U.S. Revises Plan to Send AstraZeneca Doses Abroad Amid Production Issues

Troubles at an Emergent BioSolutions plant have thrown a wrench into the Biden administration’s plans to share doses abroad.
Jim Lo Scalzo/EPA, via Shutterstock

With less than two weeks remaining to fulfill President Biden’s pledge to share 80 million doses of coronavirus vaccine with countries in need, production problems at an Emergent BioSolutions manufacturing plant are forcing the administration to revise its plan to send AstraZeneca doses overseas.

Officials are now working to replace tens of millions of doses of the AstraZeneca vaccine that it had initially planned to include in the donation with others made by Pfizer and BioNTech, Moderna and Johnson & Johnson, according to people familiar with the discussions. Those three vaccines are authorized for emergency use in the United States.

A pattern of serious lapses at the plant, in Baltimore, has thrown into question the fate of more than 100 million doses of both the AstraZeneca and Johnson & Johnson vaccines made there. The Food and Drug Administration is poring over records of virtually every batch that Emergent produced to determine if the doses are safe. The F.D.A. has so far ruled that about 25 million Johnson & Johnson doses made at the factory can be released but has made no decision on the AstraZeneca doses.

AstraZeneca’s vaccine is significantly cheaper than the other three vaccines: The federal government paid less than $4 per dose, compared to as much as $19.50 for Pfizer. An administration official said that if the AstraZeneca doses made by Emergent are declared safe, the supply will ultimately be shared with other nations.

The doses the administration is now working to send overseas this month will be a part of existing orders from the other manufacturers that have not been delivered to states, one person familiar with the planning said. Tens of millions of doses of the three authorized vaccines in the U.S. that have already been delivered are sitting unused. Over 175 million people in the U.S. have received at least one dose, according to the Centers for Disease Control and Prevention.

Until the White House announced last week that it would share 500 million doses of the Pfizer vaccine with the rest of the world, the AstraZeneca doses made up the bulk of the administration’s vaccine diplomacy commitments.

Mr. Biden committed in late April to sharing as many as 60 million doses of AstraZeneca’s vaccine with other nations, pending the F.D.A.’s ongoing review of Emergent. In May the White House said it would send at least another 20 million doses of other vaccines overseas, bringing the total to 80 million by the end of June.

Earlier this month, the White House explained how it would distribute an initial 25 million doses out of the 80 million across a “wide range of countries.” Millions of those have already been sent and more will be sent imminently, a White House spokesman said.

Jeffrey D. Zients, the White House’s Covid-19 response coordinator, said on Thursday that 80 million doses would be allocated by the end of the month, but did not specify what kind. He said the administration was working with other countries on complicated logistical issues, including securing needles, syringes and alcohol pads that would go with the doses.

“We’ll allocate all the initial 80 million doses in the coming days, with shipments going out as soon as countries are ready to receive the doses,” Mr. Zients said at a news conference. “There’ll be an increasing number of shipments each and every week as we ramp up these efforts.”

In order to share vaccines other than AstraZeneca’s, one person familiar with the plan said, the administration will likely need permission from the manufacturers. Those discussions are still ongoing, the person said.

A Palestinian receiving a vaccine this month in the village of Dura, near Hebron, in the West Bank.
Hazem Bader/Agence France-Presse — Getty Images

JERUSALEM — A deal to supply Palestinians with more than one million unused Israeli coronavirus vaccine doses collapsed Friday night, just hours after it was first announced, amid a public disagreement between the Israeli and Palestinian leaderships about whether or not the vaccines were too close to their expiry date.

The new Israeli government said Friday morning that it would give between 1 million and 1.4 million doses of the Pfizer-BioNTech vaccine to the Palestinian Authority in a trade that would see the authority donate a similar number back to Israel once its own supply arrives in September or October.

But the authority later rejected the entire deal after receiving a first tranche of about 100,000 doses on Friday evening. A spokesman for the authority, Ibrahim Melhem, said that the specifications of the doses did not conform to the agreement, and that they were too close to their expiry date to be administered in time.

The authority will instead wait for a direct delivery of four million new vaccines from Pfizer later in the year, Mr. Melhem said.

An Israeli official, who asked to remain anonymous because he was not authorized to speak publicly, said that the initial batch of doses would expire at the start of July, which was enough time for Palestinian health workers enough time to administer them.

