Big Storms Mean Big Vaccine Delays as Bad Weather Wallops the U.S. – The New York Times

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Vaccines were given out Thursday, mostly to the elderly, at a community center in the Bronx. 
Credit…James Estrin/The New York Times

Just as vaccine distribution was beginning to gather steam in the United States, brutal winter weather is delaying the delivery of hundreds of thousands of doses across the country.

Earlier this week, the Centers for Disease Control and Prevention projected “widespread delays” in vaccine shipments and deliveries because of weather affecting a FedEx facility in Memphis and a UPS facility in Louisville, both vaccine shipping hubs. Now those projections appear to be coming true.

Shipment delays have been reported in California, Colorado, Florida, Illinois, Nevada, New Jersey, Ohio, Utah, Washington and Oregon, among other states, forcing vaccine sites to temporarily shutter and coveted appointments to be rescheduled.

In Texas, where millions of residents lost power during this week’s powerful storm, a delivery of more than 400,000 first doses and 330,000 second doses was delayed in anticipation of the bad weather. A portion of those shots, roughly 35,000 doses of Pfizer’s vaccine, were sent to North Texas providers on Wednesday, but shipments will continue to depend on safety conditions.

Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said Thursday that the state was “asking providers that aren’t able to store vaccine due to power outages to transfer it elsewhere or administer it so it doesn’t spoil.”

On Monday, health officials in Texas scrambled to get more than 5,000 shots into arms after a power outage in a storage facility where they were being kept. But Mr. Van Deusen said that “reports of vaccine spoiling have been minimal.”

The Houston Health Department said Thursday it would restart vaccinations for second doses this weekend, and schedule additional first and second dose appointments next week.

The Federal Emergency Management Agency said more than 2,000 vaccine sites are in areas with power outages.

In New York City, Mayor Bill de Blasio said at a news conference on Thursday that “a vast majority of the resupply we expected for this week has not shipped from the factories yet.”

The city has had to hold off on scheduling upward of 35,000 appointments for first vaccine doses because of shipment delays and vaccine shortages. The opening of two new distribution sites was also postponed.

In Los Angeles, the city said that appointments for about 12,500 will be delayed.

Gov. Ron DeSantis of Florida said that while 136,000 Pfizer doses had arrived this week, the state had still not received its shipment for the week of 200,000 Moderna doses. He said the shipment could be delayed as late as Monday.

“Because the storms we are seeing in the rest of the country, it’s basically sitting in the FedEx warehouse — and I don’t think they can even get into it because of everything,” Mr. DeSantis said at a news conference Thursday, encouraging those who had appointments rescheduled to “hang in there, the doses are going to get here.”

Dr. Anthony S. Fauci, the nation’s top infectious disease expert, called the weather delay “significant.”

“Well, obviously it’s an issue,” he told MSNBC on Thursday. “It’s been slowed down in some places, going to a grinding halt.”

Dr. Fauci said, “We’re just going to have to make up for it as soon as the weather lifts a bit, the ice melts and we can get the trucks out and the people out. We’re going to just have to make up for it, namely do double time when this thing clears up.”

Jennifer Psaki, the White House press secretary, said that the Biden administration was working closely with manufacturing and shipping partners to assess weather conditions, and that it would have more updates on delivery issues on Friday.

As of Thursday, the C.D.C. said about 41 million people have received at least one dose of a Covid-19 vaccine, including about 16.2 million people who have been fully vaccinated.

After taking office, President Biden directed federal agencies to come up with “a framework for donating surplus vaccines, once there is sufficient supply in the United States, to countries in need.”
Credit…Oliver Contreras for The New York Times

An international effort to speed up the manufacture and distribution of coronavirus vaccines around the globe got a boost Thursday on two fronts: White House officials said the Biden administration would make good on a U.S. promise to donate $4 billion to the campaign over the next two years and the pharmaceutical company Novavax committed to eventually sell 1.1 billion doses of its vaccine.

President Biden will make his announcement on Friday during a virtual meeting with other leaders from the Group of 7, where he is also expected to call on other countries to step up their contributions. The $4 billion was approved last year by a Republican-led Senate when President Donald J. Trump was still in office.

Public health experts often say that unless everyone is vaccinated, it is as if no one is vaccinated. One of the officials, who spoke anonymously to preview the president’s announcement, noted that the move to help with efforts abroad to diminish the impact of the pandemic was also in the interest of international security for the United States.

Countries such as India and China are already using the coronavirus vaccine as a diplomatic tool; both are giving away doses to other nations in an effort to expand their global influence. National security experts said the United States should consider doing the same.

But, an official said, the United States will not be able to share vaccines now, while the American vaccination campaign is still continuing to expand.

The international vaccine effort, known as Covax, has been led by the public-private health partnership known as Gavi, the Vaccine Alliance, as well as the Coalition for Epidemic Preparedness Innovations and the World Health Organization. It aims to distribute vaccines that have been deemed safe and effective by the W.H.O., with a special emphasis on low- and middle-income countries.

So far, the United States has pledged more than any other nation, according to the White House. Officials there said the money would be delivered in multiple tranches: an initial donation of $500 million right away, followed shortly by an additional $1.5 billion. The remaining $2 billion will delivered by the end of 2022

The Novavax sale will not come immediately; its vaccine has not yet been approved by a government regulatory authority. [An earlier version of this article incorrectly described the company’s planned action as a donation, not a sale.]

Under a memorandum of understanding between Gavi and Novavax, the company agreed to provide “1.1 billion cumulative doses,” though it did not specify a time frame.

Mr. Biden was not the only G-7 member urging greater contribution to the global vaccination effort. President Emmanuel Macron of France said the United States and Europe should allocate up to 5 percent of their vaccine orders to developing countries.

“We are allowing the idea to take hold that hundreds of millions of vaccines are being given in rich countries and that we are not starting in poor countries,” Mr. Macron said in an interview with the Financial Times.

