Covid-19 Live Updates: U.S. Vaccinations Slow, Even as Caseloads Remain High

Covid wards in Michigan are filled with younger patients. A fire at a Baghdad hospital treating Covid patients kills dozens. The U.S. is under pressure to allow exports of vaccine components that India needs.

Vaccination rates are falling in the United States, despite the spread of highly contagious virus variants that are fueling the country’s alarmingly high caseload.

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More than 50,000 new U.S. cases were reported on Saturday, and case rates are similar to those of the second wave last summer. But the average number of vaccine doses being administered each day, which rose for months and peaked at 3.38 million, has now fallen to 2.86 million, its lowest level since March 31, according to data from the Centers for Disease Control and Prevention.

The vaccination rate stopped climbing on April 13, when federal health officials recommended pausing the use of Johnson & Johnson’s vaccine to allow researchers to examine a rare blood-clotting disorder that emerged in six recipients. The Food and Drug Administration lifted the pause on Friday, opting to add a warning about the risk to vaccine labeling.

Experts aren’t sure why vaccination rates have begun falling, or whether vaccine hesitancy, an issue before the Johnson & Johnson pause, is entirely to blame. They suggest the issue is more complicated. Many Americans who were eager and able to be vaccinated have now been inoculated, experts believe, and among the unvaccinated, some are totally opposed while others would get a vaccine if it were more accessible to them.

Whatever the reason for the slowdown in vaccinations, it could delay the arrival of herd immunity, the point at which the coronavirus cannot spread easily because it cannot find enough vulnerable people to infect. The longer that takes, the more time there is for dangerous variants to arise and possibly evade vaccines.

Elected leaders and public health officials are left struggling to tailor their messages, and their tactics, to persuade not only the vaccine hesitant but also the indifferent. As mass vaccination sites begin to close, more patients could get vaccinated by their own doctors, with whom people are most at ease — a shift that would require the Biden administration to distribute the vaccines in much smaller shipments to many more providers.

Resuming use of the single-shot Johnson & Johnson vaccine should help with hard-to-reach populations like Americans in remote communities, migrants and older people who may have difficulty leaving their homes.

White House and state health officials are calling the next phase of the vaccination campaign “the ground game,” and are likening it to a get-out-the-vote effort.

“We’re entering a new phase” in the country’s vaccination effort, said Dr. Mark McClellan, former commissioner of the Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University. “In most parts of the country now, there are unfilled vaccination appointments available.”

People who were clamoring for a vaccine have been inoculated, including those who were willing to schedule appointments and wait in long lines at mass vaccination sites, he said.

“Now, it’s more about bringing vaccines to the people who want them but haven’t been able to easily reach the existing sites,” Dr. McClellan said. Walk-in availability, which New York City allowed at city-run sites starting on Friday, could also help vaccinate more people, he said.

Dr. Ashish Jha, the dean of the Brown University School of Public Health, cautioned that it would be “hugely problematic” to broadly denounce those who had yet to get a vaccine — because of indifference or inconvenience — as “resisters.” He said on National Public Radio last week that “there are lots of people who are perfectly happy to get a vaccine but aren’t desperate for it — aren’t convinced that they need it badly.”

Rupali J. Limaye, a professor who studies vaccine behavior at Johns Hopkins Bloomberg School of Public Health, said as vaccinations continued, some might think: “If these other people are vaccinated, why do I need to get it?” but added, “We still need those people to get it to reach herd immunity.”

With temperatures getting warmer, many states have already eased social-distancing measures, and some have even appeared to return to normal activity, alarming officials. Dr. Anthony S. Fauci, the nation’s top infectious disease expert, has said that restrictions should remain in place until there are fewer than 10,000 new cases a day — a number that the United States will not reach by Aug. 1, according to projections from the Institute for Health Metrics and Evaluation at the University of Washington.

“It will feel over in the summer,” said Ali H. Mokdad, a professor of health metrics sciences at the institute. “But somebody like me who works in public health will feel like swimming upstream, telling people in the summer we are not out of danger.”

Hospitals in Michigan, the state with the worst current coronavirus outbreak in the country, are admitting about twice as many young adults with coronavirus now as they did during the fall peak, according to the Michigan Health & Hospital Association.

“I am putting more patients in their 20s and 30s and 40s on oxygen and on life support than at any other time in this pandemic,” said Dr. Erin Brennan, an emergency room physician in Detroit.

Public health experts say the outbreak — driven by the B.1.1.7 variant of the virus, which is more contagious and more severe — is spreading rapidly in younger age groups in the state.

Public health experts point to a number of factors contributing to the changing demographics. As pandemic restrictions have been loosened, younger people are out and about, socializing and in the work force, at a time when just one-third of American adults are fully vaccinated, most of them over 65.

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