In the initial months of the Covid vaccine rollout, states sought to balance between prioritizing the elderly, who are most likely to die from the virus, and people in professions most likely to be exposed to it. Under recommendations from the Centers for Disease Control and Prevention, people with underlying medical conditions, like Type 2 diabetes or cancer, which have been associated with an increased risk for severe virus symptoms, were slated to come next.
But with demand still outstripping the nation’s vaccine supply, a new skirmish has emerged over which health problems to prioritize.
States, which are not bound by the C.D.C.’s recommendations, have set widely varying rules amid a dearth of definitive evidence about how dozens of medical conditions may affect the severity of Covid-19. The confusing morass of rules has set off a free-for-all among people who may be among the most vulnerable to the virus as they seek to persuade health and political officials to add health conditions to an ever-evolving vaccine priority list.
At least 37 states, as well as Washington, D.C., are now allowing some residents with certain health problems to receive vaccines, according to a New York Times survey of all 50 states. But the health issues granted higher priority differ from state to state, and even county to county.
Some people with Down syndrome may get vaccines in at least 35 states, for instance, but some of those states are not offering shots to people with other developmental issues. At least 30 states allow some people with Type 2 diabetes to get vaccines, but only about 23 states include people with Type 1 diabetes. At least 19 states are making the vaccine available to some people with cystic fibrosis; at least 14 have included some people with liver disease; and at least 15 have deemed some smokers eligible. At least 30 states have prioritized vaccines for people who are overweight or obese, according to the Times survey, though they vary even there, some setting the bar at a body mass index of 25, others at 30 or 40.
Some states require a person to prove they have a medical condition, though at least 16 states and Washington, D.C., do not. And at least 12 states allow a person to get a recommendation from a health professional to get a shot, even if their medical condition has not been given priority by the state.
In the absence of large, rigorous studies of the coronavirus’s effect on people with other medical problems, medical ethicists said, there are few clear principles to apply to determine a priority sequence among many conditions. Many states are taking their cues from a list of 12 conditions that the C.D.C. has deemed to have substantial evidence for elevated Covid risks, including obesity, Type 2 diabetes, smoking and Down syndrome. C.D.C. officials have said that they regularly review the scientific literature and will expand the list as warranted.
But some medical ethicists argue that the list itself is misleading, because it suggests that the risk for all diagnoses have been considered and ranked. Is a 50-year-old with Type 1 diabetes at greater risk from Covid than a 25-year-old with sickle cell disease, or a 35-year-old with intellectual disabilities?
Nursing homes in Canada were prioritized for the first precious doses of coronavirus vaccines to few objections — they were ground zero for the pandemic’s cruel ravage. Around 66 percent of the country’s terminal Covid-19 victims lived in nursing homes, among the highest rates in the world.
But while the vaccines have given the majority of nursing-home residents protection from death by the virus, so far they have not offered more life. Unlike in the United States, where some restrictions at long-term care facilities have been loosened, health officials in Canada say they are waiting for scientific assurance that it is safe to ease regulations.
That has left some residents comparing their lives to those of prisoners and caged animals.
Most places around Canada have policies that allow visits from only one or two designated caregivers, but these measures aren’t evenly carried out. And in several cities, including Toronto and Montreal, residents are not allowed to leave the property to walk to a pharmacy or enjoy the simple pleasure of a stroll down the street.
All this has left some residents frustrated, baffled and wondering: What, exactly, am I being kept alive for?
Officials at provincial and territorial health care ministries around the country, which oversee health care, offer many reasons for not relaxing restrictions: concerns about emerging variants of the virus, the lack of research on the vaccine’s effectiveness in preventing transmission and, in some cases, the high infection rates in the surrounding community.
“We need to better understand the effectiveness of the vaccines in preventing transmission, including variant transmission, before we can safely alter visitor policies,” said Tom McMillan, an Alberta health official.
In the United States, some states have loosened restrictions as cases have dropped, allowing nursing homes to hold group activities like game night or choir practice. And some homes have permitted indoor visits under federal guidelines put in place in September that allow them if a home has been virus-free for 14 days and county positivity rates are below 10 percent, regardless of the home’s vaccination rate.
But elsewhere, homes are about to reach a full year of being closed to visitors, despite the plummeting of coronavirus cases.
The AARP and other advocacy organizations have called on the U.S. government to ease visitation guidelines as vaccines are rolled out in nursing homes. Many note that with vaccinations, the likelihood of residents contracting and dying from Covid-19 is lower, but the harm to residents from social isolation continues unabated.
