July 13, 2024


Travel Anywhere

Covid News: L.A. School System Is Expected to Issue Student Vaccination Mandate

Students at Normont Elementary on the first day of school in Los Angeles on Aug. 16.
Credit…Allison Zaucha for The New York Times

Los Angeles is poised to become the first major school district in the nation to mandate coronavirus vaccines for students 12 and older who are attending class in person.

The district’s elected Board of Education will meet Thursday afternoon to vote on the measure, which is expected to pass with broad support. The Los Angeles Unified school district is the second largest in the nation, serving over 600,000 students, and the mandate could set an important national precedent.

Students would need to receive their first vaccine dose by Nov. 21 and their second dose by Dec. 19, in order to begin the next semester fully inoculated. Those who turn 12 after those dates will have 30 days after their birthday to receive their first shot.

Students participating in in-person extracurricular activities will need to receive both shots by the end of October. The resolution mentions “qualified and approved exemptions” to the mandate, but does not offer details.

The district is offering an online independent study option for those who opt out of in-person learning this year, but so far, only a tiny percentage of students have chosen it.

The months between now and the vaccine requirement’s taking effect will allow the district to conduct outreach and educational programs for families. According to the Los Angeles County Department of Health, 58 percent of the district’s 12-to-18-year-olds have already received at least one vaccine dose.

Los Angeles Unified has been operating vaccine clinics in schools, and has the nation’s broadest school testing program, screening all students and staff members weekly. Masks are required for every individual on campus, both indoors and outdoors, and staff members must be vaccinated unless they qualify for one of the limited exceptions for serious medical conditions and sincerely held religious beliefs.

“Our goal is to keep kids and teachers as safe as possible and in the classroom,” said Nick Melvoin, a Los Angeles school board member, in a written statement expressing support for the resolution. “A medical and scientific consensus has emerged that the best way to protect everyone in our schools and communities is for all those who are eligible to get vaccinated.”

A key constituency supporting the student vaccine mandate is the city’s teachers’ union, United Teachers Los Angeles. Since the start of the pandemic, the group has pushed for stringent safety measures, and during the last academic year, a longer period of remote learning. Los Angeles and other districts in California were among the last in the country to reopen classrooms, and the union continues to ask for more aggressive quarantines for those exposed to the virus.

Initial data on infections at Los Angeles schools this year has been highly reassuring. According to a Los Angeles Times tracker based on district data, 1,620 active Covid-19 cases had been identified at schools as of Sept. 6; only 5 were linked to on-campus transmissions, at two schools.

While it is typically states, not individual districts, that mandate child vaccinations as a precondition of school enrollment, Los Angeles is not the first California district to lay out such a policy. The Culver City school system, a small district also in Los Angeles County, announced a student mandate last month, and other California districts are considering similar requirements.

Such efforts are likely to attract legal challenges.

The Food and Drug Administration has currently approved vaccines on an emergency basis for children 12 to 15 years old, but is expected to grant full approval in the coming weeks, which could pave the way for more school mandates nationwide.

President Joe Biden has addressed the nation about vaccines before, including this time in May.
Credit…Doug Mills/The New York Times

President Biden is expected on Thursday to detail his administration’s plan to put pressure on private businesses, federal agencies and schools to enact stricter vaccination mandates and testing policies as the Delta variant continues its spread across the United States, pushing the country’s daily average caseload over 150,000 for the first time since late January, overwhelming hospitals in hard-hit areas and killing roughly 1,500 people a day.

Mr. Biden, who was briefed by his team of coronavirus advisers on Wednesday afternoon, is set to deliver a speech at 5 p.m. that will address about six areas where his administration can encourage — or, at this point, push — more eligible Americans to receive vaccines, according to the White House. Officials offered few specifics, stressing that the plan was still coming together, but its underlying driver is the conviction that the only way to return to some sense of normalcy in the country is to get as many people vaccinated as possible.

“We know that increasing vaccinations will stop the spread of the pandemic, will get the pandemic under control, will return people to normal life,” Jen Psaki, the White House press secretary, told reporters on Wednesday. “That’s what our objective is, so we want to be specific about what we’re trying to achieve.”

When asked if Mr. Biden would be adding more detail to existing policies or would outline measures that would have an immediate and broad effect on Americans, Ms. Psaki replied, “It depends on if you’re vaccinated or not.”