António Guterres, the United Nations Secretary General, also offered choice words for what he described as a “wildly uneven and unfair” distribution of vaccines. In a high-level meeting of the U.N. Security Council on Wednesday, Mr. Guterres called vaccine equity “the biggest moral test before the global community.”

He called on G-7 countries to “create the momentum to mobilize the necessary financial resources” at their Friday meeting.

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Women Leaving Work Force Is a ‘National Emergency,’ Harris Says

In a meeting with women leaders, Vice President Kamala Harris said high numbers of women being pushed from the work force by the pandemic can be largely addressed by the Biden administration’s coronavirus relief plan.

“Our economy cannot fully recover unless women can participate fully. So I believe, I think we all believe, this is a national emergency — women leaving the workforce in these numbers, it’s a national emergency, and it demands a national solution. We do believe that the American Rescue Plan is a very big part of the solution to this issue. And in many ways; one, it will get immediate relief to women workers, including $1,400 checks to those who need it. And at least $3,000 in tax credits to parents for each of their children. And the beauty of the significance of this is by doing that, we will lift up nearly half of the children who are living in poverty in our country. The American Rescue Plan will also provide funding to help schools safely reopen, and make a big investment in child care to help providers keep their doors open. And it will get America vaccinated. So simply put, the American Rescue Plan will help get women back to work.” “Women are not opting out of the workforce. They are being pushed by inadequate policies. So we have an opportunity not just to throw money at a problem, but to build that architecture for the future. Use this as a moment to address the serious inequities that have been further exposed by the coronavirus pandemic.” “Do not underestimate the impacts from enhanced unemployment benefits, pandemic unemployment assistance and economic payments that have come directly into our families. They are a lifeline and we have to continue this.”

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In a meeting with women leaders, Vice President Kamala Harris said high numbers of women being pushed from the work force by the pandemic can be largely addressed by the Biden administration’s coronavirus relief plan.CreditCredit…Stefani Reynolds for The New York Times

Vice President Kamala Harris said on Thursday that the 2.5 million women who have left the work force since the beginning of the pandemic constituted a “national emergency,” one that she said could be addressed by the Biden administration’s coronavirus relief plan.

That number, according to Labor Department data, compares with 1.8 million men who have left the work force. For many women, the demands of child care, coupled with layoffs and furloughs in an economy hit hard by the pandemic, have forced them out of the labor market.

The vice president painted a dire picture of the reality that millions of American women are facing during the pandemic. “Our economy cannot fully recover unless women can participate fully,” Ms. Harris said on a video call held with several women’s advocacy groups and lawmakers.

As part of its $1.9 trillion relief plan, the Biden administration has outlined several elements that officials say will ease the burden on unemployed and working women, including $3,000 in tax credits issued to families for each child, a $40 billion investment in child care assistance and an extension of unemployment benefits. Ms. Harris said that the package would “lift up nearly half of the children that are living in poverty” in the United States, a claim backed by a Columbia University analysis of the plan.

A recent Quinnipiac poll showed broad support for the Biden administration’s proposal. It has no Republican support in Congress, but Democrats aim to pass the plan using a fast track budgetary process, known as reconciliation, which would allow them to push it through the Senate with a simple majority.

Female employment began plummeting almost immediately once the virus took hold last spring, according to a report published last year by researchers at the University of Arkansas and the Center for Economic and Social Research at the University of Southern California.

Non-college educated women and women of color have been disproportionately affected. Another report, published last fall by the Brookings Institution, showed that nearly half of all working women have low-paying jobs, which are more likely to be held by Black or Latina women and in sectors, including dining and travel, that are among the least likely to return soon to a degree of normalcy.

People arrive to get vaccinated at the Maccabi Health vaccination centre in the Israeli coastal city of Tel Aviv-Jaffa.
Credit…Jack Guez/Agence France-Presse — Getty Images

Israel has raced ahead with the fastest Covid-19 vaccination campaign in the world, inoculating nearly half its population with at least one dose. Now its success is making it a case study in setting rules for a partially vaccinated society — raising thorny questions about rights, obligations and the greater good.

Prime Minister Benjamin Netanyahu’s cabinet voted this week to open shopping malls and museums to the public, subject to social distancing rules and mandatory masking. For the first time in many months, gyms, cultural and sports events, hotels and swimming pools will also reopen, but only for some.

Under a new “Green Badge” system that functions as both a carrot and a stick, the government is making leisure activities accessible only to people who are fully vaccinated or recovered starting from Sunday. Two weeks later, restaurants, event halls and conferences will be allowed to operate under those rules. Customers and attendees will have to carry a certificate of vaccination with a QR code.

Israel is one of the first countries grappling in real time with a host of legal, moral and ethical questions as it tries to balance the steps toward resuming public life with sensitive issues such as public safety, discrimination, free choice and privacy.

“Getting vaccinated is a moral duty. It is part of our mutual responsibility,” said the health minister, Yuli Edelstein. He also has a new mantra: “Whoever does not get vaccinated will be left behind.”

Four million Israelis — nearly half the population of nine million — have received at least one dose of the Pfizer vaccine, and more than 2.6 million have gotten a second dose. But about two million eligible citizens aged 16 or over have not sought vaccines. The average number of new daily infections is hovering around 4,000.

Israel’s central government — eager to bring the country out of its third national lockdown without setting off a new wave of infections — was spurred into action by local initiatives. Chafing under the country’s lockdown regulations, an indoor shopping mall in the working-class Tel Aviv suburb of Bat Yam threw its doors open last week for customers who could prove that they had been vaccinated or had recovered from Covid-19.

In Karmiel, the mayor made a similar decision to open his city in the northern Galilee region for business. Other mayors want to bar unvaccinated teachers from classrooms while some hoteliers threatened unvaccinated employees with dismissal.

Mr. Edelstein, the health minister, said on Thursday that vaccination would not be compulsory in Israel. But his ministry is now proposing legislation that would oblige unvaccinated employees whose work involves contact with the public to be tested for the virus every two days. And he is promoting a bill that would allow the ministry to identify unvaccinated people to the local authorities.

