Pregnant and Breastfeeding Women Have Slower Response to Vaccine, Research Says
They remain susceptible to the virus for longer after the first vaccination, but achieve a mostly normal response after the second, a study says.,
The health minister of Australia announced on Wednesday that fully vaccinated residents would finally be allowed to travel abroad starting on Nov. 1, a year and a half after borders were closed to most ingoing and outgoing travel.
“Fully vaccinated Australians will not require an exemption to depart Australia,” Greg Hunt, the country’s health minister, told reporters in Canberra. He added that they would also be able to return without restrictions.
The eased restrictions will be the first stage in Australia’s plan to reopen its international borders since slamming them shut on March 20, 2020, separating families and leaving thousands of Australians stranded overseas.
The second stage, Mr. Hunt said, will allow students and critical workers to enter the country and, eventually, see borders fully reopened to tourists and other visitors.
“It’s exciting,” said Kelsey May, 25, an Australian who returned home from Britain in March of 2020, and has been separated from her partner since. But, Ms. May added: “We’ve been told so many things over the past 18 months that haven’t come to fruition. We just want to see what happens.”
On Monday, the health authorities also approved Pfizer-BioNTech vaccine booster shots for those 18 and older. They said the decision would make the country among the most highly vaccinated places in the world.
Nationwide, 62 percent of eligible Australians have had two doses of the vaccine, and 74 percent have had one dose.
But Canberra, the capital, announced it had become the first jurisdiction in the country to fully vaccinate more than 90 percent of eligible residents age 12 and older.
RIO DE JANEIRO — A congressional panel in Brazil voted to recommend nine criminal charges against President Jair Bolsonaro, including “crimes against humanity,” accusing Mr. Bolsonaro of intentionally allowing the coronavirus to spread unchecked through Brazil, causing hundreds of thousands of deaths.
With the vote on Tuesday night, the Senate panel also recommended charges against 77 other people, including government officials, lawmakers, business owners, doctors, political pundits and three of Mr. Bolsonaro’s sons, for a variety of crimes related to their response to the pandemic. The panel also recommended charges against two companies.
In a six-month investigation, the panel found that Mr. Bolsonaro and members of his administration, determined to reach herd immunity, discouraged people from wearing masks, ignored offers of vaccines from Pfizer and promoted unproven drugs long after they were found to be ineffective.
The report found that the actions, taken together, led to hundreds of thousands of deaths. Brazil has had more than 600,000 officially tallied deaths from Covid — as in most countries, experts say the real figure is much higher — second only to the United States.
Seven senators on the panel voted for the nearly 1,300-page report and four voted against it. The report had largely been controlled by the panel’s seven-member majority, all of whom oppose Mr. Bolsonaro, a strident, right-wing populist.
Mr. Bolsonaro’s office did not respond to a request for comment. Immediately after the vote, former President Donald J. Trump, who has a warm relationship with Mr. Bolsonaro, issued a statement supporting him: “Brazil is lucky to have a man such as Jair Bolsonaro working for them!”
The panel delivered the report to Brazil’s attorney general on Wednesday, who will have 30 days to decide whether to pursue criminal charges against Mr. Bolsonaro and some other government officials. (Other courts and government offices would weigh charges related to others named in the report.) Brazil’s lower house in Congress would also have to approve charges against Mr. Bolsonaro.
Political analysts, as well as some senators on the panel, have said that they doubt that Mr. Bolsonaro will ultimately face charges because the attorney general and a majority of the lower house support the president.
Mr. Bolsonaro could face more legal exposure once he leaves office. The panel’s leaders said they also plan to send the report to the International Criminal Court in The Hague.
The panel also voted to ask Brazil’s Supreme Court to request that Mr. Bolsonaro be banned from social media for the “protection of the population.” The senators included that recommendation after the president suggested during a weekly social media livestream on Thursday that the coronavirus vaccine could cause AIDS. Facebook and YouTube removed the video, and YouTube froze Mr. Bolsonaro’s channel for a week.