Administration officials see signs that more people in the country are open to receiving shots — some 14 million got their first shots in August, four million more than the number logged in July, Ms. Psaki said. However, a sizable number of people remains unvaccinated. About 27 percent of the eligible U.S. population age 12 and older have not received any Covid vaccinations, according to data from the Centers for Disease Control and Prevention, and in some of the hardest-hit states the unvaccinated percentage is higher: 42 percent in Texas, for instance, and 38 percent in Florida.

About 1.3 million fully vaccinated people have received a third shot after federal officials approved them for people with compromised immune systems. Mr. Biden has publicly supported the idea of a broadening the availability of third shots as boosters for much more of the population, but health experts have advised the White House to hold off promoting that for now.

On Wednesday, Ms. Psaki said that the White House was working toward a plan for boosters, but did not give a time frame. She told reporters that Mr. Biden had chosen Thursday to deliver an extensive speech on the virus because he understood it was “top of mind for Americans” as they return to schools and offices.

The president will also be seeking to course-correct after a difficult month for his administration, directing the public away from a chaotic and violent end to the war in Afghanistan and back toward his administration’s efforts to curb a pandemic that has upended every facet of American life.

But amid renewed fears of the virus’s damaging effect on the economy and the prevalence of a troublesome variant, even Mr. Biden’s allies say it will take more than a speech to ease concerns that a wily virus has once again spiraled out of a president’s control.

“He ran on competence, bringing adults back into the room,” said Nick Rathod, a former domestic policy adviser to President Barack Obama. “This is something that he needs to take control of and show his level of competency. I think that’s why he was hired.”

A pregnant woman receiving a dose of Covid vaccine in Havana last month.
Credit…Ramon Espinosa/Associated Press

The coronavirus pandemic could “wipe away 20 years of hard-fought gains” in reducing maternal mortality in Latin America and the Caribbean, and countries in the region should prioritize those who are pregnant and those who have recently given birth in their vaccination campaigns, officials at the World Health Organization warned on Wednesday.

“So far, more than 270,000 pregnant women have become sick with Covid in the Americas and more than 2,600 of them — or 1 percent of those infected — have died from the virus,” Dr. Carissa F. Etienne, the director of the Pan American Health Organization, a division of the W.H.O., said at a news conference.

Pregnancy enhances vulnerability to respiratory infections, including Covid-19, and is associated with a higher likelihood of serious Covid symptoms.

Most countries have reported higher numbers of cases and deaths during pregnancy in 2021 than in all of last year, and in Mexico and Colombia Covid-19 has become the top cause of maternal death this year. Mexico, Argentina and Brazil have accounted for half of all maternal Covid-19 deaths in the Americas, Dr. Etienne said.

Her organization recommends that vaccinations be universal during the first trimester of pregnancy and for those who are breastfeeding, as breast milk confers the vaccine’s protection to newborns. That is guidance similar to that issued last month by the Centers for Disease Control and Prevention.

However, less than half of the countries in Latin America and the Caribbean have set out specific vaccination guidelines related to pregnancy and birth, Dr. Etienne said.

In Mexico which has prioritized shots during pregnancy for some time, Dr. Etienne said, “not a single vaccinated woman has died from Covid during pregnancy.”

However, the pandemic has decreased access to prenatal care, Dr. Etienne said, noting that at least 40 percent of the countries in Latin America and the Caribbean have reported disruptions to maternal and newborn care. And the region continues to suffer from a general shortage of vaccines. Only 28 percent of people in Latin America and the Caribbean have been fully inoculated against Covid-19, Dr. Etienne said.

In some countries in the region, the numbers are far lower, with one-quarter of them vaccinating less than 20 percent of their population. Venezuela has fully vaccinated a little more than 11 percent of its population; Guatemala and Nicaragua have fully vaccinated less than 10 percent of their people; and in Haiti, the percentage falls to less than 1 percent.

In the Caribbean, infections are dropping as a whole, although there is an increase in Covid-19 deaths in several islands, including Jamaica and Puerto Rico.

Infections are also rising in several Central American countries, including Costa Rica, Belize, and Guatemala, where half of hospitals are over capacity.