The official added that the authority had been aware of their expiry date before agreeing to their delivery, and said the authority had only scrapped the deal because they had been criticized by Palestinians for agreeing to receive vaccines perceived to be of poor quality.

The official also said that none of the remaining 900,000 doses would have been delivered less than two weeks before their expiry date.

Negotiations over the deal began in secret several months ago, before Naftali Bennett’s new government succeeded that of Benjamin Netanyahu, who was replaced by a narrow vote in Parliament last Sunday.

The announcement follows months of debate about whether Israel, where a successful vaccine campaign has created a largely post-pandemic reality, has a moral or legal responsibility to give its spare vaccines to Palestinians in the West Bank and Gaza Strip, where infection rates are far higher.

In February and March, Israel gave vaccines to more than 100,000 Palestinians who work as day laborers in Israel, but resisted vaccinating millions of other Palestinians living under some form of Israeli control in the West Bank and Gaza.

Instead, the Palestinian Authority ordered several hundred thousand vaccine doses from the global sharing initiative, Covax, and several million from Pfizer-BioNTech. Separately, the United Arab Emirates donated tens of thousands of doses of Russia’s Sputnik V vaccine to Palestinians in Gaza.

Israeli officials said that the Oslo Accords, the interim agreements between Israel and Palestinian leaders signed in the 1990s, give the Palestinian Authority responsibility for its own health care system.

But rights campaigners noted that other parts of the Oslo Accords require Israel to work with the Palestinian leadership during an epidemic, while the Fourth Geneva Convention obliges an occupying power to coordinate with the local authorities to maintain public health within an occupied territory, including during epidemics.

Israel controls all imports to the West Bank, most of which is under full Israeli control, and shares control of imports to Gaza with Egypt.

Those who accepted Israel’s narrative about the donations said the authority’s refusal to accept the vaccines had dented claims that Israel was to blame for the slow vaccination rate among Palestinians. But those who believed the Palestinian narrative said that Israel had acted in bad faith by making the authority an offer that it had no choice but to refuse.

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With the nation unlikely to reach President Biden’s goal of having 70 percent of adults partly vaccinated against the coronavirus by July 4, he trumpeted a different milestone: 300 million shots given in his first 150 days.Stefani Reynolds for The New York Times

With the United States unlikely to reach President Biden’s self-imposed deadline of having 70 percent of American adults partly vaccinated against the coronavirus by July 4, he trumpeted a different milestone: 300 million shots administered in his first 150 days in office.

Mr. Biden spoke about the vaccination drive from the White House as his administration makes a last push to reach the July 4 goal. Vice President Kamala Harris and the health and human services secretary Xavier Becerra were both on the road Friday, trying to drum up enthusiasm about the vaccine. Ms. Harris was in Atlanta and Mr. Becerra was headed to Colorado.

“It’s an important milestone,” the president said, touting his administration’s work. “It just didn’t happen on its own or by chance.” He described the federal effort as the one of “biggest, most complicated logistical challenges in American history.”

Mr. Biden took office warning of a “dark winter” ahead, as deaths were near peak levels and vaccinations were barely underway, and he is clearly trying to portray the virus as in retreat as he nears six months in office. A fact sheet distributed by the White House in advance of Friday’s remarks noted that 15 states and Washington, D.C., have gotten at least 70 percent of adults one shot.

“The results are clear: America is starting to look like America again, and entering a summer of joy and freedom,” the document proclaimed.

When Mr. Biden set the July 4 goal in early May, he said meeting it would demonstrate that the United States had taken “a serious step toward a return to normal,” and for many people that already seems to be the case. This week, California and New York lifted virtually all of their pandemic restrictions on business and social distancing.

But the time frame is tight. An analysis by The New York Times shows that, if the rate of adult vaccinations continues on the seven-day average, the country will fall just short of Mr. Biden’s 70 percent goal, with 67.6 percent of American adults having had their first shot by July 4.

As of Friday, 65 percent of adults have had at least one shot, according to data from the Centers for Disease Control and Prevention. But the number of Americans getting their first shot has been dropping steadily, from about 500,000 a day to about 200,000 a day since Mr. Biden announced that June would be a “month of action” to reach his goal.

“I don’t see an intervention that could really bring back an exponential increase in demand to get the kind of numbers that we probably need to get to 70 percent,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health officials. “Every day it seems like it’s starting to trickle along. So I think realistically, probably the best thing we could do is to try to get to steady state at this lower level.”