One large survey of nursing-home residents and their families in Canada found that a majority reported a marked decline in cognitive function and emotional well-being, and almost half reported that their physical functioning had worsened.
The survey also found that the proportion of residents on antipsychotic medication — traditionally prescribed to manage behaviors like agitation related to dementia — had increased by 7 percent over six months.
The question of how to care for the country’s senior population during a pandemic isn’t unique to Canada and the United States. Many nursing homes around the world banned visits as the coronavirus arrived around a year ago.
Soon after, geriatricians sounded the alarm about the rapid decline in health and well-being of residents, setting off a debate about the balance between protection and quality of life, as well as the rights and autonomy of residents. As a result, many jurisdictions reintroduced some sort of visitor policy as the first wave subsided.
Many are calling for a similar discussion to happen again in Canada.
As students in some parts of the United States approach nearly a year without in-person school, new research suggests that the reading skills of young children have suffered during the pandemic.
The research, a preliminary national study from the group Policy Analysis for California Education, found that as of late fall, second graders were 26 percent behind where they would have been, absent the pandemic, in their ability to read aloud accurately and quickly. Third graders were 33 percent behind.
Those differences were equivalent to being able to read seven to eight fewer words per minute accurately.
Some previous research has come to a different conclusion, suggesting that reading skills in third to eighth grade have proven more durable than many experts feared.
The new study relied on audio recordings of one to two minutes, from 98,000 children in 111 school districts across 22 states. The samples were collected by Literably, an online assessment tool. School buildings in the districts included in the study were more likely to be fully or partly closed than those in the average American district.
Crucially, the students lost the expected reading gains in the spring of 2020, when schools abruptly shut down at the outset of the pandemic. Students resumed improving their reading skills in the fall, suggesting schools and teachers improved in their ability to deliver instruction online or in hybrid learning. But those gains were insufficient to make up for the previous losses.
The researchers did not study whether students were able to make up for the spring losses in districts that were more likely to be open in the fall.
Notably, students in lower-achieving school districts included in the study lost more learning than those in higher-achieving districts, suggesting that the pandemic has widened existing achievement gaps. And 10 percent of students who were recorded in the spring were missing from the audio assessments in the fall.
While some of those children may have been enrolled in high-quality alternatives, such as private schools, others may have been absent because of difficulties with access to remote learning, suggesting that learning loss could be even greater for the most vulnerable students.
Heather J. Hough, an author of the working paper, said schools may need to provide tutoring and extra instructional time to help students catch up. But she warned against an approach that focused only on academics, saying that young children needed recess, playtime and social time — some of which have been in short supply during the pandemic — to be able to absorb new information effectively.
“That is as critical to early reading development as the technical skills,” she said.
New York will lower its age threshold for Covid-19 vaccine eligibility beginning on Wednesday, allowing anyone older than 60 to be inoculated, Gov. Andrew M. Cuomo announced on Tuesday.
“That means people, like as old as I am, will now be eligible for the vaccine,” Mr. Cuomo, 63, said at an appearance in Syracuse.
The state will also expand its eligibility requirement the following week to open vaccination to a large number of public-facing workers, including government employees, nonprofit workers and essential building services workers. Those people can begin to get vaccinated on March 17.
New York will join a handful of other U.S. states that allow vaccinations for all people over 60; the majority have set their age eligibility requirement at 65 years old.
Mr. Cuomo pointed to expected increases in supply from the federal government as the reason behind expanding vaccine eligibility.
Among the workers eligible to get vaccinated next week are public works employees, social service and child service caseworkers, government inspectors, sanitation workers, election workers, Department of Motor Vehicle employees and county clerks.
Appointments will open for people over 60 years old starting at 8 a.m. on Wednesday, Mr. Cuomo said. People over 65 were made eligible for a coronavirus vaccine in January.
When the Centers for Disease Control and Prevention announced new freedoms for the fully-vaccinated members of the population, questions about traveling to visit grandchildren, for example, were immediate.
The answer, the C.D.C. director, Dr. Rochelle Walensky, said was yes, as long as the vaccinated grandparents lived nearby. But the agency continues to warn Americans against traveling in general.
“We know that after mass travel, after vacations, after holidays, we tend to see a surge in cases,” Dr. Walensky said Monday night on MSNBC. “And so, we really want to make sure — again with just 10 percent of people vaccinated — that we are limiting travel.”