By contrast, in South America, with the exception of Venezuela, cases and deaths have been steadily dropping. Officials with the Pan American Health Organization did not address if testing volume in the region may have affected the number of reported cases.

“We are working jointly with the ministries of health and experts in the counties to study trends and the reasons as to why these decreases have continued,” said Ciro Ugarte, the organization’s director of health emergencies. “When cases decrease it’s because we are doing things well, which means we’re implementing the public health measures that have proven once and again that they still work.”

Now though, countries in the region need to be careful not to relax those measures, he said, “because that is a great opportunity for the virus.”

Sen. Elizabeth Warren wants Amazon to change search algorithms and stop directing shoppers to Covid-19 misinformation. 
Credit…Stefani Reynolds for The New York Times

Senator Elizabeth Warren of Massachusets sent a letter to Amazon this week demanding the company do more to stop “peddling misinformation about Covid-19 vaccines and treatments” through dubious products sold on the site.

The letter, addressed to Amazon’s chief executive, Andy Jassy, and dated Sept. 7, asserts that the online retailer’s search algorithm contributes to the spread of misinformation about Covid-19 by promoting books on the site’s best-seller list that are riddled with false facts about the pandemic and vaccines.

Ms. Warren said her staff had searched Amazon using terms including “Covid-,” ““Covid-19 vaccine” and “pandemic,” they found that the top results included books like “The Truth About Covid-19: Exposing the Great Reset, Lockdowns, Vaccine Passports, and the New Normal,” which contains multiple claims that have been proven false. The book was also labeled a best seller in Amazon’s “Political Freedom” books category.

One of the book’s authors, Dr. Joseph Mercola, was issued a warning letter by the F.D.A. in February accusing him of representing vitamin supplements for sale on his website as being effective against the coronavirus.

The searches by Ms. Warren’s office also yielded first-page results of books that claimed Covid-19 vaccines were “making people sick and killing them” and literature that touted ivermectin, a deworming drug normally used for livestock, “as a Covid-19 miracle cure,” which it is not.

“Collectively, this is an astonishing sample of misinformation that appeared in only a few potential searches relating to Covid-19,” the letter states.

A search by The New York Times came up with similar results.

Ms. Warren acknowledged that Amazon had removed “sponsored” search results for pandemic-related terms like the ones that used to pop up for KN95 masks and has made an effort to direct costumers to accurate information by placing a banner at the top of all pandemic-related searches linking to the Centers for Disease Control and Prevention’s website. “But the results of my staff’s review are nevertheless deeply troubling,” the senator wrote.

“As cases of Covid-19 continue to rise, Amazon is feeding misinformation loops through its search and ‘Best Seller’ algorithms, potentially leading countless Americans to risk their health and the health of their neighbors based on misleading and inaccurate information that they discover on Amazon’s website,” she added.

Ms. Warren asked Amazon to review its algorithms within 14 days and provide public reports on both the extent to which Amazon’s algorithms are directing consumers to books and other products containing misinformation and on a plan to change the algorithms.

“We are constantly evaluating the books we list to ensure they comply with our content guidelines,” an Amazon spokesperson said in a statement to The Times. “As an additional service to customers, at the top of relevant search results pages we link to the C.D.C. advice on Covid and protection measures.”




W.H.O. Calls for a Moratorium on Boosters Through End of the Year

The World Health Organization asked wealthy nations to hold off on distributing coronavirus booster shots to healthy people until at least the end of the year in an effort to reserve vaccine supplies for low-income nations struggling to access first-doses for their populations.

A month ago, I called for a global moratorium on booster doses, at least until the end of September to prioritize vaccinating the most at risk people around the world who are yet to receive their first dose. There has been little change in the global situation since then. So today, I’m calling for an extension of the moratorium until at least the end of the year to enable every country to vaccinate at least 40 percent of its population. Globally, 5.5 billion vaccine doses have now been administered. But 80 percent have been administered in high- and upper-middle income countries. Because manufacturers have prioritized or been legally obliged to fulfill bilateral deals with rich countries willing to pay top dollar, low-income countries have been deprived of the tools to protect their people. There has been a lot of talk about vaccine equity, but too little action. High-income countries have promised to donate more than a billion doses. But less than 15 percent of those doses have been materialized. Manufacturers have promised to prioritize Covax and low-income countries. We don’t want any more promises. We just want the vaccines.

