest naming the diagnosis “vaccine-induced immune thrombotic thrombocytopenia,” or VITT. The diagnosis refers to the underlying cause: platelet-activating antibodies that cause a cascade of clotting and falling platelets.

These reports come two days after the European Medicines Agency said “unusual blood clots with low blood platelets should be listed as very rare side effects” of AstraZeneca’s vaccine. However, the agency affirmed the benefits of the vaccine outweigh the risks of Covid-19. That statement also said an abnormal immune response could be “one plausible explanation,” adding that it wasn’t possible to identify specific risk factors at this time.

Doctors say this resembles an autoimmune phenomenon known to be triggered by the blood-thinner heparin, which none of these patients had previously received. In that disorder — known as heparin-induced thrombocytopenia, or HIT — platelets are similarly activated by antibodies that attach to heparin, when bound to another protein found in platelets. 

On Friday, the European Medicines Agency announced it was also reviewing possible links between blood clots and another Covid-19 vaccine, Johnson & Johnson’s. The company said in a statement that while “no clear causal relationship has been established,” it is working with experts and regulators to take a closer look at the data.

AstraZeneca made similar comments Wednesday, stressing that its vaccine “offers a high-level of protection against all severities of Covid-19 and that these benefits continue to far outweigh the risks.”

White House Covid-19 coordinator Jeff Zients, front, speaks during a briefing on April 9.

Jeff Zients, the White House Covid-19 coordinator, on Friday defended the Biden administration’s decision not to surge coronavirus vaccines as part of its increased effort to send more federal resources to states with increases in Covid-19 cases. 

Earlier during Friday’s briefing, Zients said the federal government would deliver more testing and surge federal personnel to states with cases trending in the wrong direction.

But when pressed on why the administration would not send more Covid vaccine doses to those hurting states, Zients underscored that the virus was unpredictable.

“There are tens of millions of people across the country in every state and county who have not yet been vaccinated. And the fair and equitable way to distribute the vaccine is based on the adult population by state, tribe and territory. That’s how it’s been done, and we will continue to do so,” Zients said.

Then Zients reiterated the other plans the administration has to surge resources, saying, “That said, it is a challenging situation in many states. And we want to do all we can to help those states.”

A person is administered the Johnson & Johnson Covid-19 vaccine on April 8 in Staten Island, New York.

Jeff Zients, President Biden’s Covid-19 Response Coordinator, said Johnson & Johnson will have “relatively low level of weekly dose delivery until a company secures FDA authorization” of its independent manufacturing facility.

Zients said that Johnson & Johnson is working closely with the US Food and Drug Administration to resolve manufacturing issues at this independent contractor, Emergent BioSolutions. The Baltimore plant makes the drug substance that goes into the vaccine. It does not yet have FDA authorization to send out its material and has had some problems making the vaccine.

Once Emergent gets FDA authorization, Zients said that the company expects a cadence of up to eight million weekly doses in total across state and federal channels later in April.

Next week, the number of Johnson & Johnson Covid-19 vaccine shots allocated to states and other jurisdictions by the federal government is expected to drop 84%, according to a CNN analysis of data from the US Centers for Disease Control and Prevention.

Johnson & Johnson said it will meet its commitment to provide “at or near” 100 million doses by the end of May.

Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, speaks during a briefing on April 9.

Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said in a White House briefing Friday that Covid-19 cases and hospitalizations are increasing – particularly for younger people – while deaths are going down.

Yesterday, the CDC reported over 74,000 news cases, Walensky said.

“Deaths have continued to decrease, more than 20% with a seven-day average now of 711,” she said.

Increases in cases and emergency room visits are being seen in younger adults, many of whom have not been vaccinated, Walensky said.

Those aged 18 to 25, 26 to 54, and 55 to 64 have increasing numbers of emergency department visits, she said, while people aged 65 and older have decreasing visits, “likely demonstrating the important impact of vaccination in protecting against disease requiring hospitalization.”

Walensky said that while those are national statistics, the trends are magnified in some areas of the country. 

White House Covid-19 coordinator Jeff Zients, front, speaks during a briefing on April 9.

Jeff Zients, the White House Covid-19 coordinator, said the federal government will intensify the surging of resources to states experiencing increased Covid-19 cases. 

 Zients said the surge in resources will include coordinating the administering of existing vaccine doses, offering to send in federal personnel, provide additional testing capacity and offering more therapeutics and treatments. 

“With recent increases in cases in some states, we’re intensifying those efforts even further. We will be offering to states with significant increases in cases a set of additional tools to help them to stem the spread, including, first: working with states to ensure they are using all of the doses that they have received. Today, millions of doses have been distributed, but have not yet been administered as shots in arms.”

He continued:

Greece has joined a number of European Union countries in putting restrictions on the use of the AstraZeneca Covid-19 vaccine. 

Greece’s National Vaccination Committee has recommended the vaccine only be offered to those aged 30 and over. 

The decision follows a warning by Europe’s drug regulator on Wednesday of a slim risk that AstraZeneca’s Covid-19 vaccine could cause rare blood clots.

In a statement, the committee pointed out that despite the restrictions:

After evaluating the available data, the Committee said that “it recommends the continuation of the vaccination program with any available vaccine, including the AstraZeneca vaccine, to individuals aged 30 years and older.” 

Ahead of the announcement, Health Ministry Secretary General for Primary Health Care, Marios Themistokleous said he does expect “major changes in our vaccination schedule.”

