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An abrupt call by federal health officials Tuesday to pause use of the Johnson & Johnson coronavirus vaccine threatened to slow progress against the pandemic in the United States, as Michigan battled an alarming spike in cases and new infections trended upward nationwide.

The announcement quickly prompted more than two dozen states and the District of Columbia to temporarily halt injections of the vaccine, the only one of those available that involves a single shot. Health officials said they recommended the move out of “an abundance of caution” while they review six cases of rare and severe blood clots reported in the United States.

One of the cases they are examining is a Virginia woman who died in March, health officials confirmed Tuesday.

All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination, the CDC said.

To date, the rate of vaccinations has exceeded predictions made earlier in the year. More than a third of the country has received at least one dose, and average daily injections have topped 3 million. At the same time, average daily infections rose nearly 7 percent nationwide over the past week, driven by more-transmissible new variants and a loosening of restrictions.

Here are some significant developments:

  • President Biden tried to reassure Americans that there will be enough coronavirus vaccine shots for “every single solitary American” when asked by reporters about the recommended pause in the use of the Johnson & Johnson vaccine.
  • About 7.2 million doses of the Johnson & Johnson vaccine have been administered, and there have been only six reports of blood clots, a rate of about 1 in 1.1 million vaccinations. When distribution resumes, it’s important to remember just how rare these incidents are.
  • More than two dozen states reacted quickly to Tuesday’s announcement by the Food and Drug Administration and the Centers for Disease Control and Prevention regarding the Johnson & Johnson vaccine, pausing injections while officials review the reports of blood clots.
  • Amid the review by U.S. regulators, Johnson & Johnson is pausing the rollout of its vaccine in Europe, saying it made the decision “proactively.”
  • Anthony S. Fauci, the nation’s leading infectious-disease expert, sought to allay Americans’ worries after the pause of the Johnson & Johnson vaccine, assuring them that of the 120 million Americans who have received at least one coronavirus vaccine shot, few had issues.
  • Pfizer has ramped up their vaccine production and will deliver 10 percent more doses to the United States by the end of May than previously agreed, the company’s chief executive Albert Bourla said Tuesday.
3:25 a.m.
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For an Iraqi doctor, vaccination is bittersweet. It didn’t come in time for her father.

BAGHDAD — As the needle slipped through her skin, Tamara Amer opened her eyes as if waking from a dream. She had spent the car ride in a daze, thinking of her father and wishing he were there. She felt like she was in shock.

And then, with the prick of the needle — cold on her warm arm — the rush of feelings came back, she later recalled. There was sadness, hope and bittersweet joy. After she had spent a year of hell working daily in Iraq’s coronavirus wards, her mind was filled with the faces of patients they had lost there.

But most of all, she thought of her father, and how much they had dreamed of this day before the virus entered their home. Remembering him from her hospital chair in Baghdad this week, Amer burst into tears.

In Iraq, the arrival of coronavirus vaccines in recent weeks had given medical workers renewed hope that a route out of the pandemic was possible. Instead, the caseload is peaking. The country’s Health Ministry recorded 7,817 new cases Thursday, close to a record high, with health officials predicting that number would climb further as Iraq’s vaccination program stutters and coronavirus prevention measures like mask-wearing and social distancing are often adhered to only loosely, if at all.

2:25 a.m.
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After a pandemic year, it’s clear that it’s much safer to be outside

The photos of Clearwater Beach, Fla., went viral last spring: people crowded on the sand, seemingly unconcerned about the deadly new contagion coursing across the world. Local officials, accused of fueling a public health crisis, quickly shut 35 miles of county beaches and left them closed for weeks.

What a difference a year makes. The beaches were even busier this year, but officials say there were no talks of closure. There was also far less outcry.

And with good reason, according to many scientists and public health experts, who say that the outdoor spaces now warming under spring sun should be viewed as havens in the battle against a stubborn virus and restriction-induced fatigue. For more than a year, the vast majority of documented coronavirus clusters have been linked to indoor or indoor-outdoor settings — households, meatpacking plants, nursing homes and restaurants. Near-absent are examples of transmission at beaches and other open spaces where breezes disperse airborne particles, distancing is easier, and humidity and sunlight render the coronavirus less viable.

