Skyler Hamm, 12, received his first dose of the Pfizer-BioNTech vaccine while being comforted by his mother, Jessica Metz, during a mass vaccination event for 12- to 15-year-olds in Albuquerque, N.M., last month.
Credit…Paul Ratje for The New York Times

Coronavirus vaccines may be available for U.S. children as young as six months by the fall, drugmakers say. Pfizer and Moderna are testing their vaccines in children under 12, and are expected to have results in hand by the end of the summer.

Compared with adults, children are much less likely to develop severe illness following infection with the coronavirus. But nearly four million children in the United States have tested positive for the virus since the start of the pandemic, according to the American Academy of Pediatrics.

Doctors continue to see rare cases of multisystem inflammatory syndrome in children, a condition linked to Covid-19 that can affect multiple organs, including the heart. Vaccinating children should further contribute to containment of the virus by decreasing its spread in communities.

Pfizer announced on Tuesday that it was moving to test its vaccine in children aged 5 through 12 years. It will begin testing the vaccine in infants as young as six months in the next few weeks.

The company said last month that it expected to apply to the Food and Drug Administration in September for emergency authorization of the vaccine for children ages 2 to 11. The Pfizer-BioNTech vaccine was authorized last month for use in children 12 through 15.

Based on data from an earlier study that assessed safety, Pfizer will give two doses of 10 micrograms each — a third of the dose given to adolescents and adults — to children ages 5 to 11 years, and two doses of three micrograms each to children six months to 5 years.

“We take a deliberate and careful approach to help us understand the safety and how well the vaccine can be tolerated in younger children,” said Dr. Bill Gruber, a senior vice president at Pfizer.

The study will enroll up to 4,500 children at more than 90 clinical sites in the United States Finland, Poland and Spain. Pfizer’s researchers plan to submit the full data from the trials this summer for publication in a peer reviewed journal.

In March, Moderna began testing varying doses of its vaccine in younger children. That trial aimed to enroll 6,750 healthy children in the United States and Canada. Results are not expected till the end of the summer, and the vaccine’s authorization by the F.D.A. will take longer.

“I think it’s going to be early fall, just because we have to go down in age very slowly and carefully,” Moderna’s chief executive, Stéphane Bancel, said on Monday.

The company announced late last month that its vaccine was powerfully effective in 12- to 17-year-olds, and plans to apply to the F.D.A. for authorization in that age group. Last week, Moderna also asked the agency for full approval of its vaccine, rather than the emergency use for which it is currently authorized.

The United States will not be the first country in the world to authorize a coronavirus vaccine for young children. China has approved Sinovac’s vaccine for children as young as 3-years-old, according to the company’s chairman. The approval has not been officially announced.

Employees protesting against Houston Methodist Hospital's vaccine mandate in Baytown, Texas.
Credit…Yi-Chin Lee/Houston Chronicle, via Associated Press

Dozens of staff members at a Houston-area hospital protested on Monday night against a policy that requires employees to be vaccinated against Covid-19.

The hospital, Houston Methodist, had told employees that they had to be vaccinated by Monday. Last month, 117 employees filed a lawsuit against the hospital over the vaccine policy.

While the U.S. Centers for Disease Control and Prevention recommends health care workers get a flu shot, and some hospital systems require it, few American companies have required Covid-19 shots, despite federal government guidance that says employers can mandate vaccines for onsite workers.

Executives, lawyers and consultants say that many companies remain hesitant because of a long list of legal considerations the Equal Employment Opportunity Commission says must be followed before mandating vaccinations. Some companies say they are wary of setting mandates until the vaccines have received full approval by the Food and Drug Administration, which has so far granted emergency use authorization.

Jennifer Bridges, a nurse who led the Houston Methodist protest, has cited the lack of full F.D.A. approval for the shots as a reason she won’t get vaccinated.

Vaccine hesitancy has been high among frontline health care workers in the United States: Surveys showed that nearly half remained unvaccinated as of mid-March, despite being among the first to become eligible for the shots in December. A March 2021 survey by the Kaiser Family Foundation found that health care workers had concerns about the vaccines’ newness and their possible side effects, both of which are common reasons for waiting to be vaccinated.

By Monday evening, dozens of Houston Methodist employees had gathered outside the hospital system’s location in Baytown, Texas, holding signs that read “Vaxx is Venom” and “Don’t Lose Sight Of Our Rights.”

“If we don’t stop this now and do some kind of change, everybody’s just going to topple,” Ms. Bridges told local news media covering the protest. “It’s going to create a domino effect. Everybody across the nation is going to be forced to get things into their body that they don’t want and that’s not right.”

