About 80 Percent of K-12 Teachers and Staff Have Gotten a Covid-19 Vaccine Dose

About 80 percent of K-12 educators and staff have been given at least one vaccine dose.

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A mass vaccination event for teachers in Carteret, N.J., this month. About eight million school employees had received at least one vaccine dose by the end of March.Credit...Bryan Anselm for The New York Times

Nearly 80 percent of school staff and child care workers in the United States have received at least one dose of the coronavirus vaccine, the Centers for Disease Control and Prevention said on Tuesday.

The announcement comes as the Biden administration has made an ambitious push to reopen schools and return to in-person instruction by the president’s 100th day in office. That goal has been tempered by dangerous virus variants, protests from teachers’ unions, and the fears and frustrations of students and parents.

The push to reopen schools has gathered momentum as evidence mounted that proper safety measures limited virus transmission in schools and coronavirus cases fell sharply from their January peak. Education officials and experts have cited the urgency of getting students back in classrooms before the academic year ends.

About eight million teachers, school staff and child care workers received their first vaccine dose by the end of March, according to the C.D.C., with about two million receiving their shot through the Federal Retail Pharmacy Program.

President Biden announced the program in March, urging nationwide access to vaccines for school employees and child care workers. But a hodgepodge of eligibility guidelines followed, as some states chose not to deviate from their rollout plans. By the end of March, however, K-12 educators in all states had become eligible to receive a vaccine.

While the acceleration of vaccinations among educators and staff has reduced the resistance from teachers’ unions to reopening classrooms, school systems with powerful unions, especially on the West Coast, have been slower to revert to in-person instruction.

Union resistance has led a bipartisan group of governors in several states to prod, and sometimes force, school districts to open. The result has been a major increase in the number of students who now have the option of attending school in-person, or will soon.

According to a school reopening tracker created by the American Enterprise Institute, 7 percent of the more than 8,000 districts being tracked were fully remote on March 22, the lowest percentage since the tracker was started in November. Forty-one percent of districts were offering full-time in-person instruction, the highest percentage in that time. Those findings have been echoed by other surveys.

In February, the C.D.C. issued guidelines that said K-12 schools could reopen safely as long as they followed basic health protocols like masking or distancing.

More recently, it said that elementary school students and some middle and high schoolers could be spaced three feet apart in classrooms, instead of six feet, as long as everyone was wearing a mask. Unions had used the six-foot guidance to oppose bringing children back for normal schedules.

“Our push to ensure that teachers, school staff and child care workers were vaccinated during March has paid off and paved the way for safer in-person learning,” Dr. Rochelle Walensky, the center’s director, said in a statement released on Tuesday.

Mr. Biden hailed the C.D.C.’s newly released benchmark while visiting a vaccination site in Alexandria, Va., on Tuesday.

“That is great progress protecting our educators and our essential workers,” Mr. Biden said of the new estimate. “And because our vaccine program is in overdrive, we are making it easier to get a vaccination shot.”

The American Federation of Teachers, the nation’s second-largest teacher’s union, on Tuesday released a survey reporting that over 80 percent of association members had been vaccinated or had made a vaccine appointment. About 85 percent of members said their school was “operating on at least a part-time basis,” according to the survey.

Randi Weingarten, the federation’s president, said in a statement on Tuesday that “A.F.T. members have embraced vaccines as vital to getting back in the classroom.”

“They want to return, the road map to reopening is robust, and if we instill trust and meet fear with facts we can finally end this national nightmare,” Ms. Weingarten said.

California plans to lift virus restrictions in June if certain benchmarks are met.

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California to Lift Virus Restrictions on June 15

Gov. Gavin Newsom of California announced on Tuesday that the state would lift all its coronavirus restrictions on June 15 as long as new infections remained low and stable.

We have administered more doses than all but five nations in the world. The state of California, that 20 million mark, represents over seven million more doses than any other state in the country. That four million, on the equity mark, to me though, as I noted, is more important and significant. This state set a commitment and a audacious goal of providing over 40 percent, or upwards of 40 percent, of all our first doses and providing them under an equity metric in order to deliver on the cause of equity. We still have a lot of work to do in that space. We’re mindful of that. But that four million mark is as important as the 20 million mark. And today we have formally passed that. We are announcing today that on June 15, we will be moving beyond the blueprint and we’ll be getting rid of the colored tiers, we’ll be moving past the dimmer switch. We’ll be getting rid of the blueprint as you know it today. We anticipate enough vaccines are coming into the state of California, with two and a half million people just last week receiving the vaccine. We anticipate over 30 million people will have been vaccinated with at least one dose by the end of the calendar month. With the expectation of an abundance of doses coming in from the federal government through the end of this month and into May, we can confidently say by June 15 that we can start to open up as business as usual.

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Gov. Gavin Newsom of California announced on Tuesday that the state would lift all its coronavirus restrictions on June 15 as long as new infections remained low and stable.CreditCredit...Philip Cheung for The New York Times

California plans to lift all its coronavirus restrictions on June 15, provided there are enough Covid-19 vaccines available for anyone age 16 or older and hospitalizations remain low and stable, state officials announced on Tuesday.

The move in June will allow Californians to return to restaurants, bars, movie theaters, houses of worship and concerts without strict capacity limits for the first time in more than a year. President Biden has said there will be enough vaccines available for all adults by the end of May.

Other states have already eased health restrictions at a time when the Biden administration is pleading with them not to make those changes just yet. The country is facing a fourth possible surge of the virus, and there are concerns about the spread of worrisome virus variants. In many states, coronavirus case counts have been climbing.

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“I think if everyone continues down the road we’re on now, it will be behind us, but it’s not over yet,” Mr. Biden said on Tuesday during a visit to a vaccination site in Alexandria, Va.

Later in the afternoon, during remarks at the White House, he emphasized how serious the fight against the virus remained. “Let me be deadly earnest with you: We aren’t at the finish line. We still have a lot of work to do,” he said. “We’re still in a life and death race against this virus.”