To the frustration of airlines and others in the travel industry, the latest guidance comes as students and families are considering spring break plans almost a year after wide swaths of the United States first shut down, and a growing share of Americans tentatively book travel for later in the year.
Given the presence of virus variants in nearly every state and the need for more research on whether fully vaccinated people can still transmit the virus and other questions about the vaccines, Dr. Walensky said nonessential travel should be avoided, at least for now.
“It’s just a first step,” Jen Psaki, the White House press secretary, said on Tuesday, referring to the agency’s new guidance for fully vaccinated people. “As more people are vaccinated, they’ll look at ways to ease additional restrictions.”
The Biden administration said Tuesday that it is shipping 15.8 million additional vaccine doses to states, tribes and territories, with another 2.7 million first doses to pharmacies, Ms. Psaki said. Currently, there are 2.17 million vaccine shots being administered a day on average, she said.
What is safe for newly vaccinated Americans and their unvaccinated neighbors and family members has been uncertain in large part because scientists do not yet understand whether and how often immunized people may still transmit the virus. If they can, then masking and other precautions are still needed in certain settings to contain the virus, researchers have said.
“We know that the travel corridor is a place where people are mixing a lot,” Dr. Walensky said during a White House briefing on Monday. “We’re hopeful that our next set of guidance will have more science around what vaccinated people can do, perhaps travel being among them.”
Airlines for America, an industry organization, has argued that airplanes have a very low risk for virus transmission because of high-end cabin ventilation systems, strong disinfection practices and strict rules requiring that passengers wear masks. The industry has also argued that it plays a vital economic role and that further restrictions to travel could hinder the recovery.
“We remain confident that this layered approach significantly reduces risk and are encouraged that science continues to confirm there is a very low risk of virus transmission onboard aircraft,” the group said.
The first stimulus bill signed into law nearly a year ago, included $50 billion in grants and loans to prop up the airline industry, which was hobbled by the pandemic. In December, Congress approved another $15 billion in grants to keep airline workers employed. The relief bill passed by the Senate on Saturday, includes $14 billion more for airlines, a measure applauded by the industry.
In a Monday letter to President Biden’s coronavirus response coordinator, Jeffrey D. Zients, a coalition of travel and tourism trade groups asked to work with the White House on federal guidance for temporary virus “health credentials,” which could be used to securely and uniformly verify test results or vaccination status. Such guidance could also yield benefits beyond aviation, they argued.
“It could encourage more widespread adoption of processes to verify testing and vaccination records, from sports arenas to restaurants, business meetings, theme parks, and more,” the group wrote.
Ms. Psaki said during the briefing on Tuesday that the Biden administration welcomed “ideas that will come from the private sector and nonprofits” about how people could demonstrate that they are vaccinated, but that “our focus from the federal government is on getting more people vaccinated, and that’s where we feel we can use our resources best.”
Currently, the Biden administration requires people traveling to the United States from another country to present a negative virus test. At one point this year, administration officials were considering a similar requirement for domestic travel, a move the airline industry pushed back against, saying it was needlessly restrictive and would hurt an already struggling sector. The C.D.C. in February said it was not recommending testing for domestic travel “at this time.”
Bryan Pietsch contributed reporting.
The District of Columbia’s first attempt at an online system for residents to sign up for coronavirus vaccination performed so badly that the district decided to junk it and start over. The new one rolls out on Wednesday.
This time, the new system is meant to avoid a pitfall that plagued the old one: Huge surges of users frantically clicking at the same time, trying to score an open appointment before they’re all gone.
“What we don’t want is everyone to rush to the website at one time,” Dr. LaQuandra Nesbitt, the director of the city’s health department, said Monday at a news briefing.
That’s what was happening every Thursday and Friday when the city posted newly available appointments, said Lindsey Parker, the city’s chief technology officer. Thousands of people would constantly refresh the site in their web browsers, hoping to pounce on an appointment as soon as it appeared, and the traffic would slow the site to a crawl.
“Any time there are a number of people hitting one website at the exact same time,” Ms. Parker said on Monday, “you’re always going to have a slight lag — or you’re going to need to ensure that that load on the system is able to be balanced accordingly.”
Under the new system, there won’t be any pouncing. Residents will enter their information at their convenience; then the system will reach out to them when their turns come around to offer appointments, Mayor Muriel Bowser said at the briefing.