Those who did not meet the hospital’s vaccination deadline on Monday will be placed on a two-week unpaid suspension. If they do not meet the requirements by June 21, Houston Methodist said it would “initiate the employee termination process.”

The workers’ lawsuit accuses the hospital of “forcing its employees to be human ‘guinea pigs’ as a condition for continued employment.”

In a statement, Houston Methodist said that by Monday, nearly 100 percent of its 26,000 employees had complied with the vaccine policy. The hospital said it was aware that some employees who had not met the vaccine requirements planned to protest, and had invited other employees to join them.

“We fully support the right of our employees to peacefully gather on their own time, but it is unacceptable to even suggest they abandon their patients to participate in this activity,” the hospital said. “We have faith that our employees will continue putting our patients first.”

On Monday, Gov. Greg Abbott of Texas signed a law prohibiting businesses or government entities in the state from requiring vaccine passports, or digital proof of vaccination, joining states such as Florida and Arkansas. It’s unclear how or if the new law will affect employer mandates like Houston Methodist’s.

In some industries, including aviation, employers are taking a middle-ground approach. Delta Air Lines, which is distributing vaccines out of its flight museum in Atlanta, said in May that it would strongly encourage employees to get vaccinated and require it for new hires.

United Airlines, after considering a blanket mandate, said last week that it would require anyone hired in the United States after June 15 to provide proof of vaccination no later than a week after starting. Exceptions may be made for those who have medical or religious reasons for not getting vaccinated, the company added.

A medical staff member preparing to administer a dose of the Sinovac vaccine at a university in Qingdao, in China’s eastern Shandong Province.
Credit…Agence France-Presse — Getty Images

The chairman of the Chinese drugmaker Sinovac said China had approved the company’s Covid-19 vaccine for children as young as 3, which would make the country the first in the world to endorse a shot for such young children.

The World Health Organization has cleared both Sinovac’s vaccine and one made by another Chinese company, Sinopharm, for emergency use in adults 18 and older. China has kept the coronavirus largely under control in recent months, and schools there have remained open. But in other countries, the availability of effective vaccines for children and adolescents will be crucial for allowing schools to operate more safely.

The United States has authorized the Pfizer-BioNTech vaccine for people 12 and older. Pfizer expects to submit its vaccine for authorization for children as young as 2 in September, the company said during an earnings call last month. Moderna said last month that its vaccine was highly effective in 12- to 17-year-olds, though regulators have not yet endorsed the company’s shot for that age group.

In an interview with the state broadcaster China Central Television, Sinovac’s chairman, Yin Weidong, said the company’s clinical trials involving “hundreds” of people had found that its vaccine was just as safe and effective in people ages 3 to 17 as it was in adults.

After Sinovac reported these results to Chinese regulators, they approved the shot for use in the younger age group, Mr. Yin said. He said the government would ultimately decide when vaccines might start being administered to children.

CCTV cited an unnamed government official who confirmed that the authorities had endorsed the use of Covid vaccines in people as young as 3. Regulators have not officially announced the approval, however.

An Air India aircraft delivering vaccines to Nepal in January.
Credit…Niranjan Shrestha/Associated Press

NEW DELHI — Amitesh Prasad, a pilot with Air India, came down with Covid-like symptoms in April this year after he flew from San Francisco to the southern Indian city of Bengaluru. He was among the many pilots who had worked on one of India’s largest humanitarian missions to bring home stranded residents and transport essential pandemic-related supplies.

He died on May 9, one of at least 17 pilots in India who have died of the coronavirus, according to the Indian Pilots’ Guild, a union of about 350 pilots in the country. Almost half of them flew with Air India and the rest with private airlines, including Indigo, Go Air and Vistara, it said.

The Air India pilots had their salaries reduced during the pandemic, their union says, and it points out that many of them came to India’s aid when people and vaccines needed to be transported, even though they were not vaccinated themselves.

Now, the country’s pilots, especially those working for Air India, the debt-ridden airline controlled by Prime Minister Narendra Modi’s government, are asking for better compensation for the families of airline crew members who die of Covid.

On Monday, the Federation of Indian Pilots, a pan-India organization of pilots, filed a public interest lawsuit in the Bombay High Court, seeking better compensation, insurance benefits and vaccination for all airline crew members.

The federation said in its petition that as of February this year, nearly 2,000 Air India staff members had tested positive for Covid-19. More than 500 of them required hospitalization.

“However, there is no scheme for adequate compensation to pilots in case of their demise,” the federation said. It added that “there is no insurance scheme or any other such scheme providing safety net to the pilots.”