A line for coronavirus tests in Los Angeles. The life expectancy gap between Black and white Americans grew during the pandemic to six years, the largest figure since 1998.
Credit…Philip Cheung for The New York Times

Life expectancy in the United States fell by a full year in the first six months of 2020, the federal government reported on Thursday, the largest drop since World War II and a grim measure of the deadly consequences of the coronavirus pandemic.

Life expectancy — the average number of years that a newborn is expected to live — is the most basic measure of the health of a population, and the stark decline over such a short period is highly unusual and a signal of deep distress. The drop comes after a series of troubling smaller declines driven largely by a surge in drug overdose deaths. A fragile recovery over the past two years has now been wiped out.

Thursday’s figures give the first full picture of the pandemic’s effect on American expected life spans, which dropped to 77.8 years from 78.8 years in 2019. It also showed a deepening of racial and ethnic disparities: Life expectancy of the Black population declined by 2.7 years in the first half of 2020, after 20 years of gains. The gap between Black and white Americans, which had been narrowing, is now at six years, the widest since 1998.

“I knew it was going to be large, but when I saw those numbers, I was like, ‘Oh my God,’” Elizabeth Arias, the federal researcher who produced the report, said of the racial disparity. Of the drop for the full population, she said, “We haven’t seen a decline of that magnitude in decades.”

Still, unlike the drop caused by the extended, complex problem of drug overdoses, this one, driven largely by Covid-19, is not likely to last as long because virus deaths are easing and people are being vaccinated. In 1918, when hundreds of thousands of Americans died in the flu pandemic, life expectancy declined 11.8 years from the previous year, Dr. Arias said, down to 39. Numbers fully rebounded the following year.

Even if such a rebound occurs this time, the social and economic effects of Covid-19 will linger, researchers noted, as will disproportionate effects on people of color. Some researchers said that drug deaths, which began surging again in 2019 and 2020, may continue to lower life expectancy.

Dr. Mary T. Bassett, a former New York City health commissioner who is now a professor of health and human rights at Harvard, said that unless the country better addressed inequality, “We may see U.S. life expectancy stagnate or decline for some time to come.”

She noted that life expectancy here began to lag behind other developed countries in the 1980s. One theory is that growing economic disparities affected health. Life conditions that have exacerbated Covid-19 rates, like overcrowded housing and inadequate protections for low-wage workers, will only add to that trend, she said.

In Thursday’s figures, Black and Hispanic Americans were hit harder and the fatalities in these groups skewed younger. Over all, the death rate for Black Americans with Covid-19 was almost twice that for white Americans as of late January, according to the Centers for Disease Control and Prevention; the death rate for Hispanics was 2.3 times higher than for white non-Hispanic Americans.

The 2.7-year drop in life expectancy for African-Americans from January through June of last year was the largest decline, followed by a 1.9-year drop for Hispanic Americans and a 0.8-year drop for white Americans.

Dr. Bassett said she expected life expectancy for Hispanic people to decline further over the second half of 2020, when Covid-19 death rates for that demographic continued to rise even as they dropped for white and Black Americans.

A woman waits for her vaccination in Bates Memorial Baptist Church in Louisville, Ky., on Friday, the first day that Norton Healthcare offered shots in predominantly Black areas of the city.
Credit…Jon Cherry/Getty Images

Rates of vaccination in Black and Latino communities in New York are lower than rates in largely white communities, new data shows, the latest evidence that suggests they aren’t getting equal access to vaccines, even though they have been disproportionately been affected by the coronavirus.

The picture is hazy because accurate national data on race and ethnicity is lagging. But experts and leaders in these communities say the data shows that Black and Latino Americans are being vaccinated at lower rates because they face obstacles like language and technology barriers, disparities in access to medical facilities and getting to a site.

Some Black and Latino Americans face other problems, too, including social media misinformation and hesitancy to get the vaccine because of mistrust in government officials and doctors.

Data released on Tuesday on the 1.3 million vaccines administered in New York City showed lower rates of vaccination in predominantly Black areas. New York State also reports Latino and Black residents to be behind in vaccination totals.

President Biden has repeatedly said that racial equity is at the center of his response to the coronavirus pandemic and he appointed an adviser, Dr. Marcella Nunez-Smith, to tackle that. The Biden administration announced a program last week that began to ship vaccines to federally funded clinics in underserved communities.

The federal government also sent one million doses to about 6,500 retail pharmacies beginning last week. But researchers who did a county-level analysis, which included community pharmacies, federally qualified health centers, hospital outpatient departments and rural health clinics, found that more than one-third of U.S. counties have two or fewer of those facilities.

This makes access to vaccines more difficult, according to the study from the University of Pittsburgh School of Pharmacy and West Health Policy Center.

While vaccine hesitancy may play a role in Black and Latino communities, Sean Dickson, the director of health policy at the West Health Policy Center, said that the study shows evidence of effects from systemic health infrastructure issues.

“It’s important that we don’t rest on vaccine hesitancy as a crutch,” Mr. Dickson said, adding that it could sometimes be used to blame Black and Latino communities. “If we don’t do anything to better affirmatively distribute the vaccines in these communities, then it will become a self-fulfilling prophecy.”

In the Brownsville area of Brooklyn, Renee Muir, the director of development and community relations at the BMS Family Health Center, said she is developing a survey to gather evidence of the challenges affecting the community. Many residents have been deeply affected by the virus because of adverse health conditions and unemployment.

“Now you’re talking about people making decisions to spend $6 round trip, or eating, or paying a phone bill,” Ms. Muir said about residents traveling to get a vaccine.

On messaging platforms like WhatsApp and on social media, Latinos have been exposed to vaccine misinformation, said Dr. Valeria Daniela Lucio Cantos, an infectious disease specialist at Emory University. She has been working to help Latinos understand the vaccine and make appointments.

“There’s this emphasis on the risk and not enough on the benefits of the vaccines,” she said.

But while many older Americans struggle with the online system to register for a vaccine, sites only available in English presented an additional barrier, Dr. Cantos said.