1:25 a.m.
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Americans may be able to travel this summer, but their European hosts likely won’t be vaccinated

Americans could soon be ready to travel the world again, and many countries are eager to welcome U.S. tourism dollars back. But with most of the world lagging behind the United States in vaccinations, there could be uncomfortable disparities between travelers and their hosts.

A possible preview of the dynamic unfolded in Spain over Easter, when German and French tourists filled flights to favorite island destinations, while frustrated Spaniards were subject to coronavirus restrictions that prevented them from moving beyond their home regions.

European travel is not yet an option for Americans. The European Union still bans nonessential travel from the United States, as it deems U.S. viral levels too high. Meanwhile, a third wave of the coronavirus has shut down many of Europe’s cities. Parisians can’t stray more than six miles from their apartments. Rome’s restaurants are closed to sit-down dining. Shops in Munich have been shuttered.

1:18 a.m.
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Why Biden health officials decided to pause J&J’s coronavirus vaccine

When top Biden administration health officials gathered on a Zoom call Monday night, they knew they faced a difficult decision. Six women in the United States had developed extremely rare but potentially life-threatening blood clots after getting the Johnson & Johnson coronavirus vaccine — a problem with disturbing parallels to the one in Europe linked to AstraZeneca’s vaccine.

Initially, some suggested the government could just issue a warning to consumers and doctors. They didn’t want to undermine confidence in vaccines given the danger of covid-19. But as they talked, two big worries emerged. They feared there might be additional cases of brain blood clots they didn’t know about. And what if the government didn’t act quickly, and as a result more people got the wrong diagnosis and treatment and were hurt or died?

Their unanimous agreement to recommend a pause in using the J&J single-shot vaccine early Tuesday morning set off a fierce debate. Critics suggested they were overreacting, predicting the result would be fewer people getting vaccinated and more dying of covid-19, the disease caused by the coronavirus. Others praised the federal officials for acting quickly on their concerns — especially since the conventional treatment with anticoagulant drugs can have serious harm. The argument suggested there are no easy answers in a pandemic that has posed one excruciating challenge after another.

12:25 a.m.
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D.C., Virginia, Maryland pause J&J coronavirus vaccine appointments

A Virginia woman who died after suffering from a rare blood clot is one of six cases federal authorities are examining to determine whether the illnesses are related to the Johnson and Johnson vaccine — an investigation that led them to recommend a nationwide pause on the one-dose regimen Tuesday.

Virginia Department of Health officials said they received word from the Centers for Disease Control and Prevention that the woman’s death was being examined by the agency as it investigates possible side effects of the Johnson & Johnson vaccine.

The Virginia woman, 45, died on March 18, according to the Vaccine Adverse Event Reporting System, the system the CDC uses to monitor symptoms after vaccinations. She received the vaccine on March 6 and began feeling ill six days later, according to the report. The woman, who was not identified, died after suffering from cerebral venous sinus thrombosis in conjunction with thrombocytopenia, or low blood platelets — the combination of conditions that federal officials are investigating.

11:25 p.m.
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More than two dozen states roll back J&J inoculations after FDA urges pause

More than a dozen states and U.S. territories reacted quickly to the FDA and CDC’s announcement on Tuesday, which called for a pause in the use of the Johnson & Johnson coronavirus vaccine while they review six U.S. cases of rare blood clots in people who had received the vaccine.

Alabama, Alaska, Arkansas, California, Florida, Illinois, Kansas, Georgia, Louisiana, Maryland, Massachusetts, Michigan, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Puerto Rico ceased distribution while the CDC and the FDA investigates the cases.

The District of Columbia canceled all Johnson & Johnson appointments for the next five days. New York said it would give Pfizer-BioNTech vaccine doses to those who were scheduled to received the Johnson & Johnson shots.

Arizona, Indiana, Maine, Minnesota, Ohio and Texas did not call for a hard stop, but advised all vaccine distribution centers to temporarily halt Johnson & Johnson dosing until there is more information. Delaware said it would pause the Johnson & Johnson inoculations at state-run sites and advise providers and pharmacies to also pause. North Dakota is “strongly urging” providers in the state to pause.

