As research continues into how long coronavirus vaccines remain effective, Biden administration health officials increasingly think that vulnerable populations will need booster shots.
Senior officials now say they expect that people who are 65 and older or who have compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far.
That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.
The growing consensus within the administration that at least some Americans will need a booster is tied in part to research suggesting that the Pfizer vaccine is less effective against the coronavirus after about six months. More than half of those fully vaccinated in the United States so far have received Pfizer’s vaccine.
Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95 percent to 84 percent, according to the company.
Data from the Israeli government, which has fully vaccinated more than half of its population with Pfizer doses since January, also points to a downward trend in effectiveness against infection over time, though not against severe disease. Administration officials are viewing that data cautiously because of wide margins for error.
Dr. Anthony S. Fauci, who heads the infectious disease division of the National Institutes of Health, said the apparent steep falloff in the Pfizer vaccine’s effectiveness against infection in the Israeli data had epidemiologists “raising their eyebrows a bit.”
The administration has already purchased more than enough vaccine to deliver third doses of both Pfizer and Moderna, and has been quietly preparing to expand the distribution effort, should it become necessary.
Dr. Paul A. Offit, a member of the Food and Drug Administration’s outside advisory committee of vaccine experts, said a rise in mild or moderate cases of Covid-19 among vaccinated people did not necessarily mean a booster was required.
“The goal of this vaccine is not to prevent mild or low, moderate infectious disease,” he said. “The goal is to prevent hospitalization to death. Right now this vaccine has held up to that.”
Prematurely dangling the prospect of a third dose could also work as a deterrent against vaccination, making people less likely to get their initial shots, other health experts said.
“We don’t want people to believe that when you’re talking about boosters, that means that the vaccines are not effective,” Dr. Fauci said a congressional hearing Tuesday. “They are highly effective.”
Noah Weiland contributed reporting.
SAN FRANCISCO — The article that appeared online on Feb. 9 began with a seemingly innocuous question about the legal definition of vaccines. Then over its next 3,400 words, it declared coronavirus vaccines were “a medical fraud” and said the injections did not prevent infections, provide immunity or stop transmission of the disease.
Instead, the article claimed, the shots “alter your genetic coding, turning you into a viral protein factory that has no off-switch.”
Its assertions were easily disprovable. No matter. Over the next few hours, the article was translated from English into Spanish and Polish. It appeared on dozens of blogs and was picked up by anti-vaccination activists, who repeated the false claims online. The article also made its way to Facebook, where it reached 400,000 people, according to data from CrowdTangle, a Facebook-owned tool.
The entire effort traced back to one person: Joseph Mercola.
Dr. Mercola, 67, an osteopathic physician in Cape Coral, Fla., has long been a subject of criticism and government regulatory actions for his promotion of unproven or unapproved treatments. But most recently, he has become the chief spreader of coronavirus misinformation online, according to researchers.
An internet-savvy entrepreneur who employs dozens, Dr. Mercola has published over 600 articles on Facebook that cast doubt on Covid-19 vaccines since the pandemic began, reaching a far larger audience than other vaccine skeptics, an analysis by The New York Times found. His claims have been widely echoed on Twitter, Instagram and YouTube.
The activity has earned Dr. Mercola the dubious distinction of the top spot in the “Disinformation Dozen,” a list of 12 people responsible for sharing 65 percent of all anti-vaccine messaging on social media, said the nonprofit Center for Countering Digital Hate. Others include Robert F. Kennedy Jr., a longtime anti-vaccine activist, and Erin Elizabeth, the founder of the website Health Nut News, who is also Dr. Mercola’s girlfriend.
Now, Dr. Mercola and others in the “Disinformation Dozen” are in the spotlight as vaccinations in the United States slow, just as the highly infectious Delta variant has fueled a resurgence in coronavirus cases. More than 97 percent of people hospitalized for Covid-19 are unvaccinated, according to the Centers for Disease Control and Prevention.
President Biden has blamed online falsehoods for causing people to refrain from getting the injections. But even as Mr. Biden has urged social media companies to “do something about the misinformation,” Dr. Mercola shows the difficulty of that task.
The effects of positive coronavirus tests among Olympic athletes began playing out on Saturday, hours after the opening ceremony, as a women’s beach volleyball team did not play because of an infection.
The Czech players Marketa Slukova and Barbora Hermannova were “unable to play,” according to the official scoring report, giving the win to their Japanese opponents. Slukova is one of at least four members of the Czech Olympic team who have tested positive.
Her result was announced on Thursday, and both she and her playing partner have been ruled out of the Games because of Covid-19 regulations.
Tokyo Olympic organizers announced 17 new positive tests on Saturday among people connected to the Games. At least 127 people with Olympic credentials, including 14 athletes, have tested positive.