“It feels like the system built for vaccine distribution did not have the Latinx community in mind,” she said, using the gender-neutral term for Latinos. She added that vaccine sites asking for Social Security numbers or insurance numbers made it difficult for undocumented immigrants to feel safe.

As vaccine supplies ramp up, Dr. Paulina Rebolledo, an assistant professor at Emory, hopes that officials begin to rethink their approach by mobilizing with organizations within Black and Latino communities that are trusted by residents and speak various languages.

“We, on the provider side or the health care side, can try to do more to reach patients and have them hear our voices,” she said. “It’s their overall health we’re trying to work on, and this is just an integral part of the movement.”

Traveling nurses working at a field hospital in Cranston, R.I. Baccalaureate nursing program enrollment rose by 6 percent last year.
Credit…David Goldman/Associated Press

As the pandemic was starting to overwhelm hospitals last year, some nursing school officials feared that the crisis would deter prospective applicants from pursuing nursing careers. But preliminary enrollment data from 2020 shows the opposite to be true: Baccalaureate nursing program enrollment rose by 6 percent last year, according to a survey of 900 schools by the American Association of Colleges of Nursing.

Deb Trautman, president of the organization, attributes the increased interest to the visibility of medical workers over the last year, as television and social media tributes have highlighted their roles on the front line.

“There was an opportunity for the public to see the contributions nurses are making,” Ms. Trautman said. “They’re participating in vaccinations, in care, in helping patients and families communicate and stay connected.”

The interest wasn’t limited to nursing: Medical school applications rose 18 percent for the class entering in fall 2021, according to the Association of American Medical Colleges.

People who lost jobs during the pandemic may also be enrolling in nursing programs as they look for new career paths, according to Donna Meyer, chief executive of the Organization for Associate Degree Nursing. She said nursing work had proved potentially more lucrative than before the pandemic, especially given the increased need for traveling nurses. While hospital nurses typically make about $80,000 a year, traveling nurses have made as much as $10,000 a week during pandemic.

The survey was reported on in Kaiser Health News on Thursday.

Historically, nursing programs have been limited in the number of students they can admit each year, because of constraints on the clinical training opportunities they can offer. In 2019, bachelor’s and graduate degree programs rejected over 80,000 qualified applicants. But this year, many nursing programs made the transition to training students virtually and were able to increase capacity, according to Dr. Beverly Malone, president of the National League for Nursing.

“It was like a war call,” Dr. Malone said, referring to the pandemic. “You see what’s going on and you say, ‘I’m going to help.’”

Lorraine Wilner, a 78-year-old retiree with metastatic breast cancer, at her home in Lancaster, S.C. Instead of making longer drives into North Carolina as frequently, she can now have her blood drawn at a lab near her home and review the results with researchers over a video call.
Credit…Travis Dove for The New York Times

When the pandemic hit last year, clinical trials took a hit. Universities closed, and hospitals turned their attention to battling the new disease. Many studies that required repeated, in-person visits with volunteers were delayed or scrapped.

But some scientists found creative ways to continue their research even when face-to-face interaction was inherently risky. They mailed medications, performed exams over video chat and asked patients to monitor their own vitals at home.

Many scientists say this shift toward virtual studies is long overdue. If these practices persist, they could make clinical trials cheaper, more efficient and more equitable — offering state-of-the-art research opportunities to people who otherwise wouldn’t have the time or resources to take advantage of them.

“We’ve discovered that we can do things differently, and I don’t think we’ll go back to life as we used to know it,” said Dr. Mustafa Khasraw, a medical oncologist and clinical trial specialist at Duke University.

According to one analysis, nearly 6,000 trials registered on ClinicalTrials.gov were stopped between Jan. 1 and May 31, roughly twice as many compared with non-pandemic times.

Remote trials are likely to persist in a post-pandemic era, researchers say. Cutting back on in-person visits could make recruiting patients easier and reduce dropout rates, leading to quicker, cheaper clinical trials, said Dr. Ray Dorsey, a neurologist at the University of Rochester who conducted remote research for years.

The shift to virtual trials could also help diversify clinical research, encouraging more low-income and rural patients to enroll, said Dr. Hala Borno, an oncologist at the University of California, San Francisco. The pandemic, she said, “does really allow us to step back and reflect on the burdens that we’ve been placing on patients for a really long time.”

But virtual trials are not a panacea. Researchers will have to ensure that they can thoroughly monitor volunteers’ health without in-person visits, and be mindful of the fact that not all patients have access to, or are comfortable with, technology.

And in some cases, scientists still need to demonstrate that remote testing is reliable; homes are uncontrolled environments. “Maybe there’s a cat crawling on them or grandchildren in the next room,” he said.

Lawmakers in California on Thursday proposed a $12.6 billion package to fast-track teacher vaccines and provide incentives to public schools to reopen classrooms by April 15.

The legislation, which is virtually assured of passage early next week, would restore about 10 weeks of in-person class for the regular school year, and then only for elementary and special needs students. In most districts, California’s school year ends in late June.

But it would also include money for summer school. More important, the plan would establish California’s clearest road map yet for restoring in-person instruction. Most of the state’s large school districts, including the Los Angeles, San Diego and San Francisco districts, have been operating remotely for the vast majority of students for nearly a year.

Mr. Newsom had called for schools to reopen this month under a similar incentive structure, citing federal guidelines. The Centers for Disease Control and Prevention recently issued new guidelines saying that teacher vaccination need not be a prerequisite to reopening schools, as long as other health measures were enforced.

However, teachers unions have demanded greater workplace safety, including vaccinations, surveillance testing and extensive improvements to ventilation systems. The 300,000-member California Teachers Association, a powerful player in the state’s Democratic-dominated Capitol, aired statewide television ads this week calling for “safety first” in classrooms and warning that the pandemic is “still a threat.”

Under the legislative plan, $8 billion in state and federal money would be distributed to districts willing to provide in-person teaching by April 15 for students in kindergarten through sixth grade and for high-needs students through 12th grade.