Experts say that from a disease control perspective, the difference between 67 percent and 70 percent is insignificant. But from a political perspective, it would be the first time Mr. Biden has set a pandemic-related goal that he has not met. Mr. Biden has continually set relatively modest targets for himself and exceeded them, including his pledge to get 100 million shots in the arms of Americans by his first 100 days in office.

Annie Karni contributed reporting.

A passenger cruise ship at Port Everglades in Fort Lauderdale, Fla., last week.
Joe Raedle/Getty Images

A federal judge ruled on Friday that, beginning on July 18, the Centers for Disease Control and Prevention will no longer be allowed to enforce its rules intended to prevent the spread of the coronavirus on cruise ships in Florida.

The judge, Steven D. Merryday of the U.S. District Court for the Middle District of Florida, granted Florida’s request for a preliminary injunction blocking the C.D.C. from enforcing the rules in Florida’s ports, finding that they were based on “stale data” and failed to take into account the prevalence of effective vaccines.

The judge said that, from July 18, the rules “will persist as only a nonbinding ‘consideration,’ ‘recommendation’ or ‘guideline,’ the same tools used by C.D.C. when addressing the practices in other similarly situated industries, such as airlines, railroads, hotels, casinos, sports venues, buses, subways, and others.”

The ruling was a victory for Florida, a cruise industry hub, which had challenged the rules in April, arguing that they were crippling the industry and causing the state to lose hundreds of millions of dollars. Florida also argued that the C.D.C. had exceeded its authority and had acted “arbitrarily and capriciously” when it issued the rules last year.

“Today’s ruling is a victory for the hardworking Floridians whose livelihoods depend on the cruise industry,” the state’s attorney general, Ashley Moody, said in a statement. “The federal government does not, nor should it ever, have the authority to single out and lock down an entire industry indefinitely.”

Gov. Ron DeSantis of Florida called the ruling a “victory for Florida families, for the cruise industry, and for every state that wants to preserve its rights in the face of unprecedented federal overreach.”

“The C.D.C. has been wrong all along, and they knew it,” he said in a statement.

The C.D.C. did not immediately respond to a request for comment on Friday night. In his ruling, Judge Merryday gave the agency until July 2 to propose a “narrower injunction” that would allow cruise ships to sail in a timely fashion.

An observation area for those who just received a Covid-19 vaccine in Wuhan, China, this month. The country has administered more than 945 million doses, more than a third of the global total.
Getty Images

After a slow start, China’s Covid-19 vaccination drive is in full swing as the authorities chase the ambitious target of fully vaccinating 40 percent of the country’s nearly 1.4 billion people by the end of this month.

China has administered more than 945 million vaccine doses, more than a third of the global total, according to the New York Times vaccine tracker. With about 17 million shots injected every day this month, China is on pace to surpass a billion shots in the coming days.

The national campaign’s early lag came in part because China first prioritized vaccine exports and, because lockdowns and mass testing had largely tamed the virus, many Chinese felt little urgency about getting vaccinated. In mid-March, China had administered only about 65 million doses. In April, it was giving only 4.8 million doses per day.

Many Chinese had also been hesitant to get the shots, in part because of past scandals involving Chinese-made vaccines. Only domestically produced vaccines are being offered in the country.

To get its vaccine drive going, China pulled out its playbook for pandemic success: a top-down approach that relies on a mix of high-tech tools and old-fashioned, grass-roots mobilization — with some inducements thrown in.

Compared with the United States, where local officials have sought to boost inoculations by offering lures such as million-dollar lottery prizes and free weed, the incentives in China have been humbler. In Shanghai, one man received a bottle of water. In Anhui Province, officials have been handing out free eggs. A woman in Beijing got the equivalent of about $7 in cash.

But for some, a bigger driver appears to be widespread concern over an outbreak of the Delta variant of the coronavirus, a more transmissible version first identified in India, in the southern city of Guangzhou, which now appears to be ebbing. On Wednesday, the Guangzhou authorities reported no new local cases for the first time since the outbreak began in May.

Yuhui Li, a resident of the nearby city of Shenzhen, said she had initially been reluctant to get vaccinated because she was worried about potential side effects. She changed her mind after the outbreak in Guangzhou, she said, but demand was so high, she added, that officials in her neighborhood were no longer offering free eggs or rides to vaccination sites.

“I want to get vaccinated, but it’s really hard to make an appointment now,” said Ms. Li, 27, an assistant at a film production company.