The vote concludes an investigation that had led the nightly news in Brazil for much of the summer. The panel held more than 50 hearings, which sometimes included shocking testimony. At one point, a lawmaker wore a bulletproof vest to testify that some vaccine purchases included kickbacks.
“How many presidents of the Republic, without having been in wars, were accused of crimes against humanity?” asked Senator Randolfe Rodrigues, the panel’s vice president. “There are reasons, motives and statements like the ones we witnessed — which left us in absolute shock, all of us Brazilians — that led to this indictment request.”
Senator Eduardo Girao, one of the four senators who voted against the report, said that he believed Mr. Bolsonaro had acted wrongly, but that the report “became an instrument of political persecution.”
After the vote, the panel held a moment of silence for those who have died in the pandemic. The room then broke into applause.
Pregnant and breastfeeding women respond to the first dose of the coronavirus vaccines more slowly than other women, and mount a less potent defense against the virus, according to a new study. After the second dose, however, their response looks almost normal.
The results, published this month in the journal Science Translational Medicine, suggest that pregnant and breastfeeding women remain susceptible to the virus for longer after vaccination. The study underscores the importance of giving these women the second dose in time, and monitoring them closely in the meantime for signs of infection.
During pregnancy, the immune system is modified to tolerate the fetus — effectively a foreign entity — leaving pregnant women particularly susceptible to pathogens like the coronavirus. Because of this, pregnant women are more likely to become severely ill and to die from Covid than other women of the same age.
Earlier research had suggested that pregnancy might also dampen the response to vaccines. But the initial trials of Covid vaccines did not include pregnant and breastfeeding women because of safety concerns, so there has been limited information about how well they respond to the inoculations.
The researchers analyzed the antibodies produced by 84 pregnant women, 31 breastfeeding women and 16 nonpregnant women of the same ages, immunized with the coronavirus vaccines made by Pfizer-BioNTech or Moderna.
After the first dose, pregnant and breastfeeding women had fewer antibodies than other women of the same age. And the antibodies were less effective at recruiting other parts of the immune system to fight the virus.
Two to six weeks after the second dose, pregnant and breastfeeding women had about as many antibodies as other women their age, consistent with results from other studies, and the qualitative differences also narrowed.
Breastfeeding women boosted their response more effectively than pregnant women after the second dose, and the quality of their immune response more closely resembled that of nonpregnant women.
The women in the study were immunized at different times during pregnancy. Future studies should analyze the optimal time during pregnancy to deliver the vaccines, the researchers said.
Merck has granted a royalty-free license for its promising Covid-19 pill to a United Nations-backed nonprofit group in a deal that would allow the drug to be manufactured and sold cheaply in the poorest nations, where vaccines for the coronavirus are in devastatingly short supply.
The agreement with the organization, Medicines Patent Pool — which works to make medical treatment and technologies globally accessible — will allow companies in 105 countries, mostly in Africa and Asia, to sublicense the formulation for the antiviral pill, called molnupiravir, and begin making it.
Merck reported this month that the drug halved the rate of hospitalizations and deaths in high-risk Covid patients in a large clinical trial. Affluent nations, including the United States, have rushed to negotiate deals to buy the drug, tying up large portions of the supply even before it has been approved by regulators and raising concerns that poor countries would be shut out of access to the medicine, much as they have been for vaccines.
Treatment-access advocates welcomed the new deal, which was announced Wednesday morning, calling it an unusual step for a major Western pharmaceutical company.
“The Merck license is a very good and meaningful protection for people living in countries where more than half of the world’s population lives,” said James Love, who leads Knowledge Ecology International, a nonprofit research organization. “It will make a difference.”
Charles Gore, director of the Medicines Patent Pool, said: “This is the first transparent public health license for a Covid medicine, and really importantly, it is for something that could be used outside of hospitals, and which is potentially going to be very cheap.”
Molnupiravir was developed by Merck and Ridgeback Biotherapeutics of Miami, based on a molecule first studied at Emory University in Atlanta. All three organizations are party to this deal, which will not require a fee from any sublicensing company.