Those districts — and their local health authorities — would be required to offer vaccines to teachers and staff before they returned to classrooms. Schools would also have to comply with strict distancing, masking and other safety requirements. Families would be given the option of remaining in distance learning.

The state would also make available $4.6 billion to underwrite summer school, tutoring, extended school days and other remedial efforts to make up for the academic toll of the pandemic.

Districts that failed to reopen by April 15 would be required to return the funds.

“These clear guidelines from the state will help reopen schools in the safest way possible,” the superintendent of the Los Angeles school district, Austin Beutner, said in a statement.

Mr. Newsom, who is facing a Republican-led recall movement fueled, in part, by the pandemic-related school closures, had no immediate comment about the legislation, but has said repeatedly that he wants to reopen schools.

A man gets the coronavirus vaccine at an outdoor vaccination site on Wednesday in Bradenton, Fla.
Credit…Chris O’Meara/Associated Press

It was meant to be a feel-good event, like the two or three that Gov. Ron DeSantis of Florida holds around the state each week: a pop-up coronavirus vaccination site where the governor could show how his administration was getting the shots to people 65 and older.

But when Mr. DeSantis arrived on Wednesday at the site in Manatee County, he faced sharp questions from local reporters about why his staff had chosen to do it in Lakewood Ranch, an affluent and mostly white community developed by a Republican political donor.

The Bradenton Herald reported that the vaccinations in Lakewood Ranch would be limited to residents of two ZIP codes — the two wealthiest in the county — at a time when vaccination rates in less affluent Black communities in the state were lagging far behind.

Florida’s population is nearly 17 percent Black, but only about 5.4 percent of the more than 2.4 million Floridians who have gotten at least one of the two required vaccine doses so far have been Black, according to data from the Florida Department of Health.

Mr. DeSantis, a Republican, defended the site’s location. He said the state wanted to concentrate on communities with many retirees, especially in counties where the share of older people who have already been vaccinated is less than 42 percent, the statewide average.

“If Manatee County does not like us doing this, we are totally fine with putting this in counties that want it,” he said, citing several nearby counties in southern Florida: “If you want us to send to Sarasota next time, or Charlotte, or Pasco, let us know. We are happy to do it.”

Late on Wednesday, additional reporting by The Herald revealed that Vanessa Baugh, the county commissioner who had helped organize the vaccination site, had created a V.I.P. list of vaccine recipients that included herself and the developer of Lakewood Ranch, Rex Jensen. Mr. Jensen also helped organize the vaccination site, along with Patrick K. Neal, a local home builder who has donated $125,000 to Mr. DeSantis’s political committee since 2018. Last week, Mr. DeSantis visited a pop-up vaccination site at Kings Gate, a community in Charlotte County developed by Mr. Neal.

Ms. Baugh told The Herald that she did not get vaccinated or receive an appointment. Ms. Baugh and Mr. Jensen did not immediately respond to interview requests from The New York Times on Thursday. A spokeswoman for Mr. Neal declined to comment and directed questions to the governor’s office.

Florida was one of the first states to open up eligibility to everyone 65 and older. It has also offered vaccination to some people with underlying health conditions, and to frontline health care workers. But unlike most other states, it has not yet begun vaccinating other categories of essential workers like teachers or grocery workers, a policy that has drawn some criticism.

Mr. DeSantis opened another pop-up site on Thursday, this time in Pinellas Park, a largely white middle-income community near St. Petersburg. Before he spoke to reporters there, a man yelled, “Shame on you, Governor!”

Mr. DeSantis said questions about any preferential treatment in Lakewood Ranch should be directed to officials there, saying that the state merely identifies the pop-up sites, leaving details about who will be vaccinated to local leaders.

“We trust them to be able to sign people up,” he said.

A rare winter storm that dumped a foot of snow on Seattle couldn’t keep Fran Goldman from her first appointment for the coronavirus vaccine on Sunday.
Credit…Ruth Goldman/Ruth Goldman, via Associated Press

To get her coronavirus vaccination last weekend, Frances H. Goldman, 90, went to an extraordinary length: six miles. On foot.

It was too snowy to drive at 8 a.m. on Sunday when Ms. Goldman took out her hiking poles, dusted off her snow boots and started out from her home in the Seattle neighborhood of View Ridge. She made her way to the Burke-Gilman Trail on the edge of the city, where she then wended her way alongside a set of old railroad tracks, heading south. Then she traversed the residential streets of Laurelhurst to reach the Seattle Children’s Hospital.

It was a quiet walk, Ms. Goldman said. People were scarce. She caught glimpses of Lake Washington through falling snow. It would have been more difficult, she said, had she not gotten a bad hip replaced last year.

At the hospital, about three miles and an hour from home, she got the jab. Then she bundled up again and walked back the way she had come.

It was an extraordinary effort — but that was not the extent of it. Ms. Goldman, who became eligible for a vaccine last month, had already tried everything she could think of to secure an appointment. She had made repeated phone calls and fruitless visits to the websites of local pharmacies, hospitals and government health departments. She enlisted a daughter in New York and a friend in Arizona to help her find an appointment.

Finally, on Friday, a visit to the Seattle Children’s Hospital website yielded results.

“Lo and behold, a whole list of times popped up,” she said in a phone interview on Wednesday. “I couldn’t believe my eyes. I went and got my glasses to make sure I was seeing it right.”

Then came the snow, which would ultimately drop more than 10 inches, in one of Seattle’s snowiest weekends on record. Wary of driving on hilly, unplowed roads, Ms. Goldman decided to go to the hospital on foot. She took a test walk part of the way on Saturday to get a sense of how long the trip might take.

And on Sunday, she trekked all the way to the hospital to get her vaccine.

“I hope that it will inspire people to get their shots,” she said. “I think it’s important for the whole country.”

The rollout in Washington State, like many around the country, has been complicated by failures of technology, shortfalls in equity and a persistent imbalance of supply and demand. State officials have struggled to set up the infrastructure necessary to schedule and vaccinate the millions of people who are already eligible.

Ms. Goldman is scheduled to receive her second dose of the vaccine next month. She plans to drive.