Video player loading
The World Health Organization asked wealthy nations to hold off on distributing coronavirus booster shots to healthy people until at least the end of the year in an effort to reserve vaccine supplies for low-income nations struggling to access first-doses for their populations.CreditCredit…Esteban Biba/EPA, via Shutterstock

The United Nations-backed program to vaccinate the world against the coronavirus slashed its forecast for doses available in 2021 by roughly a quarter on Wednesday, another setback for an effort that has been hampered by production problems, export bans and vaccine hoarding by wealthy nations.

Shortly after the forecast was released, the World Health Organization asked wealthy countries to hold off on administering booster shots for healthy patients until at least the end of the year as a way of enabling every country to vaccinate at least 40 percent of their populations. The organization had previously called for a booster shot moratorium until the end of September.

“I will not stay silent when the companies and countries that control the global supply of vaccines think the world’s poor should be satisfied with leftovers,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, told reporters on Wednesday.

In its latest projection, the global immunization program, known as Covax, said that it expected to have a total of 1.4 billion doses available by the end of 2021. In June, the program had said that it expected to have access to 1.9 billion doses this year. Experts have said 11 billion are needed to slow the spread of the virus.

Covax blamed uncertainty around when vaccine exports would resume from a major manufacturing site in India, along with problems scaling up production of the AstraZeneca and Johnson & Johnson vaccines and a delay in the clearance of the Novavax shot.

“Covax is making strenuous efforts to address and mitigate these risks,” the program said, citing negotiations with the Indian government, whose decision to halt vaccine exports this spring rattled the program, as well as efforts to convince manufacturers to stop prioritizing individual countries over Covax.

The program was beset by difficulties last year as rich nations became rivals in a vaccine-buying race, paying premiums to secure their own shots while slow-walking financial pledges that Covax needed to sign deals. More recently, it has also struggled with the financing needed to get doses into people’s arms, even as the Biden administration pledged hundreds of millions of doses. Last week, the White House, which is under pressure to do more to address the pandemic, said it would invest $2.7 billion to ramp up domestic production of critical vaccine components as part of President Biden’s push to make the United States the “arsenal of vaccines for the world.”

Asked about the W.H.O.’s push to extend a moratorium on booster doses, Jen Psaki, the White House press secretary, reiterated on Wednesday that the Biden administration saw picking boosters over donating vaccines as “a false choice.”

“Our view is we can do both,” Ms. Psaki said, adding that the United States had already donated or shared about 140 million doses with more than 90 countries, more than all other nations combined, and planned to donate hundreds of millions more.

Dr. Tedros said on Wednesday that some vaccine makers and wealthy nations were using distribution problems as an excuse not to make deliveries. But health officials and people involved in Covax have said that those very delivery delays are contributing to distribution problems by making it impossible for poorer countries to plan their inoculation campaigns.

So far, Covax has delivered 245 million doses — most free to poorer nations, with the rest to countries like Canada that paid their own way. In January, the program had planned to have at least 785 million doses available by now.

Worldwide, 81 percent of shots that have been administered have been in high- and upper-middle-income countries, according to the Our World in Data project at the University of Oxford. Only 0.4 percent of doses have been administered in low-income countries. At a meeting this week with wealthy nations’ health ministers, Dr. Tedros said that he asked them, among other things, to divert their short-term vaccine deliveries to Covax and to fulfill their dose donation pledges by the end of September.

Parents in Mexico are fighting a government program that restricts vaccination to people over the age of 18, though regulators have approved shots for use in children as young as 12.
Credit…Joebeth Terriquez/EPA, via Shutterstock

Hundreds of parents in Mexico are asking for court injunctions to have their children vaccinated against Covid-19 before they return to school, because the government is yet to offer a shot to people ages 12 to 18 even though they are authorized to receive it.

The legal battle is taking place as the more transmissible Delta variant has pummeled Mexico, where only 28 percent of the population is fully vaccinated. The country is recording some of its highest daily caseloads of the pandemic, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University.

President Andrés Manuel López Obrador’s administration wants all students to return to school for in-person classes, which have been suspended for almost a year and a half. The Pfizer vaccine was approved in Mexico for use in children age 12 and above in June, but so far only those age 18 and above have been able to get shots.