Similar problems have walloped online appointment scheduling systems in a number of states. The Massachusetts website crashed in February when the state opened up eligibility to anyone 65 or older and other categories, adding about a million additional people. The problems infuriated Gov. Charlie Baker, who said in an interview with WGBH at the time that the state’s advance work had not prepared the system adequately for the rush.
When Virginia set up its vaccine registration system around the same time, some users reported that it immediately crashed and was initially impossible to navigate. The Virginia Department of Health asked users to be patient and keep trying.
New Jersey officials blamed Microsoft for glitches that plagued its vaccine-scheduling software, Bloomberg reported last month. State officials acknowledged the problems and said they were speaking with the company to try to resolve them. In the meantime, though, the state started relying more on appointment websites run by individual counties and hospitals, which were running more smoothly, according to Bloomberg.
The promoters of a Russian coronavirus vaccine known as Sputnik V demanded an apology on Tuesday from a European regulator who compared using it now to playing Russian roulette. The episode highlighted a deepening rift between Russia and the West over accusations of belittling each other’s vaccines.
The regulator, Christa Wirthumer-Hoche, heads the European Medicines Agency, which approves pharmaceuticals for use in the 27-member European Union.
Three member countries — Hungary, the Czech Republic and Slovakia — have approved or are considering approving Sputnik V. Ms. Wirthumer-Hoche said on Sunday that they should hold off until her agency finishes reviewing the vaccine’s safety and efficacy. Moving ahead before that, she said, was “somewhat comparable to Russian roulette.”
The vaccine’s Russian backers said in posts on Twitter that her comment raised “serious questions about possible political interference” in the approval process. “We demand a public apology,” they wrote.
Relations between Russia and the West over vaccine policies have been curdling for months, with each side accusing the other of risking lives by denigrating each other’s vaccines and feeding public skepticism about vaccination.
The White House spokeswoman, Jen Psaki, said on Monday that the Biden administration was monitoring disinformation spread by Russian websites about the safety of the Pfizer-BioNTech and Moderna vaccines, the first two authorized for use in the United States.
Last fall, the financial company backing the Russian vaccine openly questioned whether the novel genetic technology used in those vaccines might pose a risk of cancer or birth defects. The company also denigrated the vaccine developed by Oxford University and AstraZeneca, which uses a genetically modified chimpanzee cold virus.
Those statements were made at a time when Western vaccine experts were sharply criticizing the Russian government for approving Sputnik V before large-scale clinical trials had begun.
Since then, clinical trials have found that the vaccines from Pfizer-BioNTech, Moderna, Oxford-AstraZeneca and Sputnik V are all safe and effective.
The European Medicines Agency announced last week that it was reviewing the Russian trials, and would approve Sputnik V when it had obtained the necessary data. But that approval is not likely to quickly translate into large numbers of doses becoming available to Europeans. Manufacturing plants in Russia have been struggling for months to expand production of the vaccine.
Disneyland, which has been closed for a year, will reopen in late April.
Bob Chapek, the chief executive of the Walt Disney Company, announced the time frame on Tuesday at the company’s annual shareholder meeting but did not give a specific date.
California officials announced on Friday that theme parks in the state could reopen on a limited basis as soon as April 1. Eligibility, however, will depend on coronavirus transmission statistics in individual counties.
For instance, theme parks in counties where the virus threat remains the most severe (in the purple tier under the state’s system) must remain closed. But parks in areas where the threat of infection has eased somewhat (red tier) will be allowed to reopen at 15 percent capacity. Even less threat (orange tier) will allow for 25 percent capacity, ultimately rising to 35 percent for the lowest threat (yellow).
California will restrict attendance to in-state visitors. Regulators will also restrict indoor dining. Some indoor rides may be required to remain closed.
Disneyland is in Orange County, which is in the purple tier. But if coronavirus cases continue to decline in Southern California at the current pace, the county could fall within the orange tier by late April. The Walt Disney Company said last year that reopening a park at less than 25 percent capacity would not make economic sense.
Before the pandemic, roughly 32,000 people worked at the 486-acre Disneyland Resort, which includes two separately ticketed theme parks, three Disney-owned hotels and an outdoor shopping mall. Some furloughed employees have already returned; the Downtown Disney retail district, for instance, reopened over the summer. Mr. Chapek said that roughly 10,000 additional furloughed employees would be called back for the April limited reopening of rides and hotels.