A subway station platform in the Midwood neighborhood of Brooklyn earlier this month.
Credit…Michael M. Santiago/Getty Images

After warning that draconian cuts to public transit could be on the way, including a 40 percent decrease in subway service, New York transit officials on Thursday announced that they had avoided major reductions for the next two years after a new infusion of federal aid and better than expected tax revenues helped steady the system’s finances.

The improved financial outlook is a major dose of good news for the Metropolitan Transportation Authority, which operates the subway, buses and two commuter lines and has seen fare revenues plunge after the pandemic emptied public transit of riders.

The agency had been warning of drastic reductions, not just to the subway but also to buses, in part to pressure Congress into providing more help. The $1.9 trillion stimulus package President Biden is pushing Congress to approve includes as much as $30 billion for public transit.

Of that, the M.T.A. can expect to receive at least $6 billion, according to Senator Chuck Schumer of New York, who is now the Democratic majority leader and who played a critical role in securing financing for transit agencies during stimulus negotiations last year.

While the agency said it would avoid major cuts in 2021 and 2022, it still faces an $8 billion deficit over the next four years and the possibility of cuts in the near future without additional federal aid.

“In the short and midterm there is significant relief, but we still have a long-term structural, fiscal problem that we have not dealt with,” said Andrew Rein, the president of the Citizens Budget Commission, a financial watchdog. “The bottom line is we are not out of the woods, but we can see the light through the trees.”

The latest round of federal aid, which directed around $4 billion to the M.T.A., provided more money for day-to-day operations and freed the agency to commit more toward its capital plan for major upgrades. The agency also received around $4 billion from the first federal emergency relief package last year.

Still hanging in the balance is the agency’s sweeping $54 billion plan to modernize the system, including replacing an antiquated signal system that is a major cause of delays and disruptions. That plan was suspended after the pandemic hit but parts of it will be revived this year, according to transit officials.

Making the system more reliable is a crucial step to luring back riders as New York struggles to recover from the financial crisis set off by the outbreak.

Empty syringes wait to be filled with the coronavirus vaccine. Apple is removing the drops of blood at the end of its syringe emoji.
Credit…Jon Nazca/Reuters

As millions get vaccinated, Apple is making a design change to its syringe emoji, swapping an image with drops of blood at the end of the emoji’s needle for one that looks more like a vaccine.

The redesigned emoji is available only to members of the company’s beta program but will be publicly available with iOS 14.5. While new emojis are more difficult to approve, changing an emoji’s design can enact a similar result on a faster timeline, according to Keith Broni, the deputy emoji officer at Emojipedia, a service that archives the design and usage trends of emojis.

The syringe emoji dates to 1999 and had been used mainly to illustrate blood donations in Japan. The emoji was often used in discussions around blood donations and even tattooing, Mr. Broni said.

“When you provide someone with a communication tool, they will use it as they see fit,” Mr. Broni said. “We’ve seen many different emojis take on many different connotations.”

Mr. Broni said he had started to notice a spike in the usage of the emoji late last year, and saw that the conversations people were having on Twitter while using it had pivoted to talk about coronavirus vaccines.

Mr. Broni said he expected the change from Apple to be a permanent one, and that other technology companies would be likely to follow suit. He said the emoji that resembles a vaccine injection could be used more readily and that removing the blood would make the emoji more flexible and less intimidating.

Gov. Andrew M. Cuomo’s handling of nursing homes during the pandemic has created a rift with state lawmakers, including some fellow Democrats.
Credit…Pool photo by Mary Altaffer

The Democratic leaders of the New York State Senate are moving to strip Gov. Andrew M. Cuomo of unilateral emergency powers granted during the pandemic, setting up an unusual rebuke by members of his own party.

The measures, which could come to a vote next week, underscore the deepening division between Mr. Cuomo and state lawmakers since he acknowledged having intentionally withheld critical data on virus-related deaths from them.

The F.B.I. and the U.S. attorney for the Eastern District of New York have opened an inquiry into the Cuomo administration’s handling of nursing homes during the pandemic. The inquiry, which was confirmed by three people familiar with the matter, is in its earliest stages, and it is not clear whether it is focused on any individual.

The inquiry, first reported in The Times Union of Albany, was another indication of the shift in Mr. Cuomo’s position since March, when he emerged as a prominent national voice in a crisis through his daily briefings. Now, much of that good will has evaporated.

The Senate’s action also illustrates fatigue in the Democratic-controlled State Legislature over his use of powers that gave him broad control over the state’s response to the virus, from ordering shutdowns to managing vaccine distribution.

Lawmakers discussed limiting his powers earlier this year but did not take any steps. On Wednesday, State Senator Gustavo Rivera, a Democrat and chairman of the health committee, said it was now time for action. “We need to remind them that state government is not one big branch: There’s three of them,” he said.

The tension was out in the open on Wednesday, with Mr. Cuomo attacking critics, singling out Assemblyman Ron Kim, a Queens Democrat, who said the governor had threatened him last week — an accusation the governor’s staff called a lie.

Earlier this week, a group of State Assembly Democrats circulated a letter seeking support for revoking Mr. Cuomo’s powers and suggesting the administration had broken federal law — an accusation the governor denied on Wednesday. That came less than a week after 14 Senate Democrats signed a statement saying that “it is clear that the expanded emergency powers granted to the governor are no longer appropriate.”

Senate leaders now intend to pass a bill that would limit the governor’s ability to supersede state laws and would establish a commission of state lawmakers to evaluate future pandemic-related directives and suspensions of laws.

The last month has been one of turmoil for Mr. Cuomo, who is known for his combative politics. After a scathing report from Letitia James, the state attorney general, that suggested the death toll at nursing homes had been undercounted, the official number of residents of nursing homes and similar institutions was increased from about 8,500 to more than 15,000.

As the virus claimed the lives of thousands of nursing home residents, the state count had left out those who had died in hospitals rather than at the homes.

The governor acknowledged on Monday that there had been “a delay” in releasing the full story.