Speaking on Greece’s public broadcaster ERT Thursday, Themistokleous added there are 10,00 to 12,000 vaccinations with AstraZeneca on a daily basis in Greece and that that public participation during the last week has been over 90%. 

Meanwhile, local media are reporting an increase in people not turning up for their AstraZeneca jab appointments.

Greece is experiencing a recent surge in cases while strict measures remain in place. 

A nurse puts down a vial of the Johnson & Johnson Covid-19 vaccine in Oakland, California, on March 26.

In an official statement, Johnson & Johnson said that the company is “aware” that there have been thromboembolic events (blood clots) “reported with all Covid-19 vaccines.”

J&J said that it is working closely with experts and regulators to take a closer look at the data.

The company said people who get the Covid-19 vaccine and experience any severe symptoms should seek medical assistance immediately.

Symptoms could include shortness of breath, chest pain, swelling in the leg, persistent belly pain, neurological symptoms, excessive or easy bruising, or tiny blood spots under the skin beyond the site of injection.

Earlier this morning, the European Medicines Agency (EMA) said it is reviewing possible links between Johnson & Johnson’s Covid-19 vaccine and blood clots. 

EMA said there were reports of four serious cases of people who had developed blood clots after they got the vaccine. It is unclear if the clots are connected to the vaccine or related to some other medical issue. 

You can find more information on the J&J vaccine here.

The European Medicines Agency (EMA) is reviewing possible links between Johnson & Johnson’s Covid-19 vaccine and blood clots. 

EMA said there were reports of four serious cases of people who had developed blood clots after they got the vaccine. It is unclear if the clots are connected to the vaccine or related to some other medical issue.

One case involved a person in a clinical trial, and the three others happened during the US roll out of the vaccine. In one of the cases, the person died, the release said.

The J&J Covid-19 vaccine was authorized for use in the European Union on March 11, but the vaccines have not yet been rolled out there. The EU rollout is supposed to start in the next few weeks. Only the US is currently seeing a supply of J&J vaccines.  

The Pandemic Response Accountability Committee is reviewing the blood clot cases and will announce what it has found once the investigation is complete.

World Health Organization director-general Tedros Adhanom Ghebreyesus speaks at a news briefing in Geneva, Switzerland, on April 9.

The World Health Organization continues to believe that the benefits of the AstraZeneca Covid-19 vaccine outweigh the risk of rare side effects, WHO director-general Tedros Adhanom Ghebreyesus said during a news briefing in Geneva on Friday. 

“Even as we work to expand access to vaccines, we’re continuing to keep a close eye on vaccine safety,” Tedros said. 

All vaccines and medicines carry a risk of side effects, he said, adding that:

Earlier this week European and British medicines regulators announced a “possible link” between the AstraZeneca vaccine and rare cases of blood clots, with the UK announcing it would offer people under 30 an alternative vaccine. Later on Wednesday, WHO released a statement saying that “a causal relationship between the vaccine and the occurrence of blood clots with low platelets is considered plausible but is not confirmed.”

Tedros reiterated this point Friday. 

“The Covid-19 subcommittee of the WHO Global Advisory Committee on vaccine safety has reviewed available information from Europe and other regions and has said that a causal relationship between the vaccine and the occurrence of blood clots with low platelets is plausible, but more investigation is required,” he said. 

National Institutes of Health Director Dr. Francis Collins in Bethesda, Maryland, on January 26.

National Institutes of Health Director Francis Collins told STAT News that developing a pill to treat Covid-19 as soon as someone is diagnosed is his “dream.”

“It’s just a damn long pathway,” Collins said.

Collins said “this is an extremely high priority,” for himself and his colleague Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Biden.

It’s also important for “the Biden administration, to work with these companies to try to make sure that we speed this up,” he said. “This pandemic is going to be with us — even with great vaccines — and people are going to get sick.”

Collins told STAT that a pill like this could have further applications beyond Covid-19.

“What we might end up doing here is curing the common cold,” Collins said. “Then I wouldn’t have to listen to those jokes anymore.”

A pharmacist holds a vial of the AstraZeneca Covid-19 vaccine in Nantes, France, on March 25.

Vaccine advisers to the federal government tell CNN they don’t foresee AstraZeneca’s Covid-19 vaccine being used in the United States, and even if it were offered, they personally wouldn’t take it, given that other options are available.

European drug regulators said Wednesday there was a possible link between the AstraZeneca vaccine and rare blood clots. Some countries – more than 70 have authorized the shot – have now limited its use.

One adviser told CNN that federal health officials have privately expressed concern that offering AstraZeneca could increase vaccine hesitancy in the US, which is already a problem among some groups.

Pfizer, Moderna and Johnson & Johnson’s vaccines have excellent safety records, with tens of millions of shots without any reported serious side effects.

“Everyone would raise questions. ‘You’re not giving me that new blood clotting vaccine, are you?’ ” another adviser said, referring to AstraZeneca’s vaccine. “Why muddy the waters with a vaccine that comes with a somewhat checkered reputation?”

In an email, an AstraZeneca spokesperson declined to respond specifically to the advisers’ concerns, but pointed CNN to AstraZeneca’s Phase 3 results in its US trial, which showed that the vaccine was 76% effective at preventing symptomatic Covid-19 and 100% effective at preventing severe or critical disease and hospitalization.

According to a company statement, the blood clots are an “extremely rare potential side effect.”

Wednesday, Dr. Anthony Fauci told CNN that even if the US Food and Drug Administration granted emergency use authorization to AstraZeneca’s vaccine, there’s no need for it right now in the United States.

“It’s not any indictment against the product. We just have a lot of vaccines,” he said.