By the time Disneyland reopens, it will be the last of the company’s six theme park resorts to come back online. (The others are in Orlando, Fla.; Paris; Hong Kong; Tokyo; and Shanghai.) Mr. Chapek said the still-closed Disney Cruise Line may have “limited” sailings by the fall.
In other shareholder meeting news, Disney disclosed that its streaming service, Disney+, now has more than 100 million paying subscribers worldwide. And Robert A. Iger, who passed the chief executive baton to Mr. Chapek last year and transitioned to an executive chairman role, reiterated his intention to leave the company at the end of December.
Italy surpassed 100,000 reported coronavirus deaths on Monday, adding more than 300 in the last 24 hours. The bleak tally was crossed one year after former Prime Minister Giuseppe Conte announced a national lockdown, as the country became the first in the West to be severely affected by the virus.
Italy is currently facing a large wave of coronavirus infections driven by new variants. Intensive care units are filling up, and the government is scaling up restrictions across the country.
“We would have never thought that one year later, we would find ourselves facing such an emergency,” Prime Minister Mario Draghi said in a video message on Monday.
Italy ranks sixth in the world for total deaths from the virus, and second in Europe after Britain, according to a New York Times database. More than three million Italians, or about one in 20, have been infected.
Unlike Britain, where about a third of the population has received at least one vaccine dose, Italy has inoculated only 6.2 percent of its population, in part because of organizational problems in distributing doses to Italy’s regions.
Last week, Italy blocked the export of 250,000 doses of the AstraZeneca vaccine to Australia, saying they were needed at home. An Italian company plans to start producing the Russian Sputnik V vaccine in the summer, according to a report in Italy’s main newspaper, Corriere Della Sera.
Health authorities in Greece reported on Tuesday a large spike in coronavirus infections — 3,215 new cases in the past 24 hours — despite tightened restrictions. The figure was the highest daily total since the country entered its second lockdown in early November, and it appeared likely to scupper plans to start reopening schools and shops later this month. Officials attributed the rising infection rate in part to more infectious variants and in part to public fatigue with pandemic restrictions. Recent efforts by the police to enforce compliance have prompted public anger and protests, including one on Tuesday.
Britain’s emergency field hospitals, set up in the early days of the pandemic last year, are expected to close starting next month. They were intended to provide extra capacity to treat Covid-19 patients if hospitals became overwhelmed, but went largely unused, even when the National Health Service was stretched to its limits. Two of the sites will be turned into mass vaccination sites.
The drug regulator in Indonesia said on Tuesday that it had approved the AstraZeneca coronavirus vaccine for emergency use, Reuters reported. The country received its first million doses of the vaccine on Monday through the Covax initiative. Indonesia has been using the vaccine developed by Sinovac, a private Chinese company, since January.
The government of Hong Kong said on Monday that it was expanding eligibility for the coronavirus vaccine to include people working in catering, construction, education, tourism, public transport and property management, as well as at gyms and beauty salons. Almost half of the city’s 7.5 million people will now be eligible to book appointments online. Hong Kong has administered either the Pfizer-BioNTech vaccine or the Sinovac vaccine to more than 100,000 people so far. It has also agreed to buy millions of doses of the Oxford-AstraZeneca vaccine but has yet to approve it for emergency use.
The French Pacific territories of New Caledonia and Wallis and Futuna went into two-week lockdowns on Tuesday after both reported their first cases of community transmission of the coronavirus. According to Radio New Zealand, the outbreak in New Caledonia appears to be linked to travelers from Wallis and Futuna, the only place that was exempt from New Caledonia’s quarantine requirements. Officials have suspended all flights between the two territories.
A flight attendant in New Zealand who tested positive for the coronavirus over the weekend was found on Tuesday to have the country’s first known case of the B.1.1.317 variant, which was first detected in Russia but is not considered a variant of concern. The Ministry of Health said that 13 fellow crew members had tested negative, with one test still outstanding.
China on Monday introduced a digital vaccine passport to track its citizens’ medical history as they begin to travel abroad.
The health certificate, which runs on Tencent’s WeChat messaging app, will include a user’s Covid-19 test and vaccination history, and is intended to enable international travel, according to a report by the Chinese state-run news agency Xinhua. The service currently only works for Chinese citizens.
Europe and the United States have discussed their own versions of such systems in preparation for a likely boom in travel as ever more people get vaccinated. During a Group of 20 meeting last year, President Xi Jinping of China suggested that countries standardize services to facilitate movement across borders.