Sandee Babb, 54, of Grand Rapids, Mich., has seen nearly two dozen doctors over the past year to figure out what is causing a range of symptoms, including cardiac arrhythmia, a chronic cough, shortness of breath and joint pain, which have kept her from returning to her job as a teacher and librarian.
She could not get a coronavirus test when she first got sick in March 2020. But a September progress note from her doctor said her symptoms “could be consistent with long-haul type syndrome.”
After months documenting her condition, she submitted her unemployment application in August and is not sure when she will get an answer. “If it doesn’t come through, then I’m really stuck,” she said. “Where do I go from here?”
The Biden administration has said people with the condition known as “long Covid” could qualify for federal disability protections and benefits, which can include health care, housing and unemployment benefits.
But with no widely agreed-on method of diagnosing the ailment, those who believe they have long Covid are finding it difficult to qualify under a system that is unfamiliar and already tricky to navigate.
Studies have shown that a significant number of Covid patients continue to seek treatment for a wide range of medical conditions many months after a diagnosis. The American Academy of Physical Medicine and Rehabilitation estimates that three to 10 million Americans may have long Covid.
Yet many of those seeking benefits cannot produce a positive coronavirus test, which were in short supply at the beginning of the pandemic. And lab results and scans often show nothing unusual for those continuing to experience symptoms.
An expert committee advising the Food and Drug Administration on Tuesday recommended that regulators authorize Pfizer-BioNTech’s coronavirus vaccine for 5- to 11-year-olds, bringing about 28 million children a major step closer to becoming eligible for shots.
If the F.D.A. follows the panel’s advice in the coming days, as is expected, the Biden administration will have expanded vaccine access to all but the youngest Americans, while providing booster shots for many as well.
Biden administration officials see the pediatric dose as crucial to keeping schools open and restoring a sense of normalcy to family and work life as the pandemic hurtles toward the end of its second year. The administration wants to be seen as doing everything possible to combat the virus and build upon positive trends, as the Delta variant ebbs and the daily drumbeat of infections and deaths fades.
Younger children would start getting their shots at a time when coronavirus cases are dropping sharply. But public demand for a pediatric vaccine has been high, and some panel members said that even though young children are less likely to get severely ill from Covid-19, parents and doctors alike are anxious to protect them.
Dr. Jay Portnoy, a medical director at Children’s Mercy Hospital in Kansas City, Mo., said he had seen critically ill children in the intensive care unit and “terrified” parents. “I’m looking forward to being able to actually do something to prevent that,” he said.
The vote was 17-0 in favor, with one abstention. Federal regulators and scientists made a strong push, arguing that 8,300 children between 5 and 11 had been hospitalized with Covid-19 and nearly 100 had died over the course of the pandemic.
Covid-19 is “the eighth-highest killer of kids in this age group over the past year,” said Dr. Amanda Cohn, a top C.D.C. vaccine official. “Use of this vaccine will prevent deaths, will prevent I.C.U. admissions and will prevent significant long-term adverse outcomes in children.”
Data from Pfizer showed that the vaccine had a 90.7 percent efficacy rate in preventing symptomatic Covid-19 in a clinical trial of 5- to 11-year-olds. Still, many advisory committee members expressed concern about limited safety data, turning repeatedly to the risk of myocarditis, a rare condition involving inflammation of the heart muscle, in young vaccine recipients. Myocarditis and pericarditis, inflammation of the lining around the heart, have been tied to the Pfizer-BioNTech and Moderna vaccines, particularly in younger men.
The Pfizer dose for younger children would be one-third of the strength given to people 12 and older, with two shots given three weeks apart. Experts have said that could diminish the risk of the heart-related side effects.
If F.D.A. regulators follow the committee’s advice, as they typically do, an authorization could come within days. The Centers for Disease Control and Prevention’s own panel of outside experts is scheduled to meet Tuesday and Wednesday, and is also expected to endorse a pediatric dose. The C.D.C., which sets vaccine policy, would likely then quickly recommend the rollout of shots.