In Guangdong Province, which encompasses Guangzhou, only 36 percent of the population had been fully inoculated by early June.

China has a long way to go before fully vaccinating 70 percent of the population, about 980 million people, which the authorities say they hope to achieve by the end of the year. To meet the target, China has cranked up production of the two main vaccines in use, those produced by the companies Sinovac and Sinopharm. Both vaccines appear to reduce the risk of severe Covid, though to a lesser extent than the vaccines made by Pfizer and Moderna.

Some cities are further along than others. In Beijing, the capital, more than 80 percent of residents 18 and older were fully vaccinated as of Wednesday. Given the uneven rollout, and the fact that most people have not received two doses, Chinese health experts have warned against loosening the country’s border controls, which remain among the strictest in the world.

GLOBAL ROUNDUP

Doses of AstraZeneca’s Covid vaccine being administered last month at a mosque in Cologne, Germany.
Thilo Schmuelgen/Reuters

BRUSSELS — AstraZeneca must send the European Union 50 million additional doses of its Covid vaccine by late September, a court in Brussels said Friday in a ruling on a bitter fight between the bloc and the Anglo-Swedish company. That is hundreds of millions fewer than the bloc demanded.

In another boost for AstraZeneca, the ruling said that failure to supply the smaller number of doses, on a timetable ending Sept. 27, would incur a penalty of €10 per dose (about $12) — and not that amount per dose per day, as the E.U. wanted.

The European Commission, the bloc’s executive arm, claimed victory in a part of the ruling that found that AstraZeneca chose not to use all means at its disposal to deliver the doses in the contract with the E.U., and compelled the company to make its best efforts to fulfill its obligations in the future. The contract was signed under Belgian law, putting the dispute in the hands of Belgian courts.

“This decision confirms the position of the Commission,” said the body’s president, Ursula von der Leyen. “AstraZeneca did not live up to the commitments it made in the contract. It is good to see that an independent judge confirms this.”

But the ruling eases pressure on AstraZeneca, and the company’s general counsel, Jeffrey Pott, said he was “pleased.”

The two sides could still appeal, but given their expressions of satisfaction, that seemed unlikely. Under Belgian law, a separate lawsuit over damages will be tried in September.

The ruling offered AstraZeneca a lift in a bruising year. Its cheap and easy-to-store shot has been used in 135 countries, including poorer nations, but the discovery of that a small number of recipients have developed exceedingly rare, serious blood clots has prompted some nations to place restrictions on its use.

The dispute with the E.U. began in January, when AstraZeneca, citing production problems, substantially cut its expected deliveries for the first quarter of the year, even as coronavirus cases were picking up across the continent. The vaccine, which the company developed with Oxford University, was the pillar of the E.U.’s vaccination plans, and officials accused AstraZeneca of using the promised doses to serve Britain, which had just left the bloc and had signed an earlier contract with the company.

On April 26, the bloc sued to compel AstraZeneca to deliver a total of 300 million doses by September, as it said the company had agreed to, and proposed penalties including €10 million (about $11.9 million) a day for each of four alleged breaches of contract, which could have rapidly ballooned into the billions. Following a court hearing last month, AstraZeneca accelerated its E.U. deliveries, and now, having sent 70 million doses, faces a maximum of €100 million in penalties.

But with its trust in AstraZeneca broken, the E.U. has shifted its reliance from AstraZeneca’s vaccine to Pfizer-BioNTech’s shot and mRNA vaccines in general.

In other news from around the world.

  • The European Union vaccine campaign has gathered speed in the last month, with about 55 percent of the adult population having received at least one shot. The bloc seems to be on track to fulfill its goal of having 70 percent of adults fully vaccinated by the end of July.

  • President Yoweri Museveni of Uganda announced new restrictions to help control a rising wave of cases just weeks after closing down schools and suspending public gatherings and prayers. The new restrictions, which went into effect Friday, include a ban on travel, except for cargo transport and essential workers. The restrictions will last for 42 days.

  • Fiji, the Pacific archipelago nation of about 900,000 people, is fighting a major outbreak. Leading health officials have asked Australia to deploy a medical support team to its capital, Suva. The government has so far resisted calls to impose a national lockdown, instead using local restrictions, to help contain the virus.

  • The final games of Europe’s biggest soccer championship may be moved out of London after Britain extended limits on travel and crowd sizes. The governing body that runs European soccer is in talks with the government regarding exemptions that would allow thousands of fans from overseas to watch the semifinal and final matches of the Euro 2020 at London’s Wembley Stadium next month. UEFA announced it has a contingency plan, but it added that it is confident the games will be played in London as planned.