But in California, cases have been declining since hitting a peak early this year, with the state now averaging around 2,700 new cases a day, the lowest figure since last June.

And according to data from the Centers for Disease Control and Prevention, as of Tuesday, 35 percent of the state’s total population has received at least one vaccine shot, and 18 percent are fully vaccinated.

“With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California’s economy,” Gov. Gavin Newsom said in a statement. “We can now begin planning for our lives post-pandemic.”

The state will, however, keep in place a mask mandate for the foreseeable future, and there will be some limits on large indoor events or conventions of more than 5,000 people at least until fall.

The state has become a high-profile case study of the ways in which reopening a vast economy can be much more complex, unequal and politically fraught than shutting one down.

California was the first state to implement a stay-at-home order last year, on March 19, plunging the state’s 40 million residents into the nation’s largest experiment in preventing transmission of what was then a mystery-shrouded virus.

Since then, California has toggled among various levels of restriction as new cases have surged, receded and then surged again, overwhelming hospitals in the winter, even as other states have allowed full reopenings.

Mr. Newsom was widely criticized last year when he attended a dinner for a lobbyist friend’s birthday at one of Napa Valley’s most exclusive restaurants, the French Laundry, after imploring Californians to be vigilant and to refrain from seeing their relatives during the holidays.

His administration’s ever-changing reopening strategies, which have been implemented piecemeal across the state’s 58 counties, have also come under fire.

The latest announcement will lift what state leaders have referred to as California’s “Blueprint for a Safer Economy,” which laid out a system of color-coded tiers of restrictions. As individual counties reached certain case thresholds, they were allowed to move through the tiers, a system first introduced in August when the state was grappling with an alarming rise in new cases.

Mr. Newsom and other state leaders emphasized that the state needed to have the ability to quickly reimpose emergency measures if hospitals started to fill up.

Around Thanksgiving, there were signs that public health officials’ worst fears would be realized. By December, hospitals — especially in hard hit areas, like Los Angeles — were overwhelmed with patients, and the state ordered Californians to stay at home again.

Now, as the focus has turned to the state’s vaccine rollout,Californians have been frustrated with what they have seen as a confusing and chaotic effort.

When state officials recently announced that the state would expand vaccine eligibility to anyone 16 or older starting April 15, Dr. Christopher Longhurst, U.C. San Diego Health’s chief information officer, predicted “continued frustration as more people become eligible but supply is not available to meet demand.”

Experts have also criticized the process for allowing poorer and harder-hit communities to be bypassed, even though state officials have repeatedly said equity was a “North Star” for their efforts.

Leaders in California are painfully aware of the divide between the state’s wealthiest and often whitest communities, on the one hand, and its poorest communities, often home to predominantly Latino essential workers, on the other, and so advocates for equity have said that speed and precision should both be priorities in the distribution of vaccines.

“Equity and scale are possible for the wealthiest states in the nation,” Jacqueline Martinez Garcel, chief executive of the Latino Community Foundation, said recently.

State officials said on Tuesday that they were confident in the state’s ability to inoculate millions more Californians, including particularly vulnerable workers, over the next couple of months.

“We’ve been very thoughtful and measured with who’s eligible to be vaccinated,” said Dr. Mark Ghaly, the state’s secretary of health and human services.

Tracking the Coronavirus ›

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Biden moves up eligibility deadline to April 19 for all American adults.

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President Biden at the White House on Tuesday.Credit...Amr Alfiky/The New York Times

President Biden said Tuesday that he is speeding up the deadline for states to make all adults eligible for a coronavirus vaccine — to April 19.

The announcement comes as nearly every state in the nation has already heeded earlier calls by the president to accelerate the timelines for when all adult residents will be eligible to be vaccinated — a vast majority now meeting or coming ahead of the April 19 target. On Tuesday, Oregon said those who are 16 or older will be eligible for vaccination on April 19.

“No more confusing rules. No more confusing restrictions,” Mr. Biden said in a speech from the White House

Mr. Biden’s most recent target comes almost a month after he set an original deadline of May 1 for every state, and a week after he said that by April 19, 90 percent of adults would be eligible for a shot and will be able to get one within five miles of their home.

A White House official said last week that Mr. Biden revised the timeline because states, encouraged by increases in shipments, were ramping up their vaccination programs more rapidly than expected.

Mr. Biden visited a vaccination site at Virginia Theological Seminary in Alexandria, Va., earlier on Tuesday afternoon. While he was there, he said that if everyone, including those who are fully vaccinated, “continues down the road we’re on now, it will be behind us, but it’s not over yet.”

During his remarks at the White House, he emphasized how serious the fight against the virus remained. “Let me be deadly earnest with you: We aren’t at the finish line. We still have a lot of work to do,” he said. “We’re still in a life and death race against this virus.”

The U.S. vaccination campaign has steadily picked up pace: About three million doses are being given on average each day, as of Tuesday, compared with well under one million when Mr. Biden took office in January, according to the Centers for Disease Control and Prevention.

Every state has now given at least one dose to a quarter or more of its population. About 63 million people have been fully vaccinated. And the White House on Tuesday told governors that over 28 million more doses of vaccines will go out to states, jurisdictions and other programs this week.

Mr. Biden has said he hopes for 200 million doses to be administered by his 100th day in office, a goal that the nation is on pace to meet. As of Tuesday, more than 152 million shots have been administered beginning on Jan. 20, according to data reported by the C.D.C. The federal government has delivered a total of about 219.2 million doses to states, territories and federal agencies since last year.

The recent burst in supply has prompted governors to move up eligibility timelines on their own weeks ahead of Mr. Biden’s original May 1 marker.

“Today, we are pleased to announce another acceleration of the vaccine eligibility phases to earlier than anticipated,” Gov. Larry Hogan of Maryland said on Monday, announcing that all Maryland residents age 16 or older would be eligible starting on Tuesday for a vaccine at the state’s mass vaccination sites, and from April 19 at any vaccine provider in the state.