During a long debate before the vote, some committee members questioned whether every child in the age group really needed the vaccine or whether it should be limited to those at high risk of severe Covid-19 — an easily identifiable group, with underlying conditions such as obesity or other risk factors.
Dr. James E.K. Hildreth, the president and chief executive of Meharry Medical College, said that since many children between 5 and 11 may already have some immunity after contracting the virus, the need to vaccinate broadly in the age group might be less urgent.
“It just seems to me that in some ways we’re vaccinating children to protect the adults, and it should be the other way around,” he said. “I do believe that children at highest risk do need to be vaccinated. But vaccinating all of the children to achieve that just seems a bit much for me.”
Unequal access to coronavirus vaccines in developing countries is deepening a “great divergence” between rich and poor nations and slowing economic recovery from the pandemic, the United Nations organization that monitors labor market developments said on Wednesday.
Vaccination campaigns have proved critical in aiding recovery of working hours and economic productivity. But uneven access to vaccines has resulted in a two-speed recovery for rich and poor countries according to Guy Ryder, the director of the International Labor Organization.
“We are building back worse at least as looked at from the perspective of the developing world,” Mr. Ryder told reporters in Geneva, adding that he will be delivering that message to leaders of the Group of 20 summit, who will meet in Rome this weekend.
Worldwide, about 76 percent of shots that have gone into arms have been administered in high- and upper-middle-income countries, according to the Our World in Data project at the University of Oxford. Only 0.5 percent of doses have been administered in low-income countries.
The I.L.O. estimated in a report released Wednesday that for every 14 workers who were fully vaccinated in the second quarter of the year, one full-time job was added to the global labor market. By early October, it said, 34.5 percent of the world’s population had been fully vaccinated but at rates that varied from 59.8 percent of the population in high-income countries to 1.8 percent in low income countries.
As a result, labor market recovery has stalled in 2021 and the number of hours worked this year are now expected to be far lower than previously estimated, the I.L.O. said.
Fiscal stimulus packages provided another key aid to recovery. But 86 percent of the stimulus available through these initiatives was concentrated in high-income economies, the organization said.
The I.L.O. said that with more equitable distribution of vaccines it would take low-income countries little more than three months to catch up with the pace of working hour recovery in rich countries.
The organization’s findings echo the alarm expressed repeatedly by Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, who has slammed the unequal delivery of Covid-19 vaccines as a “catastrophic moral failure” and set a target of vaccinating 40 percent of every country by the end of the year.
South Korea warned residents that it would strictly enforce Covid restrictions during Halloween, as the government remains wary of large outbreaks that might threaten its reopening plans next month.
Local authorities have raised alarms that parties leading up to Oct. 31 pose a potential risk as South Korea prepares to ease Covid restrictions the next day. Halloween is not widely celebrated in South Korea, but it is becoming more popular, especially in the capital, Seoul.
“We are concerned, especially ahead of Halloween this weekend, that there might be many violations of social distancing rules,” the minister of health, Kwon Deok-cheol, said on Wednesday, urging people to comply with the restrictions that remain in place.
The country still has a mask mandate, limits the size of social gatherings and requires restaurants and bars to close at 10 p.m. in Seoul.
To mitigate the risk of an outbreak, which might jeopardize South Korea’s reopening, health officials said on Friday that they would intensively check businesses’ and customers’ compliance with Covid rules for seven days starting Wednesday from 8 p.m. to midnight. The inspectors will focus on areas including Itaewon, Hongdae and Gangnam Station in Seoul, and parts of Incheon and Busan, where there are many young people and foreigners who are expected to celebrate.
Partygoers may let their guard down knowing that the restrictions are set to expire on Nov. 1, said Robert Joe, 43, who lives in Itaewon.
“Everyone knows everything is going to be lifted more or less,” he said. “The sense of urgency, I think, has probably lessened.”
Foreigners caught violating rules, the health officials said on Friday, may be subjected to deportation, and businesses violating rules may be prosecuted, suspended or fined.