Tennessee health officials are resuming several programs to promote vaccinations for public school students, just two weeks after such efforts were halted because Republican elected officials had complained that parents should make the decisions.
The criticism of the programs had reached a fever pitch just before the firing of the state’s top immunization official, Dr. Michelle Fiscus, earlier this month.
Dr. Fiscus, medical director for vaccine-preventable diseases and immunization programs, attributed her ouster to the pushback among Republican lawmakers in the state. She is one of scores of public health officials across the United States who have quit or been forced from their jobs in a political climate that has grown increasingly polarized over the coronavirus and the vaccines.
On Friday, Dr. Lisa Piercey, the state health commissioner, said at a news conference that the state had temporarily suspended its outreach efforts in light of the criticism from conservatives, but officials were now trying to target messages to parents. She said the department would be taking part in several back-to-school vaccine events in partnership with schools.
“There was a perception we were marketing to children and that was totally against our view of the importance of parental authority,” she said. “We strongly believe that parents are the best decision markers.”
The state health department has also removed its logo from school-based fliers and has now revised fliers and reminder postcards to ensure they are directed at parents. The department also took down social media posts that depicted a child without a parent.
In a text message on Friday, Dr. Fiscus said the state’s decision to halt the programs, even temporarily, had a cost. “It’s unfortunate that Tennessee Department of Health chose to pause outreach to vulnerable populations during back to school and that we lost two weeks of critical time to vaccinate children, but I’m happy to hear they’re resuming now,” she said.
New cases in Tennessee have more than tripled over the past 14 days, to nearly 900 new infections a day, according to a New York Times database. Hospitalizations have risen about 68 percent to an average of 462 each day last week. Dr. Piercey said that in some counties 20 percent of coronavirus tests were coming back positive.
Republicans had charged that the state’s previous public-service advertisements urging teenagers to be vaccinated had gone too far in its efforts to raise awareness of the shot among young people.
“When you have advertisements like this, with a young girl with a patch on her arm, all smiling,” Scott Cepicky, a Republican state representative, said as he held up a printout of a social media post during a recent hearing. “We all know how impressionable our young people are, and wanting to fit in life.”
Breaking with many of her fellow elected Republicans, Gov. Kay Ivey of Alabama this week placed the blame for rising coronavirus cases in her state on “the unvaccinated folks” and said that she had run out of ideas for how to change minds.
“Folks are supposed to have common sense, but it’s time to start blaming the unvaccinated folks, not the regular folks,” Governor Ivey said during a news conference on Thursday. “It’s the unvaccinated folks that are letting us down.”
Alabama has the nation’s lowest vaccination rate, with only about 33.9 percent of residents fully vaccinated, according to federal data.
The average number of new daily cases in the state has tripled in the last two weeks, to more than 1,100 a day, the highest rate since mid-February, according to a New York Times database. Hospitalizations have also increased, and almost 100 percent of those are unvaccinated people, Ms. Ivey said.
“These folks are choosing a horrible lifestyle of self-inflicted pain,” she said.
In her four years in office, Ms. Ivey has proved to be a reliably conservative Southern Republican. She was a staunch supporter of former President Donald J. Trump, defends gun rights and opposes taking down monuments to Confederate leaders.
But at a time when many other Republican lawmakers remain reluctant to publicly confront vaccine skepticism, even as the Delta variant rips through conservative communities, her explicit condemnation of the unvaccinated demonstrated, yet again, that she has a pronounced independent streak when it comes to the handling of the pandemic.
In March, Ms. Ivey bucked pressure from fellow Alabama Republicans when she extended the state’s mask mandate until early April, even as Republican governors in Texas and Mississippi had lifted such requirements in the name of personal freedom. But like many Republican governors, she signed a bill banning vaccine passports in May, and earlier this week, she said she does not think Alabama schools need a mask mandate to reopen safely.
Still, Ms. Ivey did not mince words on Thursday as she beseeched residents to get the vaccines, which she described as “the greatest weapon we have to fight Covid.”
“Get a shot in your arm,” she said. “I’ve done it. It’s safe. The data proves it. It doesn’t cost anything. It saves lives.”
Asked by a reporter if she should be held responsible for failing to bring the virus under control, Ms. Ivey voiced frustration. “I’ve done all I know how to do,” she said. “I can encourage you to do something, but I can’t make you take care of yourself.”
The unvaccinated are not a monolithic group. Some are deeply opposed to the shots or remain reluctant, often because of misinformation about the vaccines. Others are still procrastinating. Though vaccine hesitancy is an issue on both the right and the left, the political disparity is stark. The Kaiser Family Foundation reported at the end of June that 86 percent of Democrats had at least one shot, compared with 52 percent of Republicans.
On Friday, Jen Psaki, the White House press secretary, declined to take a similar tone toward the unvaccinated when asked about Ms. Ivey’s comments.