Also on Monday, Gov. Philip D. Murphy of New Jersey said residents 16 or older in his state would be eligible on April 19. Mayor Muriel Bowser of Washington said later on Monday that city residents 16 or older would also be eligible on April 19.

In Hawaii, Lt. Gov. Josh Green said on Monday that the state was hoping to open up vaccinations to people 16 years or older on the island of Oahu in two weeks, according to a local television news outlet. The rest of the state has already done so.

The Food and Drug Administration authorized the Pfizer-BioNTech vaccine for use in people as young as 16 while the Moderna and Johnson & Johnson vaccines can be given to those 18 and older.

Public health experts have said that the vaccines are in a race against worrisome coronavirus variants that were first identified in Britain, South Africa and Brazil. New mutations have continued to pop up in the United States, from California to New York to Oregon.

The shots will eventually win, scientists say, but because each infection gives the coronavirus a chance to evolve further, vaccinations must proceed as fast as possible.

As that race continues, the optimism sown by the steady pace of vaccinations may be threatening to undermine the progress the nation has made. Scientists also fear Americans could let their guard down too soon as warmer weather draws them outside and case levels drop far below the devastating surge this winter.

Cases are now rising sharply in parts of the country, with some states offering a stark reminder that the pandemic is far from over: New cases in Michigan have increased by 112 percent and hospitalizations have increased by 108 percent over the past two weeks, according to a New York Times database.

The United States is averaging more than 64,000 new cases each day, a 20 percent increase from two weeks earlier. That’s well below the peak of more than 250,000 new cases daily in January, but on par with last summer’s surge after reopenings in some states, like Arizona, where patrons packed into clubs as hospital beds filled up. The United States is averaging more than 800 Covid-19 deaths each day, the lowest level since November.

Sheryl Gay Stolberg contributed reporting.

Vaccine passports are becoming the next coronavirus divide. The White House is skittish; Texas’ governor opposes them.

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People waiting in line to enter a Covid-19 vaccination site at Booker T. Washington High School in Houston.Credit...Go Nakamura for The New York Times

Under a new executive order issued by Gov. Greg Abbott of Texas this week, government agencies, private businesses and institutions that receive state funding cannot require people to show proof that they have been vaccinated against the coronavirus.

Mr. Abbott said that vaccination status is private health information, and that no one should have to disclose it as a condition of engaging in normal activities. His order includes an exception allowing nursing homes and similar care facilities to require documentation of vaccination status for their residents.

As the United States struggles to emerge from the worst public health crisis in a century, the arrival of digital vaccine verification apps — a modern version of the World Health Organization’s “yellow card” that provides international proof of yellow fever vaccination — has generated intense debate over whether proof of vaccination can be required at all.

A wide range of businesses, including cruise lines, airlines, sports stadiums and theaters, are eager for people to be issued some kind of credential, often called a vaccine passport, that they can present to show they are immunized so that the businesses can more safely reopen, especially as the number of new virus cases rises across the country.

Cathay Pacific airlines, for instance, convinced that digital proof of vaccination will bring about the return of safe international travel, asked its pilots and crew to try out a new mobile app that showed their vaccination status on a recent flight from Hong Kong to Los Angeles. But the World Health Organization, citing equity concerns, said on Tuesday that it currently did not support mandatory proof of vaccination for international travel.

And Walmart, the largest U.S. private employer, is offering electronic verification apps to patients vaccinated in its stores so they “can easily access their vaccine status as needed,” the company says.

At least 17 companies or nonprofits are developing websites or apps that might be used by sporting venues, restaurants and other businesses seeking to keep their customers and employees safe, according to Joel White, the executive director of the Health Innovation Alliance, a broad coalition of health providers, tech companies, employers and insurers.

Backers of digital vaccination cards are pressing the Biden administration to become involved, at least by setting standards for privacy and for verifying the accuracy of the records.

The White House is clearly skittish.

“The government is not now nor will we be supporting a system that requires Americans to carry a credential,” Jen Psaki, the White House press secretary, said on Tuesday. “There will be no federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential.”

Last week, the chief technology officer of the Department of Health and Human Services held a conference call with state and local health officials, who are mystified by the administration’s reticence.

“It’s going to be necessary to have this, and there is going to have to be some kind of system where it’s verified,” said Dr. Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. “I think everybody in our network is a little bit perplexed by the way the federal government seems to be at arm’s-length with this.”

Every state, in fact, already has a database, or an “immunization registry.” And under “data use agreements,” the states are required to share their registries with the C.D.C., though the agency de-identifies the information and not all states have agreed to provide it.

Politicians are already girding for a fight.

On Sunday, Gov. Tate Reeves of Mississippi said he opposes the idea of vaccine passports, and last week, Gov. Ron DeSantis of Florida issued an executive order banning policies that would require customers to provide any proof of vaccination. Gov. Pete Ricketts of Nebraska has said his state would not participate in any vaccine passport program.

The political and cultural divide aside, vaccine passports do raise daunting political, ethical and privilege questions.

In 1905, the Supreme Court ruled that states can enforce compulsory vaccination laws. “A community has the right to protect itself against an epidemic of disease which threatens the safety of its members,” Justice John Marshal Harlan wrote in Jacobson v. Massachusetts, the 1905 case. For more than a century, that ruling has allowed public schools to require proof of vaccinations of its students, with some exceptions for religious objections.

Private companies, moreover, are free to refuse to employ or do business with whomever they want, subject to just a few exceptions that do not include vaccination status. But states can probably override that freedom by enacting a law barring discrimination based on vaccination status.

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‘It appears we are following Michigan’: Minnesota officials warn of a surge propelled by a virus variant.

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Gov. Tim Walz of Minnesota chatted with Amanda Sloan of St. Paul at a vaccination site in Eagan, Minn., on Monday.Credit...Anthony Souffle/Star Tribune, via Associated Press

Minnesota is reporting a sharp rise in coronavirus cases and hospitalizations, as health officials warn about the spread of the more contagious and possibly more lethal virus variant first found in Britain.