South Korea’s approach to the Halloween festivities contrasts that of the United States, where many health departments have only recommended that people take precautions, like getting vaccinated and wearing masks, instead of threatening penalties. In Massachusetts, the towns of Lexington and Belmont will offer free Covid tests after Halloween.
Halloween festivities will continue with lifted restrictions in other places, too. Northern Ireland will lift restrictions on indoor dancing and permit nightclubs to reopen on Oct. 31, and trick-or-treating will be allowed in Australia’s capital, Canberra.
Here’s what else is happening around the world:
In Sweden, health officials announced that health care workers, nursing staff and people over 65 will be eligible for a booster. The extra shots will eventually be extended to 1.5 million Swedes, according to the minister of health and social affairs, Lena Hallengren.
Denmark is also offering a booster to medical workers, older people and people who are at high risk of contracting the coronavirus. Norway, which is experiencing a rise in cases, is urging those over 65 to get a booster at least six months after receiving their second shot.
Spain’s Constitutional Court on Wednesday struck down the government’s second state of emergency, which was introduced in late 2020. The decision opens the door to thousands more reimbursement claims from people who were fined for violating Covid-19 lockdown rules.
The ruling is in line with a decision from July, when the same court also declared unconstitutional the first state of emergency. That one was introduced in March of 2020, when Spain was initially hit by the pandemic.
Spain’s second state of emergency lasted about six months, from November 2020 to May of this year. The court ruled on Wednesday that Spain’s left-wing government overstepped its constitutional powers, in particular by limiting parliamentary oversight over the lockdown rules. The ruling followed a complaint filed by Spain’s far-right opposition party, Vox.
Children ages 5 to 11 may be eligible for the Pfizer-BioNTech Covid vaccine by early next month: two shots spaced three weeks apart. But unlike youths 12 and older, who get the same dosage as adults, the younger age group will receive one-third the amount that a 12-year-old would get.
This has created some confusion for parents of 11-year-olds on the cusp of turning 12. Is it best to hold out for the larger dose? Or is it better to get the smaller dose right away? Does the weight or height of the child make any difference?
Five experts in immunology and infectious diseases agreed that the appropriate dosage is best determined by a child’s age, not his or her size. So if your 11-year-old is able to get the shot in November, do it right away, rather than waiting for your child to turn 12.
The virus isn’t going away anytime soon, they said. And different variants could potentially make the virus more infectious or dangerous, said Donna L. Farber, a professor of microbiology and immunology at the Columbia University College of Physicians and Surgeons.
The sooner your child can be vaccinated, the better, the experts said. The shots greatly reduce the chance of becoming severely ill from Covid, and they curb the likelihood of getting infected in the first place and then passing that infection to others.
Nearly three months after Tyson Foods mandated coronavirus vaccines for all its 120,000 U.S. workers, more than 96 percent of them are vaccinated, the company’s chief executive, Donnie King, said in an employee memo on Tuesday.
Less than half of Tyson’s work force was inoculated when it announced on Aug. 3 that it would require vaccines. Nearly 60,000 more Tyson employees got the shot following the announcement, Mr. King said. Tyson has said workers must be fully vaccinated by Nov. 1 as a condition of employment.
“This is an incredible result,” Mr. King wrote, “not only for our company, but for your families and our communities across the country.”
Tyson was one of the first major companies to mandate vaccines after incentives like paid time off to be inoculated started to lose traction. Its stance was notable because it included frontline workers even as labor shortage concerns prevented many companies from expanding vaccine mandates beyond the office.
Meatpacking involves close quarters and long hours, which make its workers particularly vulnerable to catching the coronavirus. A number of workers died last year after the virus swept through the nation’s processing plants.
“Has this made a difference in the health and safety of our team members? Absolutely,” Mr. King wrote of the vaccine requirement. “We’ve seen a significant decline in the number of active cases, companywide.”
Mr. King said he had “received many notes from team members who have helped convince others in their family, and in their community, to get vaccinated.”
Tyson has plants across the South and Midwest. In Arkansas, where it is based, 57 percent of residents have received at least one dose of the coronavirus vaccine.