All six cases of blood clots occurred among women between the ages of 18 and 48, and symptoms occurred six to 13 days after vaccination, according to the CDC and FDA. The CDC will hold a meeting Wednesday to review the cases and assess their potential significance, the statement said. The FDA will continue to investigate the cases.

10:57 p.m.
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Biden, Obama to be featured on TV special to push coronavirus vaccinations

Biden and former president Barack Obama will appear in an hour-long television special on Sunday to encourage Americans to get vaccinated.

The “Roll Up Your Sleeves” special is set to air on NBC at 7 p.m. Eastern time and was created by ATTN:, a media company, alongside the nonprofit Civic Nation’s Made to Save initiative, a campaign launched this month to push for equitable access to vaccines and to bolster confidence in the shots, especially in communities hit hardest by the pandemic.

Biden will speak directly to the public during his appearance, urging Americans to get a shot when they can, according to a news release from Civic Nation. The appearance comes as the administration continues a vaccination campaign that includes television ads and a grass-roots network of leaders meant to encourage people to get their shots.

The television special will feature former first lady Michelle Obama, who will appear alongside Faith Hill, Jennifer Lopez and Lin-Manuel Miranda. Top infectious-disease expert Anthony S. Fauci will be interviewed by actor Matthew McConaughey. Barack Obama will appear with NBA stars Charles Barkley and Shaquille O’Neal. The special will also feature television doctors Eric Dane, Ryan Eggold, Ken Jeong, Ellen Pompeo and Jane Seymour, according to the release.

The slate of big-name appearances also includes Billy Crystal, Wanda Sykes, Sterling K. Brown, Lana Condor, Jennifer Hudson, Dale Jarrett, Joe Jonas, Eva Longoria, Demi Lovato, Joel McHale, Kumail Nanjiani and Amanda Seyfried, as well as Vin Gupta, a critical care pulmonologist at the University of Washington.

9:46 p.m.
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New pandemic-era $350 million aid program announced for D.C. rent and utility bills

Mayor Muriel E. Bowser (D) on Monday announced a $350 million assistance program for D.C. residents trying to pay past and future rent and utility bills.

The program — called Stronger Together by Assisting You (STAY DC) — will be funded by appropriations from Congress as well as money injected into the city by the American Rescue Plan, which was passed into law in March.

In a news release, Bowser said the purpose of the program is to help residents “pay their bills now so that they can stay in their homes once the public health emergency ends.”

The program’s launch comes as both tenants and small landlords in the District have stepped up their criticism of the District’s relief effort for tenants who are behind on rent but still shielded from eviction by the city’s pandemic-linked moratorium.

9:13 p.m.
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American Muslims grapple with their second Ramadan in the age of covid

While the start of quarantine last Ramadan shut down everything normal about the holy month, for Karim Amin, it also brought an unexpected heightened spirituality and creative intensity.

“It hurt not to be around everybody [last spring], but we did a lot of dope things,” said the Baltimore entrepreneur and activist.

As Ramadan begins Tuesday, Amin is navigating a maze of decisions, including whether and where to listen to the nightly taraweeh prayer, how close to stand to others if he goes in person and how many people to break fast with. Embedded in each of these choices is the same dilemma: how to make the holy month meaningful and communal when Muslims are going in all different directions about how to mark it.

Amin is just one of millions of American Muslims for whom the second pandemic Ramadan is a spiritual, medical and political morass.

8:37 p.m.
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D.C. expands vaccine eligibility to all but seeks to control appointments to boost equity

As eligibility for the coronavirus vaccine expanded to all D.C. adults on Monday, Mayor Muriel E. Bowser (D) made clear that the city will keep its focus on equity, despite demands from residents and businesses to open access as widely and quickly as possible.

“We have a system that we know is equitable and is getting the vaccine out,” Bowser said in response to a question about the health department telling pharmacies not to dole out appointments on their own.

The request, made last week, has frustrated independent pharmacy owners, who get doses directly from the federal government and have created their own sign-up systems to allocate them.

The city says it has been successful in reaching many of the people in greatest need of vaccination — last week, officials announced they had offered appointments to every senior citizen, essential worker, and adult with a qualifying health condition who had registered for a shot.