The state reported an average of 1,776 new daily cases on April 3, before the Easter holiday weekend delayed reporting, according to a New York Times database. It surpassed 2,000 new confirmed cases on April 1, a figure not seen since early January. Hospitalizations have also climbed by about 37 percent from two weeks earlier.

Sara Vetter, interim director of the Minnesota Health Department’s Public Health Laboratory, said the state was starting to follow the virus trend in Michigan, where cases have surged in recent weeks.

“If you look at the trajectory of our curve, it appears we are following Michigan,” Dr. Vetter said. She added, though, that vaccinations would probably keep the state from reaching the peak in cases that was seen in November.

Several factors are driving up case reports, she said. One is people not following public health guidelines. Another is the spread of the B.1.1.7 variant first found in Britain.

Health officials believe that more than half of the new cases in the state in recent days are of the B.1.1.7 variant, which is about 50 percent more transmissible than earlier versions of the virus and may also be deadlier. The variant appears to be spreading the most in the Southwest metro and Twin Cities areas compared with the rest of the state, Dr. Vetter said.

The Minnesota Department of Health has attributed recent outbreaks in schools to the more contagious variant, and it has urged schoolchildren and teenagers to get tested at least every two weeks through the end of the school year. An outbreak of B.1.1.7 variant cases connected to participants in youth sports in Carver County prompted a warning from health officials last month.

Dr. Ruth Lynfield, a state epidemiologist, said there had been a notable rise in cases in people age 10 to 19, who accounted for about one in six new cases from mid-February to the end of March, compared with just one in nine over a similar period in October and November.

“It’s a race of vaccine against variants,” Dr. Lynfield said. “People really need to work hard and be patient, and continue to wear masks and continue to socially distance.”

Other states in the Northeast and the Midwest have also reported increases in new cases and hospitalizations, though few have worsened as rapidly as Minnesota. Scientists have warned about another surge in cases nationwide as states have lifted restrictions and new variants are spreading, even as the nation’s vaccination campaign is gathering speed. The United States is now vaccinating on average about three million people a day, up from roughly two million a month ago.

About 35 percent of Minnesota’s population has received at least one dose of a Covid-19 vaccine, according to a New York Times vaccine tracker. State officials extended eligibility for the vaccine last week to include all adults age 16 or older.

Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a former member of President Biden’s coronavirus advisory board, said the B.1.1.7 variant’s presence in Minnesota was a “game changer” that would make the situation in the state a lot worse.

“The variant is adding on to what would have been an increase in cases anyway, but it surely is adding on in a very powerful way,” Dr. Osterholm said.

How will China vaccinate 560 million people? It’s starting with free ice cream.

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Several businesses in China are offering incentives for those getting inoculated, including this Lego stall outside a vaccination center in Beijing.Credit...Gilles Sabrié for The New York Times

In Beijing, the vaccinated qualify for buy-one-get-one-free ice cream cones. In the northern province of Gansu, a county government published a 20-stanza poem extolling the virtues of the jab. In the southern town of Wancheng, officials warned parents that if they refused to get vaccinated, their children’s schooling and future employment and housing were all at risk.

China is deploying a medley of tactics, some tantalizing and some threatening, to achieve mass vaccination on a staggering scale: a goal of 560 million people, or 40 percent of its population, by the end of June.

China has already proven how effectively it can mobilize against the coronavirus. And other countries have achieved widespread vaccination, albeit in much smaller populations.

But China faces a number of challenges. The country’s near-total control over the coronavirus has left many residents feeling little urgency to get vaccinated. Some are wary of China’s history of vaccine-related scandals, a fear that the lack of transparency around Chinese coronavirus vaccines has done little to assuage. Then there is the sheer size of the population to be inoculated.

To get it done, the government has turned to a familiar tool kit: a sprawling, quickly mobilized bureaucracy and its sometimes heavy-handed approach. This top-down, all-out response helped tame the virus early on, and now the authorities hope to replicate that success with vaccinations.

Already, uptake has skyrocketed. Over the past week, China has administered an average of about 4.8 million doses a day, up from about one million a day for much of last month. Experts have said they hope to reach 10 million a day to meet the June goal.

“They say it’s voluntary, but if you don’t get the vaccine, they’ll just keep calling you,” said Annie Chen, a university student in Beijing who received two such entreaties from a school counselor in about a week.

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An E.U. vaccine official confirms a link between AstraZeneca’s shot and rare blood clots and a British trial was halted.

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Millions of people have received the AstraZeneca vaccine without safety problems, but reports of rare blood clots have raised concerns.Credit...Alessandro Grassani for The New York Times

A top vaccines official at the European Medicines Agency said on Tuesday that AstraZeneca’s vaccine was linked to blood clots in a small number of recipients while a clinical trial in Britain was halted, the first indications from a leading regulatory body and the vaccine’s developers that the clots may be a real, if extremely rare, side effect of the shot.

The agency itself has not formally changed its guidance, issued last week, that the benefits of the AstraZeneca vaccine outweigh the risks. It said on Tuesday that its review was ongoing and that it would announce its findings this week. But any further ruling from regulators would be a setback for a shot that Europe and much of the world are relying on to save lives amid a global surge in coronavirus cases.

The medicines agency said last week that no causal link between the vaccine and rare blood clots had been proven. Only a few dozen cases of blood clots have been recorded among the many millions of people who have received the vaccine across Europe.

But the vaccines official, Marco Cavaleri, told an Italian newspaper that “it is clear there is an association with the vaccine.” He said that it would likely remain up to individual countries to decide how to respond, given the variation in supply of Covid-19 vaccines and in the state of the virus.

Those comments represented the first indication from a member of a leading regulatory body that the blood clots could be a genuine, if extremely rare, side effect of the AstraZeneca vaccine. Previously, health officials in several European countries temporarily restricted the use of the shot in certain age groups, despite the European Medicines Agency’s recommendation to keep administering it.

Regulators in Britain and at the World Health Organization have also said that, while they were investigating any rare side effects, the shot was safe to use and would save many lives.