In the United States and various Latin American countries, vaccinations for children age 12 and above are well underway. But Mexican officials have downplayed the risk of the virus for minors, saying older people still waiting for their doses should be given priority.

Alma Franco, a lawyer from the southern region of Oaxaca, was one of the first parents to sue and win an injunction. When she was granted the vaccine for her 12-year-old son, she tweeted a photo of the constitutional appeal, or “amparo,” a legal process used in Mexico. In her appeal arguing that her son should be entitled to vaccination, Ms. Franco cited both the Health Department’s approval for the Pfizer vaccine and Mexico’s laws around equal medical care.

Since then, she said, about 1,000 parents from around the country have emailed her asking how they can do the same.

“Most of the parents who have asked me for the amparo are just worried about what’s happening at a global level, and particularly in Mexico,” Ms. Franco said.

Hugo López-Gatell Ramírez, the deputy health minister who is running Mexico’s response to the coronavirus, said at a news conference on Tuesday that 262 legal appeals have been filed by parents since August, with the number rapidly increasing. He said that although he understood why parents want to ensure their children are vaccinated, every dose given to a student because of judicial action would otherwise have gone to someone with a higher risk of dying from Covid-19.

“Scientific evidence is abundantly clear and consistent that those who have the highest risk of severe Covid, hospitalization, intubation and death are older people,” Mr. López-Gatell said. “There is a scale where the risk is progressively decreasing for younger ages.”

The new school year in Mexico began on Aug. 30, and the Mexican department of public education released a statement on Tuesday saying that 12 million students 18 and under were attending classes in over 135,000 schools. Entering the second week of the academic year, 88 schools have had coronavirus cases, and 39 had closed “as a preventive measure,” Delfina Gómez Álvarez, the secretary of education, said in the statement.

Credit…Cooper Neill for The New York Times

Three Vermont state troopers accused of being involved in a fake Covid-19 vaccination card scheme have resigned amid a federal investigation, the authorities said.

The troopers, Shawn Sommers, Raymond Witkowski and David Pfindel, were suspected of having “varying roles” in the production of fraudulent coronavirus vaccine cards, the Vermont State Police said in a news release on Tuesday.

Mr. Sommers and Mr. Witkowski resigned on Aug. 10, a day after another trooper raised concerns with supervisors about their conduct, the police said. Mr. Pfindel resigned on Sept. 3 after an investigation by the state’s Department of Public Safety.

The Vermont Troopers’ Association, an organization that represents troopers, detectives and sergeants of the Vermont State Police, did not immediately respond for comment on Wednesday morning.

“The accusations in this case involve an extraordinary level of misconduct — a criminal violation of the law — and I could not be more upset and disappointed,” Col. Matthew T. Birmingham, the director of the Vermont State Police, said in a news release.

In August, Gov. Phil Scott of Vermont announced that some state employees who work with vulnerable populations would be required to get vaccinated against Covid-19. About 77 percent of people ages 12 and older have been fully vaccinated, according to a Times database.

As businesses and states reopen amid rising cases of the virus, many have required vaccination cards as proof that someone has been inoculated against Covid-19. Instead of getting vaccinated, some people have turned to faking that proof. In March, the federal Department of Health and Human Services’ Office of Inspector General and the F.B.I. issued a public service announcement to warn the public that selling fake vaccination cards with a government logo on them is a crime.

In July, a homeopathic doctor in California became the first person to face federal charges for selling fake Covid-19 vaccination cards. And in May, the owner of a bar in California was arrested on charges that he had sold fake Covid-19 vaccination cards.

The authorities in Greece are investigating 10 vaccination centers across the country on suspicion of issuing fake vaccination certificates for Covid after dozens of forged documents were linked to health centers and hospitals.

There is a high rate of vaccine hesitancy in Greece, even as experts warn of infection rates rising following the return to the cities after summer holidays on the islands.

At one health center in the small town of Palamas in central Greece, 44 fake certificates were issued in August alone and have been traced to an administrative employee who is being sought by the authorities. Five employees of a hospital in Thessaloniki, Greece’s second city, were suspended after using fake certificates to dodge vaccination which is obligatory for health workers. And a doctor in Messolongi in western Greece, is under scrutiny after using a sample from a patient with Covid to issue an antibody certificate to a colleague, according to local news media reports.