8:11 p.m.
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Biden tries to reassure Americans there are enough vaccine shots available amid Johnson & Johnson pause

President Biden sought to reassure Americans that there will be enough coronavirus vaccine shots for all eligible adults, even as federal health officials called for a pause in the use of the Johnson & Johnson inoculation.

Speaking to reporters in the Oval Office, Biden said the administration made sure it had 600 million doses of the Moderna and Pfizer vaccines. Both vaccines require two doses, meaning 300 million people would be fully vaccinated.

“So there is enough vaccine, that is basically 100 percent, unquestionable, for every single, solitary American,” Biden said.

He made the remarks as he was meeting with members of the Congressional Black Caucus.

Health officials called for a pause in the use of the Johnson & Johnson vaccine as they review reports of six U.S. cases of a rare and severe type of blood clot among the 6.8 million people who have received that vaccine.

Hours earlier, White House officials sought to deliver the same reassurances. Jeff Zients, the White House’s covid-19 response coordinator, said the administration’s call for a pause in the use of the Johnson & Johnson vaccine will not have a significant effect on the White House’s vaccination efforts.

“Let me start by saying that this announcement will not have a significant impact on our vaccination program,” Zients said during a news briefing at the White House, noting that the Johnson & Johnson vaccine has accounted for less than 5 percent of the 190 million shots already administered.

7:23 p.m.
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Muslims mark another Ramadan under coronavirus restrictions

Millions of Muslims around the world began observing the holy month of Ramadan on Tuesday, an introspective time of dawn-to-dusk fasts and prayer followed by communal feasts and family gatherings — and this year, once again, coronavirus restrictions.

Last year’s Ramadan arrived during the world’s first round of pandemic-related lockdowns. In many countries, mosques, like other places of worship, were closed, cutting off Muslims from the communal prayers, meals and charity work that distinguish the month-long holiday.

This year, some conditions have eased: Mosques in many countries have reopened, and clerics in places such as Saudi Arabia and Indonesia have emphasized that it is permitted to receive coronavirus vaccine shots while fasting.

But much of the world remains under some form of social restrictions as new surges, driven by virus variants, continue to necessitate limits on movement and gatherings.

6:38 p.m.
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South Africa suspends rollout of Johnson & Johnson vaccine

CAPE TOWN — South Africa on Tuesday suspended the rollout of its Johnson & Johnson coronavirus vaccine as a “precautionary measure” following a call by U.S. health officials to pause its use.

South African Health Minister Zweli Mkhize said the decision was made “out of an abundance of caution” following urgent consultations with government health officials and scientists.

He said no incidents of clotting have been reported in any of the 289,000 health-care workers who have received the vaccine.

“The feeling of all the bodies I have consulted with has been that because this announcement came from the FDA, we would need to collate as much info as possible before we continue with our own rollout,” Mkhize told reporters, referencing the U.S. Food and Drug Administration. “We’re not closing down on J&J. At this point, we think this is the best way to deal with it. It is a precautionary issue and not a permanent sensation of the entire program.”

Mkhize said the pause would not have a significant impact on the country’s vaccination program, which until now has focused on immunizing the country’s 1.25 million health-care workers.

“We’re hoping it will only be for a few days until we have enough information,” he said.

The country halted the planned rollout of the vaccine developed by AstraZeneca earlier this year after data showed it gave minimal protection against a new variant identified in the country late last year.

5:52 p.m.
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What you should do if you’ve received the Johnson & Johnson coronavirus vaccine

The medical issues that led to Tuesday’s recommended pause in administration of the Johnson & Johnson vaccine are exceedingly rare, government health officials said at a news conference.

Six women who received the vaccine are known to have suffered cerebral venous sinus thrombosis — a rare form of stroke — also had low platelet counts in their blood. Platelets help your blood clot to stop bleeding.

But the illness is severe. One of the six women has died, authorities said, and another is in critical condition. All the known cases are among women between the ages of 18 and 48.

So what should you look for if you are one of the 6.8 million people who have received Johnson & Johnson’s one-dose vaccine, or are scheduled to receive it soon?