The vaccine’s developers had repeatedly said that their data did not show a link to the rare blood clots. But on Tuesday, the University of Oxford, which developed the vaccine with AstraZeneca, said it had paused vaccinations in a clinical trial testing the shot in children and teenagers in Britain while it waits for additional information from Britain’s drug regulator.

The rare blood clotting issues have so far been reported in adults. No safety issues have arisen in the clinical trial, according to a university spokesperson.

Mr. Cavaleri, the European Medicines Agency vaccine official, told the Italian newspaper Il Messaggero that European regulators had not determined why the vaccine might be causing the rare blood clots, which generated concern because the cases were so unusual. They involved blood clots combined with unusually low levels of platelets, a disorder that can lead to heavy bleeding.

The most worrisome of the conditions, known as cerebral venous sinus thrombosis, involves clots in the veins that drain blood from the brain, a condition that can lead to a rare type of stroke.

The clots are, by all accounts, extremely rare. European regulators were analyzing 44 cases of cerebral venous sinus thrombosis, 14 of them fatal, among 9.2 million people who received the AstraZeneca vaccine across the continent. Emer Cooke, the European Medicines Agency’s director, said that the clotting cases in younger people translated to a risk for one in every 100,000 people under 60 given the vaccine. Younger people, and especially younger women, are at higher risk from the brain clots, scientists have said.

In Britain, regulators last week reported 30 cases of the rare blood clots combined with low platelets among 18 million people given the AstraZeneca vaccine, which was developed with the University of Oxford. No such cases were reported in people who had received the Pfizer-BioNTech vaccine in Britain.

Regulators in Britain have said that people should get the vaccine “when invited to do so.” But British news reports indicated Monday night that regulators were considering updating that guidance for certain age groups.

Monika Pronczuk, Emma Bubola and Rebecca Robbins contributed reporting.

The U.S. gambled on a vaccine manufacturer, but documents show it long had problems.

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Although audits always find problems, federal officials and outside experts said that the pattern of lapses suggested the mistake that ruined as many as 15 million doses reflected deeper quality issues at Emergent BioSolutions.Credit...Samuel Corum for The New York Times

WASHINGTON — More than eight years ago, the federal government invested in an insurance policy against vaccine shortages during a pandemic. It paid Emergent BioSolutions, a Maryland biotech firm known for producing anthrax vaccines, to have a factory in Baltimore always at the ready.

When the coronavirus pandemic arrived, the factory became the main U.S. location for manufacturing Covid-19 vaccines developed by Johnson & Johnson and AstraZeneca, churning out about 150 million doses as of last week.

But so far, not a single dose has been usable because regulators have not yet certified the factory to allow the vaccines to be distributed to the public. Last week, Emergent said it would destroy up to 15 million doses’ worth of the Johnson & Johnson vaccine after contamination with the AstraZeneca vaccine was discovered.

Emergent and government health officials have long promoted their partnership as a success, but an examination by The New York Times of manufacturing practices at the Baltimore factory found serious problems, including a corporate culture that often ignored or deflected missteps and a government sponsor, the Biomedical Advanced Research and Development Authority, that acted more as a partner than a policeman.

Previously undisclosed internal documents and interviews with current and former federal officials and former company employees depict a factory operation that was ill-equipped to take on such a mammoth manufacturing task, despite Emergent’s having received a $163 million federal contract to improve the center and prepare it for high-volume production.

The loss of the Johnson & Johnson doses was not the first time that the company threw out coronavirus vaccine for fear of contamination. Between early October and January, Emergent discarded five lots of AstraZeneca vaccine — each the equivalent of two million to three million doses — because of contamination or suspected contamination, according to internal logs, a government official and a former company supervisor.

Audits and investigations — including ones conducted in 2020 by Johnson & Johnson, AstraZeneca, two federal agencies and Emergent’s own quality evaluators — found that Emergent had not followed some basic industry standards at the Baltimore plant, and identified repeated shortcomings in efforts to disinfect and prevent contamination.

Although audits always find problems, federal officials and outside experts said that the pattern of lapses suggested deeper quality issues at the factory in Baltimore.

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N.Y.C. public school students can opt back in to standardized testing this year.

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Students exiting a school in Queens, N.Y., amid the pandemic in March.Credit...Jeenah Moon for The New York Times

Students in New York City’s public school system, the largest district in the United States, will be able to take standardized tests this year, a process that has been drastically disrupted because of the pandemic. For the first time, New York City will ask families to opt in to state math and English exams, which all students in grades three through eight are typically asked to take during the spring. Last year, those exams were canceled altogether when city schools were shuttered as New York became a global center of the pandemic.

Though some city and state education officials have sought a waiver from the federal government to cancel the exams again this year, President Biden’s administration is requiring states to offer testing. New York’s solution — asking parents to opt their children in to take the test — will no doubt mean that smaller numbers of students will sit for the exams this year compared with numbers of previous years.

The smaller test score data will significantly disrupt at least two years of state testing, which will make it difficult to track student progress over time on those exams. It is not clear whether eighth graders applying to academically selective high schools will need test scores for admission.

A relatively small percentage of city students refuse the exams each year, as part of a national test refusal movement known as opt out. Students learning in-person and remotely who choose to participate in standardized testing will report to their school buildings during their scheduled exam over a range of dates in April and May.

Garment workers who lost their jobs in the pandemic are still waiting for severance pay.

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A garment worker in Cambodia signaled support for a campaign demanding relief for garment workers who have lost jobs and reform of the apparel industry, including a severance guarantee fund.Credit...Enric Catala/Wsm

Garment workers in factories producing clothes and shoes for companies like Nike, Walmart and Benetton have seen their jobs disappear in the past 12 months, as major brands in the United States and Europe canceled or refused to pay for orders after the pandemic took hold and suppliers resorted to mass layoffs or closures.

Most garment workers earn chronically low wages, and few have any savings. Which means the only thing standing between them and dire poverty are legally mandated severance benefits that are often owed upon termination, wherever the workers are in the world.