Nicole Hong and William K. Rashbaum contributed reporting.

Among the people who will be able to sign up for a vaccine on Thursday are grocery store and manufacturing workers. As many as 160,000 people with certain medical conditions could be newly eligible next month.
Credit…Alex Edelman/Agence France-Presse — Getty Images

Washington, D.C., residents employed in grocery stores or manufacturing were added Thursday evening to the roster of workers who can sign up for a Covid-19 vaccine, and city officials said inoculations will soon widen further to cover people with a range of medical conditions.

The next expansion, on March 1, is for people of any age with a covered medical condition,  including asthma, sickle cell disease, cancer, developmental disabilities, some heart conditions and more. It could make as many as 160,000 more people eligible for the vaccine, Dr. LaQuandra S. Nesbitt, the director of the city’s health department, said at a news conference.

Dr. Nesbitt said officials were optimistic that they would be able to handle the influx of eligible residents. Earlier this week, New York State expanded its criteria to cover people with chronic health conditions, leading to a flood of calls from New Yorkers seeking appointments, some of whom had trouble getting one.

Washington’s newly announced rules also cover pregnant and obese people, but they do not include smokers or people who are overweight, two groups that had previously been considered for this phase of vaccinations, The Washington Post reported.

Dr. Nesbitt indicated that health officials were trying to balance the need for vaccinating at-risk populations with the fact that vaccine doses are limited.

About 23 percent of city residents may have medical conditions that will make them eligible, though Dr. Nesbitt noted that some may have already been able to get a vaccine under the criteria of earlier phases, such as if they are older than 64 or an essential worker. People will “self-attest” to their medical conditions when they register or while at the vaccination site, Dr. Nesbitt said.

In addition to grocery store employees, Mayor Muriel E. Bowser said, Thursday’s expansion will also cover outreach workers in the in health and human services or social services fields and people who work in food packaging.

Gov. Charlie Baker of Massachusetts toured a sports arena in Worcester in December as it was being readied for use as a field hospital during a  peak period of the pandemic.
Credit…Pool photo by Nancy Lane

Thursday was supposed to be a great day for Gov. Charlie Baker of Massachusetts, whose vaccination effort was beginning to hit a stride after stumbling badly in January.

At 8 a.m., almost a million more residents of the state — those between 65 and 75, and those with two or more medical conditions — were to become eligible to book vaccinations online.

Except — not.

When the big moment came, instead of getting appointments, many thousands of users received a message that the state’s new web application, vaxfinder.mass.gov, had crashed.

Overwhelmed by volume, the site intermittently returned to life over the next three hours —  but it turned out that, because of the website problems, the state had not been able to post 50,000 of the 77,000 newly available appointments.

Not for the first time, Twitter became a clearinghouse for widespread frustration.

Governor Baker said on Thursday that website technicians “did a lot of scenario work” in advance, but “obviously it didn’t prepare the site.”

“My hair is on fire about the whole thing,” he told WGBH, a Boston public radio station. “People are working really hard to get it fixed.”

He added, “People did a lot of work preparing for this, but clearly they didn’t do enough.”

He has said federal vaccine supply constraints were holding back the state’s effort, and said on Thursday that he was considering sending National Guard troops to Kentucky and Tennessee to pick up shipments that may be stalled there because of bad weather.

A popular Republican who spent much of his career as a health care executive, Governor Baker came under intense public criticism for the slow, patchy availability of vaccinations in the state in January.

The state gave priority to workers in hospitals and nursing homes, but many of them refused the shots, so much of the state’s initial stockpile of doses sat unused in cold storage. Six weeks into the effort, Massachusetts trailed most of New England, and ranked below average nationally, in the share of its population that had been vaccinated by that time.

The state opened mass vaccination sites in February and quickly improved its performance, rising to rank ninth in the country, according to a New York Times database.

Expanding eligibility was a sign of that progress, since Massachusetts did so after crossing an important threshold, with more than half its residents over 75 having received at least one of the two required vaccine doses. Last week the state also began a first-in-the-nation experiment, offering vaccinations to those who accompany people who are 75 and older to mass vaccination sites.

Still, lawmakers criticized the effort as inequitable, increasing the advantage of wealthy families with working cars and free time to transport elders to be vaccinated at distant sports stadiums. The Democratic-controlled legislature has scheduled oversight hearings on the vaccine program later this month.

global roundup

A line for coronavirus testing in Hong Kong on Wednesday.
Credit…Lam Yik Fei for The New York Times

The Hong Kong government said on Thursday that it had approved Sinovac’s coronavirus vaccine, a drug manufactured by a mainland Chinese company that has faced scrutiny around the world over shipping delays and spotty data disclosures.

Hong Kong’s health authorities said the first million doses of the vaccine, called CoronaVac, would arrive on Friday and that vaccinations would begin next week, starting with essential workers and people over 60.

The announcement is notable because Hong Kong is one of only a few governments in Asia to have approved CoronaVac for use. Several other countries have said they would only do so after receiving full trial data from the manufacturer.

Malaysia and Singapore, for instance, have both ordered doses from Sinovac. But officials in both countries have had to reassure their citizens that they would approve a vaccine only if it had been proved safe and effective.

In January, officials in Brazil said that the efficacy rate of CoronaVac was just over 50 percent, barely above the World Health Organization’s threshold for an effective Covid-19 vaccine. The company said the efficacy rate was weaker than expected because the trial had been conducted among health care workers, who had a higher risk of contracting Covid-19, and included people with “mild symptoms.”

Sinovac has given government-appointed experts in Hong Kong late-stage trial data for CoronaVac showing a 62.3 percent efficacy rate after two shots, Lau Chak Sing, the spokesman of a coronavirus vaccine advisory panel, told reporters on Tuesday. The advisers reviewed the data and determined that vaccine’s benefits outweighed the risks, he said.

Sinovac did not release the data publicly.