In a letter addressed to the chairman and managing director of Air India last month, the Indian Pilots’ Guild said that the country lost three pilots in just a span of five days between April 9 and 14.

It asked the state carrier some pointed questions: “Until how long will our service to the nation be taken for granted considering the pay cut and the lack of recognition of our contribution throughout the pandemic?”

The union said Air India was paying about 500,000 to 1 million rupees ($6,800 to $13,700) as compensation to the family if a pilot died of Covid-19 while performing their duties. The number, it said, was a fraction of what other airlines paid and might be just enough to take care of a deceased colleague’s hospital bills. Indigo, a private airline, was paying 50 million rupees or more than $680,000, the union said in one of its letters.

The union said that it had sent repeated requests to the government asking that flight crews be prioritized for vaccinations. In a letter addressed to India’s health minister, Dr. Harsh Vardhan, on April 16, the union urged the government to recognize crew members as “essential workers.”

“We urge you to vaccinate all aircrew at the earliest,” it said.

Two Air India pilots who requested anonymity fearing reprisals from the government said they were frustrated by the way their calls for better compensation and protesting salary cuts had fallen on deaf ears. They also said they feared being exposed to new variants of the virus circulating in other countries while doing their jobs.

Despite all of that, the pilots said they were being paid salaries that were nearly 40 to 70 percent less than what they received before the pandemic. The pay cuts came into effect in April last year as global travel came to a halt.

Hardeep Singh Puri, India’s civil aviation minister, has said that the country’s Vande Bharat Mission to evacuate Indians was the “world’s largest” repatriation drive, transporting more than 9 million people so far. “India did not cower in the face of this health crisis of the century,” he said in a tweet on Tuesday.

But neither Mr. Puri nor Air India have responded to their pilots’ requests. The Ministry of Civil Aviation in New Delhi didn’t immediately respond to a request for comment.

In May, the union wrote a letter to Air India, asking company executives to show “a similar kindness” to what it showed when it asked its pilots to show up for duty when it needed to rescue Indians from some of the worst-affected regions in the world, including the United States, China and Italy.

“The need of the hour is to immediately provide a befitting compensation to our colleagues who have already paid the ultimate price,” it said.

Mr. Prasad’s daughter said it was too painful to think of her father and declined an interview request.

Global Roundup

Workers at the Navotas Fish Port received the Covid vaccine in the Philippines, on Monday.
Credit…Aaron Favila/Associated Press

The Philippine government said it would expand its Covid-19 vaccination drive this week by opening up shots to millions more essential workers, as officials sought to step up a sluggish effort and lift the economy.

With more doses arriving from China, Russia and the Covax vaccine-sharing initiative, officials said that the Philippines in the coming months would inoculate more than 35 million people who work outside the home, including medical staff, public transport employees, journalists and others. But so far, the government has only a fraction of the doses it needs to do that.

Carlito Galvez Jr., the leader of the government’s coronavirus strategy team, said at a news conference on Monday night that vaccinating these workers was necessary to “drive the economy.”

Because they must work outside the home, these workers “are among the most vulnerable to the disease and must be protected, regardless of the industry they belong to,” Mr. Galvez said.

About six million people have received at least one vaccine dose in the Philippines, where until now only frontline workers, older people and those with certain medical conditions have been eligible for shots. Many Filipinos have expressed doubts about the safety of the vaccines. Experts say that it could take many more months to inoculate enough of the country’s 108 million people to reach herd immunity, if it occurs at all.

The government said that the Philippines has received approximately 9.3 million vaccine doses, and that some shipments had been delayed. Most of the doses are from Chinese drugmaker Sinovac; others in use include the Sputnik V vaccine from Russia and the AstraZeneca and Pfizer shots supplied by Covax.

Mr. Galvez said that more doses were expected to arrive in the coming months, including 15 million more Pfizer doses in the third quarter of the year.

New coronavirus infections in the Philippines have declined from a peak in March and April, but the disease continues to race through the country, especially in outlying provinces. Health officials on Monday reported 71 deaths from the virus, bringing the total death toll to nearly 22,000. The country has recorded more than 1.2 million infections, among the highest totals in Asia.

President Rodrigo Duterte warned that anyone who flouted health protocols could be charged with a criminal offense, noting during a weekly cabinet meeting on Monday that he has seen many people not wearing masks in public. Mr. Duterte, who is known for blustery talk, said that someone who was infected with the coronavirus but did not wear a mask “could be charged with murder.”

“If not,” he added, “you could also be charged with reckless imprudence.”