According to a new report from the Worker Rights Consortium, however, garment workers are being denied some or all of these wages.

The study identified 31 export garment factories in nine countries where, the authors concluded, a total of 37,637 workers who were laid off did not receive the full severance pay they legally earned, a collective $39.8 million.

According to Scott Nova, the group’s executive director, the report covers only about 10 percent of global garment factory closures with mass layoffs in the last year. The group is investigating an additional 210 factories in 18 countries, leading the authors to estimate that the final data set will detail 213 factories with severance pay violations affecting more than 160,000 workers owed $171.5 million.

“Severance wage theft has been a longstanding problem in the garment industry, but the scope has dramatically increased in the last year,” Mr. Nova said. He added that the figures were likely to rise as economic aftershocks related to the pandemic continued to unfold across the retail industry. He believes the lost earnings could total between $500 million and $850 million.

The report’s authors say the only realistic solution to the crisis would be the creation of a so-called severance guarantee fund. The initiative, devised in conjunction with 220 unions and other labor rights organizations, would be financed by mandatory payments from signatory brands that could then be leveraged in cases of large-scale nonpayment of severance by a factory or supplier.

Several household names implicated in the report made money during the pandemic. Amazon, for example, reported an increase in net profit of 84 percent in 2020, while Inditex, the parent company of Zara, made 11.4 billion euros, about $13.4 billion, in gross profit. Nike, Next and Walmart all also had healthy earnings.

Some industry experts believe the purchasing practices of the industry’s power players are a major contributor to the severance pay crisis. The overwhelming majority of fashion retailers do not own their own production facilities, instead contracting with factories in countries where labor is cheap. The brands dictate prices, often squeezing suppliers to offer more for less, and can shift sourcing locations at will. Factory owners in developing countries say they are forced to operate on minimal margins, with few able to afford better worker wages or investments in safety and severance.

“The onus falls on the supplier,” said Genevieve LeBaron, a professor at the University of Sheffield in England who focuses on international labor standards. “But there is a reason the spotlight keeps falling on larger actors further up the supply chain. Their behavior can impact the ability of factories to deliver on their responsibilities.”

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Saudi Arabia issues new restrictions on pilgrims to Mecca during Ramadan.

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Muslims, maintaining social distancing, performed the Friday Prayer at the Grand Mosque in Mecca, Saudi Arabia, in February.Credit...Saudi Press Agency/via Reuters

Saudi Arabia says it will restrict access to the Grand Mosque in Mecca during the Muslim holy month of Ramadan to people who have been vaccinated against the coronavirus or who have recovered from the disease.

The new restrictions, announced on Monday by the state-run Saudi Press Agency, are intended to prevent Mecca from becoming a hub for virus transmission during the most sacred month of the Islamic calendar.

In a typical year, millions of Muslims travel to Mecca from around the world to perform both the hajj pilgrimage, which is undertaken at a specific time of the year, and the lesser umrah pilgrimage, which can be done at any time.

The kingdom has not yet announced restrictions for the hajj, which will take place in July this year and which all Muslims who are financially and physically able must perform at least once in their lives.

Both the annual observance of Ramadan, when most Muslims fast from dawn to dusk, and the hajj are among the five pillars of Islam. The hajj and umrah pilgrimages are important economic drivers in Saudi Arabia, bringing billions of dollars into the kingdom in normal years.

Last June, as the coronavirus spread globally, the Saudi authorities drastically cut participation in the hajj by foreign visitors, limiting it to a few thousand pilgrims who were already in the kingdom — a tiny fraction of the 2.5 million people who had come for the hajj the year before.

The new measures, which will take effect when Ramadan begins around April 14, do not specify how many people will be allowed into the Grand Mosque or nearby sites at any one time. Pilgrims will need to book their visits to the shrine on a government app to prevent crowding.

Visitors will be required to prove that they are fully vaccinated, or had received the first dose of a two-dose vaccination more than 14 days before visiting. Alternatively, they can provide proof that they recovered from Covid-19.

Saudi Arabia imposed lockdowns and restricted international air travel earlier in the pandemic to try to limit coronavirus cases inside the kingdom, but the stringent limits on international flights were eased last month, reopening the possibility for Muslims abroad to reach the holy sites.

U.K. community leaders step in to help strengthen trust in vaccines.

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“Those people have not been catered for,” said Dr. Raja Amjid Riaz, a surgeon who is a leader at the Central Mosque of Brent in North London.Credit...Andrew Testa for The New York Times

Minority communities in Britain have long felt estranged from the government and medical establishment, but their sense of alienation is suddenly proving more costly than ever amid a coronavirus vaccination campaign that depends heavily on trust.

With Britons enjoying one of the fastest vaccination rollouts in the world, skepticism about the shots remains high in many of the communities where Covid-19 has taken the heaviest toll.

“The government’s response to the Black, Asian and minority ethnic communities has been rather limited,” said Dr. Raja Amjid Riaz, 52, a surgeon who is also a leader at the Central Mosque of Brent, an ethnically diverse area of North London. “Those people have not been catered for.”

As a result, communities like Brent offer fertile ground for the most outlandish of vaccine rumors, from unfounded claims that they affect fertility to the outright fabrication that shots are being used to inject microchips.

With the government seen as still disengaged in Black, Asian and other ethnic minority communities even as they have been hit disproportionately hard both by the virus itself and by the lockdowns imposed to stop its spread, many local leaders like Dr. Riaz have taken it upon themselves to act.

Some are well-known and trusted figures like religious leaders. Others are local health care workers. And still others are ordinary community members like Umit Jani, a 46-year-old Brent resident.

Mr. Jani’s face is one of many featured on 150 posters across the borough encouraging residents to get tested for the virus and vaccinated, part of a local government initiative.

The goal is to reframe the community’s relationship with the power structure, and perhaps establish some trust.

“In Brent, things have been done to communities and not in partnership,” said Mr. Jani, who said he had seen the toll the virus has taken on the area’s Gujarati and Somali communities.

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Many homeless people have no easy way to get stimulus checks.