Ιt is thought that the real number of fake certificates is much higher, and Greece’s national transparency authority is seeking to determine whether they are the work of nationwide forgery rackets similar to rings under investigation in France and elsewhere.

The Greek government passed a law this week imposing a 5,000-euro ($5,900) fine for each instance of fraud. The same fine applies to individuals caught using fake certificates to go to work or gain entrance to cafes or leisure venues only serving the vaccinated.

“We won’t allow anyone to defraud the system and put public health at risk,” Greece’s health minister Thanos Plevris said on Monday.

About 54 percent of the population of 10 million has been fully vaccinated, compared with an average of 69.4 percent in the 27-nation European Union. More than 6,000 Greek health workers have been suspended without pay in the past week after refusing to get the jab in contravention of a new law obliging them to get the vaccine.

— Niki Kitsantonis

Piazza San Marco in Venice in July. Italy has reintroduced some restrictions for U.S. travelers.
Credit…Giulia Marchi for The New York Times

Italy now requires travelers from the United States to take a test before arrival, and unvaccinated American visitors must isolate for five days. Sweden is barring all nonessential U.S. visitors. The Netherlands says vaccinated travelers must isolate after arriving from the United States — and unvaccinated ones are not welcome.

In removing the United States from a safe list of countries whose residents can travel without coronavirus testing or quarantine requirements, the European Union last week opened the door to myriad rules, restrictions and hurdles for travelers, with the bloc’s member countries implementing different measures.

The surge of coronavirus deaths and hospitalizations in the United States has led some countries — including Bulgaria, Italy, the Netherlands and Sweden — to enforce new obstacles, and the list could grow.

The E.U. suggestion to reimpose restrictions on unvaccinated U.S. travelers is not binding, however, and many European governments have yet to act on it. Some may even choose to ignore it entirely, creating confusion for travelers.

For questions about requirements in a given European Union member state, the best answers can usually be found on the website of its U.S. Embassy. Most, including France, Spain and Germany, still welcome travelers from the United States without much hassle.

It is different for a few others, and that’s where the confusion starts.

For instance, any traveler from the United States, no matter their nationality, is prohibited from entering Bulgaria “unless they meet an exception,” according to the U.S. Embassy in Sofia. Those exceptions include students with a visa, citizens from an E.U. country, and foreign officials or medical professionals.

In Italy, meanwhile, the U.S. Embassy in Rome states that vaccinated travelers must take a virus test 72 hours before arrival, and that unvaccinated ones must isolate for five days. France has no travel restrictions on American visitors, but a “health pass,” based on testing or proof of vaccination, is needed to access cultural venues, restaurants or bars, among other places.

These varying measures, which can appear dizzying to non-Europeans, reflect a reality that the pandemic has only amplified: As much as the European Union strives to present a unified front on many issues, the bloc is made of 27 member countries with diverging — sometimes competing — interests, and facing different epidemiological situations.

After the European Union closed its external borders in March last year, it urged member states to reopen to U.S. travelers and some others in June, hoping that a revival of tourism would boost E.U. economies.

Yet some countries had already moved ahead, while others waited for the recommendations from E.U. officials. A similar scenario is at play with the new travel guidelines. And the hurdles don’t only affect travelers from the United States or other non-European countries; some member states have implemented new measures for travelers coming from other E.U. countries, too.

Overall, the European Union has fared better than the United States in vaccinations: 70 percent of the E.U. adult population has been fully inoculated, compared with 64 percent in the United States.

And while the more transmissible Delta variant of the virus is becoming dominant in Europe, case numbers across most of the continent have not yet resurged to the levels seen in the United States.

Yet just as the virus’ spread varies across U.S. states, E.U. member countries are seeing divergent outbreaks. More than 83 percent of Belgium’s adult population has been fully vaccinated against the coronavirus, for instance, but only 20 percent have been inoculated in Bulgaria, which has one of the highest death rates in the world and has lately faced a surge of hospitalizations and deaths.

United Airlines employees at O’Hare International Airport in Chicago.
Credit…Nam Y. Huh/Associated Press

United Airlines, one of the first large businesses to require employees to be vaccinated against the coronavirus, said Wednesday that it would impose strict limits even on workers who are granted exemptions from the rule.