The Chinese pass offers an encrypted, scannable code that could allow other countries to process the data of travelers, according to the Xinhua report.
In China, health code software that tracks a user’s location and can link them to hot spots and outbreaks have become de rigueur for daily life. A green code, which indicates a clean history, is required to do everything from entering a grocery store to taking public transportation.
But privacy concerns mean that Mr. Xi’s vision for a standardized system is unlikely to occur. In China’s case, the police have built surveillance systems that closely watch WeChat, and one early version of the country’s health code software appeared to send data directly to the police.
At 8:30 on weekday mornings, there is now enough space in the Main Concourse at Grand Central Terminal for travelers to walk at least six feet apart. Most move at a stroll rather than the New York City speed walk. Early last year, about 160,000 people passed through the station each weekday. Ridership is now less than a quarter of that.
The pandemic has profoundly disrupted the largest public transit system in America, throwing it into financial turmoil. But getting more people on public transportation will be a key component of New York City’s plan to become carbon-neutral by 2050. The system needs to grow — right at a time when it is facing a sharp decline in ridership and revenue.
Subway rides, bus rides and car trips in New York City fell drastically last March as coronavirus cases surged and the city entered a mandatory lockdown. Some residents who could afford to leave the city did so. Many employees switched to remote work.
Before the pandemic, New York City’s subways were the city’s most popular mode of transit. There were nearly 1.7 billion turnstile swipes in 2019. But last March, ridership fell 90 percent and has recovered to only a third of what it was before.
Transportation researchers attribute New York City’s drop in public transit riders to the shift to remote work and say that the dip in tourism may also be contributing.
Subway ridership has not fallen equally in every neighborhood. Stations in higher-income areas have seen much larger declines.
Neighborhoods in Queens, Brooklyn and the Bronx, which are home to more people of color and families with lower annual income than most parts of Manhattan, are also home to many of the city’s essential workers — and have retained more of their subway riders. Those subway stations report closer to 40 percent of their pre-pandemic ridership.
One full year after the start of the pandemic, there are now 8.5 million fewer employed people in the United States. While it’s a sign of how much damage was done to the economy, that number represents a huge improvement over the worst months of job loss last spring.
But neither the initial losses nor the subsequent gains have been spread evenly. Relative to their employment levels before the pandemic, significantly fewer Black and Hispanic women are working now, according to the latest government data, than any other demographic — and women are lagging behind men across race and ethnicity.
Research has shown that some of the disproportionate impact on women has been driven by the need to care for children during the pandemic, a circumstance that is often not captured in the official unemployment rate, which only accounts for people actively seeking work. Even among women, however, white women have not experienced the same changes in employment levels as women of color.
Greater share of
population is working
Greater share of
population is working
Comparing the percent change in employment totals to a year ago serves as a useful benchmark for how hard the pandemic hit the American work force. But to see how the recovery is exacerbating existing inequality in the economy, it’s important to look at where different groups started from.
One way to see disparities in employment that existed well before the pandemic is to look at the share employed among the working-age population in each demographic over time. This measure, known as the employment-population ratio, has long been lower for women and Black men.
Race and gender are not the only demographic categories across which job loss has hit workers unevenly.
Workers who are on the older and younger ends of the spectrum also experienced outsize losses. Younger people, who also tend to be overrepresented in some of the most affected industries like food service, were much more likely to lose work early in the outbreak and are still among the furthest from their pre-pandemic employment levels.
However, they have regained jobs more rapidly than older people, who may be more wary of returning to work and increasing their exposure to the coronavirus.
In a study published last month, researchers from the Centers for Disease Control and Prevention analyzed safety data from the first 13.7 million Covid-19 vaccine doses given to Americans. Among the side effects reported to the agency, 79.1 percent came from women, even though only 61.2 percent of the vaccines had been administered to women.
Nearly all of the rare anaphylactic reactions to Covid-19 vaccines have occurred among women, too. Anaphylaxis is a severe allergic reaction, and C.D.C. researchers reported that all 19 of the individuals who had experienced such a reaction to the Moderna vaccine had been female. Women made up 44 of the 47 who had anaphylactic reactions to the Pfizer vaccine, they wrote.
“I am not at all surprised,” said Sabra Klein, a microbiologist and immunologist at the Johns Hopkins Bloomberg School of Public Health. “This sex difference is completely consistent with past reports of other vaccines.”