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A line for meals at the Bowery Mission in New York last month. Some people who would benefit most from the stimulus are having the hardest time getting it.Credit...Andrew Seng for The New York Times

For most Americans, the third stimulus payment, like the first two, arrived as if by magic, landing unprompted in the bank or in the mail.

But it’s not as straightforward for people without a bank account or a mailing address. Or a phone. Or identification.

Just about anyone with a Social Security number who is not someone else’s dependent and who earns less than $75,000 is entitled to the stimulus. But some of the people who would benefit most from the money are having the hardest time getting their hands on it.

“There’s this great intention to lift people out of poverty more and give them support, and all of that’s wonderful,” said Beth Hofmeister, a lawyer for the Legal Aid Society’s Homeless Rights Project. “But the way people have to access it doesn’t really fit with how most really low-income people are interacting with the government.”

Interviews with homeless people in New York City over the last couple of weeks found that some mistakenly assumed they were ineligible for the stimulus. Others said that bureaucratic hurdles, complicated by limited phone or internet access, were insurmountable.

Paradoxically, the very poor are the most likely to pump stimulus money right back into devastated local economies, rather than sock it away in the bank or use it to play the stock market.

“I’d find a permanent place to stay, some food, clothing, a nice shower, a nice bed,” said Richard Rodriguez, 43, waiting for lunch outside the Bowery Mission last month. “I haven’t had a nice bed for a year.”

Mr. Rodriguez said he had made several attempts to file taxes — a necessary step for those not yet in the system — but had given up.

“I went to H&R Block and I told them I was homeless,” he said. “They said they couldn’t help me.”

As variants have spread, progress against the virus in the U.S. has stalled.

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People dining indoors in Northville, Mich., on Sunday. Coronavirus cases are rising even as restrictions are eased, with a more transmissible variant of the virus making up many of the cases in Michigan and elsewhere.Credit...Emily Elconin/Reuters

U.S. coronavirus cases have increased again after hitting a low late last month, and some of the states driving the upward trend have also been hit hardest by variants, according to an analysis of data from Helix, a lab testing company.

The country’s vaccine rollout has sped up since the first doses were administered in December, recently reaching a rolling average of more than three million doses per day. And new U.S. cases trended steeply downward in the first quarter of the year, falling almost 80 percent from mid-January through the end of March.

But during that period, states also rolled back virus control measures, and now mobility data shows a rise in people socializing and traveling. Amid all this, more contagious variants have been gaining a foothold, and new cases are almost 20 percent higher than they were at the lowest point in March.

“It is a pretty complex situation, because behavior is changing, but you’ve also got this change in the virus itself at the same time,” said Emily Martin, an epidemiologist at the University of Michigan School of Public Health.

Michigan has seen the sharpest rise in cases in the last few weeks. B.1.1.7 — the more transmissible and more deadly variant of the coronavirus that was first discovered in Britain — may now make up around 70 percent of all of the state’s new cases, according to the Helix data.

Higher vaccination rates among the country’s older adults — those prioritized first in the vaccination rollout — mean that some of those at highest risk of complications are protected as cases rise again.

But almost 70 percent of the U.S. population has still not received a first dose, and only about half of those ages 65 and older are fully vaccinated. And in many states, those with high-risk conditions or in their 50s and 60s had not yet or had only just become eligible for the vaccine when cases began to rise again, leaving them vulnerable.

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Global Roundup

A tiny German state pilots a cautious reopening.

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A gym in Saarbrücken, Germany, reopened on Tuesday to anyone with a negative coronavirus test in the previous 24 hours.Credit...Oliver Dietze/DPA, via Associated Press

The tiny German state of Saarland, home to around 990,000 people, is making a cautious return to a new kind of normal in a pilot project that state officials hope could show how to keep the local economy open while controlling infections. From Tuesday, residents who test negative for the coronavirus will be able to use outdoor dining areas, gyms and movie theaters and even attend live theater performances.

Even as cases have continued to rise in Germany, prompting calls for a harsher national lockdown to halt a third wave of the pandemic — which has already shut down many of its European neighbors.

“More vaccinating, more testing, more mindfulness, more options: That’s the formula we want to use as Saarland break new ground in the fight against the coronavirus pandemic,” Tobias Hans, the governor of the state in southwestern Germany, said last week as he announced the reopening plans.

Under the guidelines, as many as 10 people can meet outdoors, and anyone with a negative test result within the previous 24 hours can visit stores, gyms, theaters and beer gardens — places that have largely been closed across Germany since the country announced a “lockdown light” in November.

(Many stores have been open since March, when a court overturned the rules.)

The Saarland project begins the same day that new regulations require travelers from the Netherlands to present a negative coronavirus test to cross the border into Germany. Travelers from the Czech Republic, France and Poland face similar measures.

In other news from around the world:

  • The new leader of Tanzania said she would set up a committee to look into the coronavirus pandemic in the country — a sharp departure from her predecessor’s stance. “We cannot isolate ourselves as an island,” President Samia Suluhu Hassan said in a speech on Tuesday in the port city of Dar es Salaam. Tanzania has not shared data on the coronavirus with the World Health Organization since April, and it has reported just 509 cases and 21 deaths, figures that have been widely viewed with skepticism. President John Magufuli, who died last month, had scoffed at masks and social distancing measures, argued that “vaccines don’t work,” and said that God had helped the country eliminate the virus.

  • The World Health Organization does not support requiring vaccination passports for travel, a spokeswoman said on Tuesday during at a news briefing in Geneva, Switzerland.

    “At this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” the spokeswoman, Margaret Harris, said, according to Reuters. She also cited concerns over the “question of discrimination against the people who are not able to have the vaccine for one reason or another.”

  • Australia said it would write to the European Union to request 3.1 million doses of the AstraZeneca vaccine, which Prime Minister Scott Morrison said the bloc has failed to provide despite a contractual agreement. The E.U. has denied blocking the shipments, saying it held up only one shipment of 250,000 doses in March. On Wednesday, Mr. Morrison, whose government has been under fire for a slow rollout of vaccinations, said he would again write to the E.U. “to seek the export licenses for the full amount of the doses.”