Pitching CoronaVac to the Hong Kong public could be tough: A recent poll conducted by the University of Hong Kong showed that fewer than three in 10 residents would take it, because of worries about its weak efficacy. The Pfizer-BioNTech vaccine had the highest level of acceptability, at 55.9 per cent.

Hong Kong’s health authorities approved the Pfizer vaccine in late January, and the first doses are expected to arrive in late February.

Beijing officials once hoped that Sinovac and other Chinese-made vaccines would burnish the country’s global reputation. At least 24 countries, most of them low and middle income, signed deals with the Chinese vaccine companies because they offered access when richer nations had claimed most of the doses made by Pfizer and Moderna.

Now Beijing is on the defensive, and China’s state-run media has been waging a misinformation campaign against the American vaccines, questioning their safety and promoting the Chinese ones.

In other news from around the world:

  • India will require travelers arriving from Brazil and South Africa to undergo a coronavirus test, to prevent variants from spreading. The Health Ministry said on Thursday that India had recorded one case of the variant circulating in Brazil, four variant cases from South Africa and 187 from Britain. India has recorded nearly 11 million cases during the pandemic. Its death toll of 156,014 is the world’s third-highest after the United States and Brazil, according to a New York Times database.

  • Nepal on Thursday approved a vaccine manufactured by Sinopharm, a state-owned vaccine maker from China. The Sinopharm vaccine is the second to be approved for emergency use in Nepal after Covishield, the Indian-made version of the Oxford-AstraZeneca vaccine. Nepal, which borders both China and India, is one of the places where the two countries are competing to distribute vaccines. Nepal approved Sinopharm’s vaccine days after the Chinese foreign minister, Wang Yi, had pledged to donate 500,000 doses. India has already sent a million Covishield doses. As of Thursday, more than 400,000 frontline health workers and other essential workers had been vaccinated.

  • China has begun requiring that travelers isolate for 14 days before flying in from some countries in Africa and Asia, according to notices posted on Chinese embassies’ websites this week. Places affected include Egypt, South Africa, Zimbabwe, Pakistan and Saudi Arabia. China already required anyone entering from abroad to quarantine for multiple weeks upon arrival, as do numerous other countries. Mandatory quarantine before travel appears to be far rarer.

  • Spectators were allowed back into the Australian Open on Thursday, hours after the state of Victoria ended a five-day lockdown it had imposed to contain an outbreak in a Melbourne quarantine hotel. The tennis tournament’s director, Craig Tiley, said that 7,477 fans would be allowed in for each session, about half capacity. Fans are required to wear masks while indoors or when they are unable to socially distance.

  • Zimbabwe began its first vaccinations using 200,000 Sinopharm doses donated by China. The country’s daily new cases have slowed down after a recent wave, and the government relaxed some lockdown rules on Monday. Zimbabwe has recorded 35,423 cases and 1,418 deaths, according to a New York Times database.

  • Almost a year since the country’s first confirmed case, New Zealand on Friday began its first vaccinations, which went to the health workers who will inoculate people working at airports and in quarantine hotels on Saturday. The country last week received around 60,000 doses of the Pfizer-BioNTech vaccine, the only one approved by the government so far.

Rita Alba, right, a registered nurse, directs Alba Carrasco to the recovery area after giving her the first dose of the coronavirus vaccine at a pop-up vaccination site at the Bronx River Addition NYCHA complex in January.
Credit…Mary Altaffer/Associated Press

A little-known program that allows New Yorkers to get a Covid-19 vaccination if they volunteer at vaccine distribution sites has stopped accepting new applicants who do not have experience in health care.

Vaccine distribution began in New York State in mid-December. To fill out staffing shortages, New York City had enlisted its Medical Reserve Corps, a volunteer network that responds to public health emergencies. Without fanfare, the agency recruited volunteers — medical and nonmedical staff alike. In exchange for 36 hours of service, volunteers were eligible to receive their first dose of the vaccine.

On Thursday, the Medical Reserve Corps told The New York Times in an email that it would only accept health care professionals going forward. “The NYC MRC has traditionally been used for medical/health care volunteers. As the number of volunteers swelled — including city employees serving in the hubs — we went back to limiting MRC to recruitment of healthcare professionals,” the agency said.

Volunteering was a way for many New Yorkers who are not yet eligible for vaccination to jump to the front of the line, as receiving the vaccine has proved elusive. According to data gathered by The New York Times, about 10 percent of 11 million eligible New Yorkers have received their first dose.

The task of vaccinating is daunting: A single vaccination site might require people to act as administrative employees, security officers, medical greeters, translators, emotional support staffers, schedulers, traffic monitors and, of course, vaccinators.

Some volunteers bristled at the idea of working three 12-hour shifts without receiving a single penny from the city, even if they did receive the vaccine in exchange.

Others, though, thought they struck gold. “I thought that it was the best deal in the world, the three shifts,” said Seth Rosen, the director of development at the National LGBT Bar Association. He volunteered in the South Bronx. “I was happy to do that in order to be vaccinated.”

But nearly all volunteers complained that signing up was opaque and convoluted.

Enrollment instructions on the city’s website are targeted only to licensed clinical professionals. In response, a number of unauthorized documents outlining the sign-up process for general staff began popping up on the internet: circulating around social media or forwarded among friends.

Adam, a filmmaker who did not want to use his last name because volunteers were told not to speak to the press, registered for his volunteer service after receiving an unofficial document. It detailed the steps required for registration over four separate websites, each one requiring different accounts and passwords. Users were taught how to create an account on the city’s official website; then how to register on ServNY, the state’s volunteer program; then how to register with the state’s Department of Health Public Account Management System; and, finally, how to create an account for the Public Health Responders program.

In all, it required 32 steps.

“It was so bureaucratic — right out of Kafka,” said Adam.

And now it’s over.

The city Medical Reserve Corps sent an email to volunteers on Thursday saying general staffing roles were “at capacity for the foreseeable future.”

“Leadership has decided that NYC staff will be filling in the gaps moving forward,” the email said. “Given where we were with staffing four weeks ago, having this role entirely covered is a significant accomplishment — and a relief. Once again, thank you.”

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