Any employee who is allowed to remain unvaccinated for religious or medical reasons will be placed on leave, in many cases unpaid, starting Oct. 2, United said. Workers who are not granted exemptions face being fired unless they get their first shot by Sept. 27 or are fully vaccinated within five weeks of receiving the denial.

“Our highest priority through the pandemic — and the sole reason we instituted a vaccine requirement for every U.S. employee at United Airlines — has been to keep people safe,” Kirk Limacher, a United human resources executive, said Wednesday in a memo to employees who had requested exemptions.

The policy addresses a big question facing large businesses that have announced vaccine mandates in recent months: How will companies police the use of religious or medical exemptions?

United, which announced its mandate last month, is reviewing such requests. Those who are approved for medical exemptions will be placed on medical leave, which may be paid depending on the airline’s collective bargaining agreements. Those who are approved on religious grounds will be placed on unpaid leave.

When exempt employees will be allowed to return to work will depend on their role. Customer-facing employees, including pilots, flight attendants and gate agents, will not be allowed to return until the “pandemic meaningfully recedes,” Mr. Limacher wrote.

Those who have operational roles, but who do not regularly interact with customers, will be allowed to return once the airline puts new safety protocols in place, such as mask requirements and regular testing. The airline expects to provide an update on such policies by mid-October, but noted that the return-to-work date for those workers “might be significantly later.”

Workers in administrative or managerial roles will also be allowed to return only once the airline decides on appropriate safety protocols. Those employees are generally required to work from the office at least some days, so working permanently from home is not an option, the airline said.

United did not say how many employees had submitted proof of vaccination. The company said about half of those who were unvaccinated when the mandate was announced a month ago had since received shots.

The airline said last month that about 90 percent of pilots and 80 percent of flight attendants were vaccinated. Those employees had received incentives that United later extended to more workers.

Other businesses have taken a different approach to encourage employees to get vaccinated. Delta Air Lines said last month that it would not require vaccines, but that it would impose penalties on unvaccinated workers, including a $200 monthly health insurance surcharge, an approach that comes with more legal complications than a mandate.

Waiting in line for the Covid-19 vaccine in Pamplona, Spain, earlier this month. The country has authorized an extra shot for people with weakened immune systems.
Credit…Alvaro Barrientos/Associated Press

Spain has become the latest nation to authorize an extra shot of a Covid-19 vaccine for people with weakened immune systems, joining a growing trend by countries to move toward additional doses.

The World Health Organization has warned that booster programs could divert supplies needed by largely unvaccinated countries, but agency officials have taken pains to distinguish between booster shots used to shore up immunity in vaccinated populations and additional doses that may be needed by the immunocompromised to develop immunity in the first place.

The decision in Spain, announced on Tuesday by the country’s health regulator came after the European Medicines Agency, the E.U.’s drug regulator, said there was no urgent need to give booster doses of Covid-19 vaccine to fully inoculated individuals without underlying health issues, citing a report from the European Center for Disease Prevention and Control. But, the agencies added, extra doses should be considered for those with weakened immune systems, and as a precautionary measure for frail older adults, especially those living in nursing homes.

The agency said that at this time, top priority should go to getting unvaccinated people shots. The drug regulator is continuing to assess data on booster shots.

On Wednesday, the W.H.O. asked wealthy countries to hold off on administering booster shots for healthy patients until at least the end of the year as a way of enabling every country to vaccinate at least 40 percent of their populations. The organization had previously called for a booster-shot moratorium until the end of September.

Several countries, including the Czech Republic, France, Germany and Israel, have already announced or begun booster programs for specific groups. The United States has cleared extra shots for people with weakened immune systems who had gotten the two-dose vaccines made by Pfizer-BioNTech or Moderna. But top health officials advised the White House this month to scale back moves toward a wider booster program for most Americans in order to give more time to review the scientific data.

Despite the flurry of booster programs in wealthier nations, the science of whether they are needed is not yet clear. Experts generally agree, however, that a third shot is warranted for people with compromised immune systems, who may not have mounted a strong immune response to the initial doses. Several countries are now offering additional shots to this vulnerable group.