“I don’t think our role is to place blame,” she said. “But what we can do is provide accurate information to people who are not yet vaccinated about the risks they are incurring not only among themselves but also the people around them.”
PARIS — As Europe and the United States scramble to find an appropriate balance between curbing the Delta variant of the coronavirus and curbing personal freedom, President Emmanuel Macron has led the way down a narrow path combining limited compulsion to get vaccinated with widespread coercion.
His approach of ordering health workers to get vaccinated by Sept. 15, and telling the rest of the French population they will be denied access to most indoor public venues if unvaccinated or without a negative test by Aug. 1, has prompted other countries including Italy to follow suit, even as it has stirred pockets of deep resistance.
“You are creating a society of generalized control for months, maybe years,” Éric Coquerel, a lawmaker from the far-left France Unbowed party, said during a tumultuous 48-hour parliamentary debate on Mr. Macron’s measures that ended early Friday with a relatively narrow victory for the president.
Barreling through 1,200 proposed amendments, defying accusations of authoritarianism and chaos from the hard right and left, the lower house voted by 117 to 86 to back President Macron’s attempt to strong-arm the French to get vaccinated by making their lives miserable if they do not.
Europe’s problem is similar to that of the United States: vaccination levels that at around or just under 60 percent are inadequate for herd immunity; surging Delta variant cases; and growing divisions over how far getting an injection can be mandated.
But where the United States has generally not gone beyond hospitals and major health systems requiring employees to get Covid-19 vaccines, major European economies including France and Italy are moving closer to making vaccines mandatory for everyone.
Mr. Macron’s measures, announced July 12 as the only means to avoid yet another French lockdown, have spurred both protests and an extraordinary surge in vaccinations, with 3.7 million booked in the first week after the president spoke, and a record of nearly 900,000 vaccinations in a single day on July 19. In this sense, his bold move has been a success.
PHNOM PENH, Cambodia — The patients sit in packed ambulances before passing through metal gates. Once inside, they get a number, a thin blanket and a bedsheet to use as a mosquito net. Lights shine at all hours for surveillance. Each person is given four bottles of water a day and three small meals.
The Cambodian government, racing to contain a raging coronavirus outbreak, has set up a system of forced quarantine centers that patients say are run more like makeshift prisons than hospitals. No one is allowed to leave until they test negative — and most people are stuck for at least 10 days.
The sprawling quarantine centers are the product of an overwhelmed and underfunded health care system, a jolt of recent Covid deaths and an authoritarian streak that often turns to a robust security apparatus in times of trouble. The Cambodian government has gone from nonchalance to closures to crackdowns, and Prime Minister Hun Sen has thundered against anyone who escaped government treatment, eluded quarantine or violated home isolation.
Phnom Penh health officials confirmed this month that 21 Covid “care centers” had been set up across the capital. Or Vandine, secretary of state at the Ministry of Health, said that she did not know how many patients were in the state-run quarantine camps, but that officials were doing all they could to “make conditions in the camps livable.”
Officials rarely talk about the quarantine centers, but they are impossible to hide.
Congressional Memo
Breakthrough coronavirus cases have emerged in multiple offices in Congress, including the speaker’s. The line for in-house testing snakes through a long corridor and into a visitors’ center atrium. The Capitol’s doctor has warned of the possible return of a mask mandate.
The Delta variant has reached Capitol Hill, but a common enemy has only made recriminations and anger worse between the two political parties.
Republicans, caught between a political base that is often resistant to vaccination and an imperative to save the lives of their voters, point their fingers at Democrats and blame them, without evidence, for covering up the virus’s origins.
Democrats fault Republicans who have done little to push back against vaccine skeptics in their ranks, and even now are soft-pedaling their calls for people to take the shot.
For much of the vaccinated nation, the coronavirus resurgence is somewhere else. In states like Vermont, Hawaii and Massachusetts, where at least 84 percent of the adults have at one shot or two, surges in Alabama, Florida, Missouri and Arkansas are far, far away.
But the Capitol is one of the few places in America where red and blue mingle almost daily — and resentment is high.
“Congress is like a nationwide convention every single day,” said Representative Jamie Raskin, a Democrat who has begun wearing a mask again, though he is fully vaccinated and 76.5 percent of adults in his state of Maryland have received at least one shot. “There are people who have come from every corner, hamlet and precinct of the country. It’s a petri dish for the development of political ideas, but also plagues.”
Republicans point out that the most recent high-profile carriers of the current plague were Democrats, Texas legislators who fled Austin to stop passage of a measure restricting voting. Six of them — all of whom said they were vaccinated — then tested positive, and are suspected of infecting a senior aide to Speaker Nancy Pelosi. The aide, who was also vaccinated, is mildly symptomatic.