In a 2013 study, scientists with the C.D.C. and other institutions found that four times as many women as men ages 20 to 59 reported allergic reactions after receiving the 2009 pandemic flu vaccine, even though more men than women got those shots.
The news isn’t all bad for women, though. Side effects are usually mild and short-lived. And the physical reactions are a sign that a vaccine is working — that “you are mounting a very robust immune response, and you will likely be protected as a result,” Dr. Klein said.
But why do these sex differences happen? Part of the answer could be behavioral. It’s possible that women are more likely than men to report side effects even when their symptoms are the same, said Rosemary Morgan, an international health researcher at the Johns Hopkins Bloomberg School of Public Health. There’s no vaccine-specific research to support this claim, but men are less likely than women to see doctors when they are sick, so they may also be less likely to report side effects, she said.
Still, there’s no question that biology plays an important role.
Research has shown that, compared with their male counterparts, women and girls produce more — sometimes twice as many — infection-fighting antibodies in response to the vaccines for influenza, M.M.R., yellow fever, rabies, and hepatitis A and B. They often mount stronger responses from immune fighters called T cells, too.
Sex hormones including estrogen, progesterone and testosterone can bind to the surface of immune cells and influence how they work. Exposure to estrogen causes immune cells to produce more antibodies in response to the flu vaccine, for example.
The size of a vaccine dose may also be important. Studies have shown that women absorb and metabolize drugs differently than men do, often needing lower doses for the same effect. But until the 1990s, drug and vaccine clinical trials largely excluded women.
The coronavirus pandemic has weakened democracy across Europe, according to a human rights group that looked into 14 countries. On Tuesday, the group warned against increasing threats to journalists, limits on freedom to protest, and the weakening independence of the judicial systems, among other developments.
Governments across the world have seized extraordinary powers to fight the pandemic, and from South America to Europe and Asia, critics have cautioned that new powers that have little to do with the public health crisis could bear consequences on the rule of law for years to come.
Fears over the misuse of such prerogatives by governments in Eastern Europe have been widely documented, and in its report, the Berlin-based Civil Liberties Union for Europe said that countries such as Hungary, Poland or Slovenia had used the pandemic to strengthen their hold on power and limit criticism of the government.
But the report also sheds a new light on threats that loom in countries with strong democratic participation such as France, Germany, Ireland and Sweden.
“People’s freedoms, including the right to protest, have been curtailed in a bid to stop the spread of the virus and lawmaking has often gone through fast-track procedures,” the report said. It added that these extraordinary measures had “limited oversight of the executive and restricted the possibility for civil society to get involved in the political process.”
The group also warned about an increasingly hostile environment for journalists in Spain and Italy, and the rising disruption of protests and arbitrary detention of protesters in France, Croatia, and Bulgaria. In Germany, the police cracked down on protests that happened despite protesters respecting social distancing rules, the report noted, and in Ireland, privacy concerns around a Covid tracking app have remained unanswered by the authorities.
“No E.U. country is immune to threats to democracy and more concrete efforts are badly needed to revert worrying trends,” the group said.
GÓSOL, Spain — The castle that crowns the hill above the village of Gósol used to be among the grandest along Spain’s border with France, with views of fertile farms and forests rich in timber that stretched up to the cloudy mountaintops.
But the castle is in ruins now, and until last year, Gósol had fallen on hard times, too. The town census had gone down in nearly every count since the 1960s. The school was on the verge of closing for lack of students. The mayor had even taken to television with a plea to his countrymen: Come to Gósol, he asked, or the town would disappear.
It took a pandemic for Spaniards to heed his call.
Among those who packed their bags was Gabriela Calvar, a 37-year-old who once owned a bar in a beach town near Barcelona, but watched it go under during last year’s lockdowns and decamped to the mountains for a new start.
María Otero, a web designer who found she could telecommute, brought her husband and three children to Gósol, the place where her grandparents had been born, but where she had only spent the summers milking cows on visits.
It was the rare silver lining of a troubled time: About 20 or 30 newcomers to a dwindling town of 140 souls, where even the tiny school on the town plaza got a second chance after parents started enrolling their children there.
“If it weren’t for Covid, the school would have closed,” said Josep Tomás Puig, 67, a retired mail carrier in Gósol who spent his life watching the younger generation depart to Spain’s cities. “And if the school closed, the town might as well have closed too.”