In its statement, the Spanish regulator said that it had so far not gathered evidence demonstrating that an additional shot should be made available more widely as a booster. It also did not estimate how many people were considered vulnerable enough in terms of their immunity systems to warrant a third dose now, but stressed that this extra shot for that group should preferably be administered using the same vaccine already given to the individual, at least 28 days after the last shot. Since late 2020, Spain has used four different coronavirus vaccines: those made by Pfizer and BioNTech, Moderna, AstraZeneca, all of which take two doses, and the one from Johnson & Johnson, which is a single-shot vaccine.

Spain has been among the European leaders in terms of vaccination rollout, with over 34 million people, equivalent to 72.5 percent of its population, vaccinated as of Tuesday, according to data from the health ministry.

Receiving a vaccine in Bethlehem in August.
Credit…Samar Hazboun for The New York Times

The Palestinian Authority has banned weddings, mourning tents and other gatherings, taking measures to stem the most significant outbreak of the coronavirus in the occupied West Bank in months.

An average of 1,074 infections have been recorded daily over the past week by the Health Ministry, the highest seven-day average in the territory since at least April. Serious cases of the virus have also jumped, with the number of hospitalized people increasing more than sevenfold in the past month, according to ministry data.

The ban on gatherings is scheduled to come into effect on Monday. Officials had originally said it would begin this week, but elected to postpone the date to allow people who had already reserved wedding halls this weekend to celebrate, said Ghassan Nimr, a spokesman for the Interior Ministry.

Wedding hall owners, who have closed their businesses for much of the pandemic, expressed frustration that they would need to close once again.

“I have 20 employees: What am I supposed to tell them?” said Hanna Abu Alees, the owner of the Golden Roof Hall in Bethlehem. “Should I say go home and good luck finding a way to feed your families?”

Mr. Abu Alees, 73, said he had been trying to limit the spread of the virus at his facility by distributing masks and hand sanitizer during events and capping attendance at 300 to 400 people, less than the 1,000 it can hold.

Health Minister Mai al-Kaila suggested on Tuesday that the authority could enact even more restrictive measures if the virus continues to spread widely.

“As the health minister, I can’t hold on to a mask for everyone and give a mask to everyone,” Ms. al-Kaila told government-run television. “In order to not close the country, let us follow the guidelines,” she said, adding that vaccinations and social distancing are not “a big deal and it should be a matter of personal responsibility.”

While many Palestinians have expressed skepticism about getting vaccinated, the number of people in the West Bank receiving inoculations has risen in recent weeks since the government announced that public sector employees who did not get the shots would be placed on unpaid leave until the end of the pandemic. The Transportation Ministry has also said that people must present vaccination certificates to receive services like renewing licenses or vehicle registration.

More than 820,000 people in the West Bank, whose population is estimated to be about 2.75 million, have received at least one dose, according to Health Ministry statistics.

The Macy’s Thanksgiving Day Parade in 2019.
Credit…Brittainy Newman/The New York Times

Participants in the Macy’s Thanksgiving Day Parade must be masked and vaccinated, with a few exceptions, the company said on Wednesday, as the annual tradition plans a return to a version of its old self this November after a muted performance last year.

The announcement is the latest sign that New York is determined to resume some semblance of normalcy even as it grapples with the spread of the highly contagious Delta variant of the coronavirus.

Macy’s said its 95th celebration would travel a longer route than the one block it was confined to in 2020 and bring in marching bands and other groups that were unable to perform last year. It will allow 80 to 100 handlers for its giant character balloons after reducing the number last year.

The company said that it anticipated thousands of participants again, though fewer than its typical 8,000, and that all volunteer participants and staff must be fully vaccinated. They must also wear face coverings, with some exceptions for performers, and maintain social distancing throughout much of the event.

The pandemic upended traditions including festivals and Santa Claus meetings last year, and the parade became largely a television event as many spectators were told to stay home and the parade route shrank from its usual two-mile stretch. Some balloons even had flights that were pretaped for broadcast. A representative for Macy’s said the company was still determining this year’s route but expected that it would be closer to two miles.

“We applaud Macy’s work to creatively continue this beloved tradition last year,” Mayor Bill de Blasio said in a statement, “and look forward to welcoming back parade watchers to experience it safely, live and in person this November.”