In other developments around the globe:

  • Spain reopened its borders on Monday to Americans and other vaccinated visitors from countries that the authorities consider to have a low risk of spreading Covid-19, seeking to shore up the summer tourism that is a pillar of its economy. Visitors from countries that Spain lists as presenting a higher risk, like France and Germany, must now produce only a negative antigen test, rather than the more costly PCR test previously required. Cruise ships will also be able to dock again at Spanish ports.

Raphael Minder contributed reporting.

A worker at the Hollingsworth Cannabis Company packaged pre-rolled marijuana joints near Shelton, Wash., in April 2018.
Credit…Ted S. Warren/Associated Press

As part of its strategy to vaccinate more of its population, Washington State will allow adults to claim a free marijuana joint when they receive a Covid-19 vaccination shot.

The state’s liquor and cannabis board announced on Monday that the promotion, called “Joints for Jabs,” was effective immediately and would run through July 12.

The board said it would allow participating marijuana retailers to provide customers who are 21 or older with a prerolled joint at their stores when they received their first or second dose at an active vaccine clinic. The promotion applies only to joints, not to other products like edibles.

So far in Washington, 58 percent of people have received at least one dose, and 49 percent are fully vaccinated, according to a New York Times database.

Washington is not the only state to offer a cannabis promotion. An Arizona dispensary recently announced a similar campaign, providing free marijuana joints or gummy edibles to Arizonans 21 and older who receive a vaccination.

Washington’s liquor and cannabis board recently allowed for a free beer, wine or cocktail to residents with proof of vaccination.

Since the U.S. pace of vaccinations began to decline sharply in mid-April, states and cities have started promotions like free beer in New Jersey and a raffle to win full-ride college scholarships in New York and Ohio. Several states have held lotteries awarding cash prizes of $1 million or more.

Andy Slavitt, a White House virus adviser, has said the Biden administration was encouraging states to be creative — including through lotteries or other financial incentives — to get people vaccinated. The federal government is allowing states to use certain federal relief funds to pay for those types of programs.

A sushi bar with a conveyor belt in Kanazawa, Japan.
Credit…Andy Haslam for The New York Times

As parts of Japan endure a prolonged state of emergency to battle the latest coronavirus surge, one restaurant chain came up with a way to replicate the sushi bar experience at home: renting out conveyor belts.

Kappa Sushi, which operates more than 300 sushi bars across Japan, is offering takeout customers a mini version of the conveyor belts that run through their restaurants and ferry little plates of nigiri and rolls to diners at their tables. For an additional 3,300 yen, or about $30, customers can pick up a 49-inch oval belt, about the size of a toy train set, that sits atop a table and moves the takeout dishes around and around.

Momoko Okamura, a spokeswoman for the Kappa chain, said the company came up with the idea in 2019, before the pandemic. But with Tokyo, Osaka and several other cities under a state of emergency that curtails restaurants’ operating hours, Kappa unveiled the rental service last month at five of its locations. About 75 customers have signed up so far, Ms. Okamura said.

“Most customers are families with small children, who feel reluctant to eat out and feel safer eating at home,” she said. “They want to have a bit of fun at home, or when they have some events at kindergartens or school. We also target corporate customers but the service is popular among families.”

With a minimum order of about $27, and an $18 deposit, a Kappa customer can pay to rent the conveyor belt along with the meal. Last month, Reiranran, a Japanese internet personality with 154,000 YouTube subscribers, posted a video showing her opening a long black case about the size of a massage table inside her Osaka apartment.

She placed the conveyor belt on her coffee table, plugged it in and arranged her order on the belt: plates of shrimp nigiri, tuna, egg and an assortment of other sliced fish. With the flick of a switch, the belt whirred to life. Sipping a beer, she began picking from the moving dishes.

“It’s been so long to see sushi revolving and have a drink,” she said.

With restaurants barred from staying open late or serving alcohol under emergency measures imposed across parts of the country in April, sushi delivery places and fast-food joints, including McDonald’s and KFC, are among the few dining businesses that are surviving during the pandemic in Japan. Some sushi restaurants have introduced refrigerated lockers to allow contact-free pickup; others offer kits for families to assemble their meals at home, complete with paper sushi chef hats for children.

Some Japanese have tried to replicate the experience of kaitenzushi — the affordable, family-friendly conveyor-belt sushi introduced in Osaka in 1958 — by modifying toy train sets to carry sushi trays, and posting videos on YouTube. A popular toy company, Takara Tomy, is planning to release a new train set next month that is designed to carry sushi trays.

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