To help encourage vaccination, executives have visited plants to have small group conversations about the vaccines. The company also addressed common myths about the vaccine and took questions from employees at a panel that included two outside physicians.
“We hit this number thanks to the many, many thousands of individual conversations,” Mr. King said.
As part of its efforts, Tyson negotiated an agreement with the United Food and Commercial Workers union, which represents several thousand of its workers, to endorse the mandate in return for more benefits for all workers, like paid sick leave. The union’s president, Marc Perrone, applauded the vaccination efforts on Tuesday.
“Working together, the UFCW and Tyson set a new standard with this vaccine mandate, and have proved what’s possible when we listen to workers and negotiate the implementation of vaccination mandates fairly and responsibly,” Mr. Perrone said in a statement.
“We urge every company, across this country, to do what is right by their frontline workers and work cooperatively with their unions and employees to help end this pandemic and keep all of America’s essential workers and their families safe,” he added.
Tyson is offering employees religious or medical accommodations to the mandate and does not have a cutoff date for evaluating those considerations, a spokesman said. It will assess requests “based on careful consideration of the individual facts and our commitment to the safety of our employees.” Some unvaccinated employees granted exemptions, though, will be placed on leave.
“To those who remain unvaccinated — this is your choice, and we respect that choice,” Mr. King said. “If you change your mind and want to rejoin Tyson — let us know. Our doors are open.”
The results of Tyson’s vaccine mandate will be examined closely by other companies, as well as federal and local officials, as they weigh their own approaches to vaccine mandates. Last month, President Biden asked the Occupational Safety and Health Administration to order large employers to require vaccination against the coronavirus or weekly testing. Many companies are now preparing to move forward but have been awaiting more details.
So far, vaccine mandates have largely proven effective. United Airlines, which said in August that it would require all employees to provide proof of vaccination, recently announced that more than 99 percent of its work force was vaccinated. In California, health care employers have reported vaccination rates of 90 percent or higher.
Legal experts generally say companies have the right to make vaccine mandates, but there has been pushback, particularly from local politicians. Arkansas is seeking to require employers that mandate vaccines to allow for exemptions, including a testing alternative. And Gov. Greg Abbott of Texas issued an executive order banning private employers from mandating coronavirus vaccines.
Germany’s new governing coalition plans to drop nationwide pandemic restrictions and hand responsibility back to state governments to set their own rules, which could vary from one region to another.
Representatives of the three parties that are expected to form the new federal government announced on Wednesday (not Tuesday, as an earlier version of this item said) that they intend to allow the country’s national epidemic status to lapse in late November. That status provides the legal framework for imposing national lockdowns, mask requirements and other measures.
The announcement could be considered the first public act of the new government, which is still in the complicated process of being formed by the three parties after the general election of Sept. 26. The new prime minister and cabinet are not expected to be inaugurated for several weeks yet. Officials warned that shifting responsibility to the states did not mean that restrictions would vanish.
“The 25th of November will not be a ‘Freedom Day’,” said Dirk Wiese, a deputy parliamentary group leader of the Social Democratic Party, which is expected to lead the new government, referring to a nickname used in Britain for the day nearly all virus restrictions were dropped there.
“We want to go through the fall and winter responsibly, so that by spring we have Covid-19 behind us,” Mr. Wiese said.
The other two parties working to form the new government are the Greens and the Free Democrats. All three gained seats in parliament in the election, while the party that led the outgoing coalition government, the Christian Democrats, lost ground.
The outgoing government remains in office in a caretaker role while the new one is formed. The departing health minister, Jens Spahn, a Christian Democrat, has said he too believed the national epidemic status should be allowed to lapse.
New coronavirus cases have risen by 80 percent over the past two weeks, according to a New York Times database, even though at least two-thirds of the population is fully vaccinated. The three coalition parties said on Wednesday that they would set up a federal panel to work on increasing the vaccination rate.
“We are of the common opinion that we are far from where we could and should be as far as vaccination is concerned,” said Katrin Goring-Eckardt, the parliamentary group leader for the Green party.