Many children who never had Covid-19 symptoms later developed a mysterious inflammatory syndrome.

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New York-Presbyterian Morgan Stanley Children’s Hospital in Manhattan treated Jack Morrow, 14, for one of the first known cases of pediatric multi-system inflammatory syndrome related to Covid-19.Credit...Gabriela Bhaskar for The New York Times

Many children and teenagers who developed the mysterious inflammatory syndrome that can emerge several weeks after contracting the coronavirus never had classic Covid-19 symptoms at the time of their infection, according to the largest study so far of cases in the United States.

The study, led by researchers from the Centers for Disease Control and Prevention, found that in over 1,000 cases in which information about whether they got sick from their initial Covid-19 illness was available, 75 percent of the patients did not experience such symptoms. But two to five weeks later, they became sick enough to be hospitalized for the condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect multiple organs, especially the heart.

Published on Tuesday in JAMA Pediatrics, the study said that “most MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus. Experts do not yet know why some young people, and a smaller number of adults, respond this way.

“It means primary-care pediatricians need to have a high index of suspicion for this because Covid is so prevalent in the society and children often have asymptomatic disease as their initial Covid infection,” said Dr. Jennifer Blumenthal, a pediatric intensivist and pediatric infectious disease specialist at Boston Children’s Hospital, who was not involved in the study.

The researchers evaluated 1,733 of the 2,090 cases of the syndrome in people age 20 and younger that had been reported to the C.D.C. as of January.

The findings show that although the syndrome is rare, it can be serious. The C.D.C’s data only included patients who were hospitalized. More than 90 percent of those young people experienced symptoms involving at least four organ systems and 58 percent needed treatment in intensive care units.

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‘Hang in there,’ Trudeau urges, as virus cases in Canada continue to rise.

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Prime Minister Justin Trudeau of Canada visited a vaccination clinic in Ottawa in Ontario in March.Credit...Blair Gable/Reuters

Prime Minister Justin Trudeau said on Tuesday that Canada had entered “a very serious third wave of this pandemic,” echoing recent remarks by health care officials.

He urged Canadians to “hang in there” for the next few weeks, because vaccine shipments are forecast to increase.

“We’re in a situation where everyone is exhausted,” Mr. Trudeau said during a news conference. “This has been a very, very long year.”

Several Canadian provinces recently increased lockdown restrictions as rising case counts began to strain many hospital intensive-care units. Dr. Theresa Tam, the country’s chief public health officer, said that there was a 4 percent increase in the number of Covid-19 patients admitted to hospitals last week, while virus-related admissions to intensive-care units went up by 18 percent.

She said about one-third of patients currently hospitalized for Covid-19 have been admitted to intensive care units. In mid-January, the peak period for hospitalizations in Canada during the second wave of the pandemic, that number was less than one-fifth.

On Saturday, Canada reported its one millionth coronavirus case since the start of the pandemic. As of Monday, 23,132 Canadians had died from the virus.

Dr. Tam said that she was particularly concerned about the growing prevalence of virus variants in many regions, and she urged Canadians to help limit the spread of the variants by refraining from traveling between provinces.

Public health officials from the largest cities in Ontario, the most populous province, are urging the provincial government to further increase restrictions, including shutting down nonessential stores, as reported cases reached a level not seen since early January. Toronto, the country’s largest city, said that it would close its schools starting Wednesday.

Many Canadians continue to express frustration about the rate of vaccinations. To date, 11.91 percent of Canadians have received at least one dose and just 1.76 percent are fully vaccinated, far fewer than in the United States. Mr. Trudeau said that Canada remained on track to vaccinate all its residents by the end of summer.

Many of the most vulnerable U.S. counties have lower vaccination rates.

The United States reached a milestone on Saturday, topping 3 million average daily vaccinations for the first time. But speed isn’t the only priority for the country’s vaccination campaign. The Biden administration has also committed to distributing shots equitably to the communities most affected by the pandemic.

Yet more than three months into the rollout, the most socially vulnerable counties in the U.S. have a lower vaccination rate on average than the nation’s least vulnerable. The majority of the most disadvantaged counties with the fewest fully vaccinated people are in the South, while the most vaccinated, least vulnerable counties are in the Midwest.

Vaccination rates by county social vulnerability

Share of total population fully vaccinated. Circles sized by county population.

MidwestNortheastSouthWest
Source: Centers for Disease Control and Prevention, Texas Department of State Health Services, Colorado Department of Public Health & Environment, Massachusetts Department of Public Health, U.S. Census Bureau | Note: No C.D.C. data available for Hawaii, Texas and some counties. Georgia, Vermont, Virginia and West Virginia were excluded because more than a quarter of data is missing.

Counties are ranked according to the Social Vulnerability Index, an indicator from the Centers for Disease Control and Prevention that is used in public health crises and is based on socioeconomic status, housing, transportation, race, ethnicity and language. Each county’s vaccination rate is its share of all residents that have been fully vaccinated, a figure that does not reflect those who have only received one dose of a two-shot vaccine.

A handful of the most vulnerable counties do have some of the top vaccination rates in the country — in places like Apache, Ariz., and Nome Census Area, Alaska — reflecting the work that states, community organizations and federal agencies, such as the Indian Health Service, have done to target at-risk populations. The C.D.C. found similar results in its own analysis, noting that many states have more work to do to reduce vaccination inequities.

In early March, a New York Times analysis of state-reported race and ethnicity information showed that the vaccination rates for Black and Hispanic people in the United States were far outpaced by that of white people. Public health experts have said that obstacles to vaccine access, such as flexible work schedules and access to dependable transportation, deserve much of the blame for these vaccination disparities.

A recent survey conducted by the Kaiser Family Foundation found that the number of Americans, particularly Black adults, who want to get vaccinated has continued to increase. But it also found that vaccine skepticism remains stubbornly persistent, particularly among Republicans and white evangelical Christians.

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