  • In Taiwan, health officials in the central county of Miaoli have come under criticism for coronavirus-related restrictions that ban some foreign tech laborers from all non-essential travel. The regulations prevent migrant workers, largely from Vietnam and the Philippines, from leaving their dormitories unless going to and from work at several technology manufacturing companies, where there have been a cluster of cases. Activists say the measures are discriminatory, and workers fear that the cramped conditions could be a breeding ground for the virus.

  • The Delta variant, first found in India, is now the most prevalent version in Moscow. Quickly rising case numbers put Russia at risk of following in the path of other countries such as India that seemed to have squelched infections only to see a resurgence.

  • Britain made people in England ages 18 and older eligible to be vaccinated, Prime Minister Boris Johnson said on Friday. The broadening of eligibility comes days after a surge in cases of the highly transmissible Delta variant led Mr. Johnson to keep restrictions in place for an additional four weeks.

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After a year of tight coronavirus restrictions, the European Union recommended on Friday that its member states lift the ban on nonessential travel for visitors from the United States.Susan Wright for The New York Times

The European Union recommended on Friday that its member states lift the ban on nonessential travel for visitors from the United States, a move sure to be welcomed by Americans eager to travel to the continent after more than a year of tight restrictions.

The recommendation is nonbinding, and each member state can decide what regulations, including quarantines, to impose on visitors. Americans have been mainly barred from Europe as the United States grapples with one of the highest caseloads in the world.

The opening is also expected to provide relief for southern European countries that are highly dependent on tourism, including Italy and Portugal. Those countries pressed the European Commission, the executive arm of the European Union, to act so that the entire summer tourism season would not be hurt by the absence of Americans, who are considered relatively big spenders.

Despite the bloc’s recommendation, Europeans are still barred from entering the United States for nonessential travel even if they have been fully vaccinated, following a sweeping travel ban announced by President Donald J. Trump in March 2020 and extended in January by President Biden.

The formal decision on Friday was made by Europe’s economy ministers, who agreed to add the United States to a list of countries considered safe from an epidemiological point of view. That means that travelers from those countries should be free to enter the bloc, even if they are not fully vaccinated, on the basis of a negative PCR test for an active coronavirus infection.

But the European Union cannot compel member nations to open to American visitors. Each country is free to keep or impose more stringent restrictions, such as an obligation to quarantine upon arrival or to undergo a series of further tests.

Countries like Greece and Spain, more heavily dependent on tourism, already moved in recent weeks to reopen to tourists from outside the European Union, including from the United States. The European Commission criticized those early moves.

An early voting site was set up at SUNY Downstate Medical Center in Brooklyn on Wednesday. Vaccines will be available for voters there over the weekend.
Kirsten Luce for The New York Times

New York State will open nine pop-up coronavirus vaccination sites this weekend at or near early polling locations in ZIP codes that have relatively low inoculation rates, Gov. Andrew M. Cuomo’s administration announced on Friday.

New York has at least partially vaccinated 70.6 percent of the state’s adult population as of Thursday, according to federal data, and the number of new reported cases has declined steadily since March, according to a New York Times database. The governor relaxed virtually all remaining virus-related restrictions earlier in the week, though businesses still have the option of requiring customers and employees to follow health precautions.

But there are pockets of the state where the vaccination rate is far lower than that of the state as a whole. Mr. Cuomo’s administration, local officials and private entities have tried to encourage vaccinations through incentives like free tickets to baseball games and lottery tickets, and by making shots more accessible.

The new pop-up sites — coming as New York City prepares for its first mayoral primary with ranked-choice voting and other parts of the state hold their own electoral primaries on June 22 — are another way to make shots readily available, Mr. Cuomo said.

“We remain laser-focused on making the vaccine accessible in every community, and will go wherever New Yorkers go in order to reach them,” Mr. Cuomo said in a statement. He added that “these new pop-up sites at early voting locations will allow New Yorkers to perform two civic duties at once — casting their ballot and rolling up their sleeve.”

Vaccines will be available on Saturday at Columbia University Medical Center’s Russ Berrie Medical Science Pavilion in Manhattan; SUNY Downstate Medical Center in Brooklyn; Claremont Neighborhood Centers in the Bronx; the Gerard Carter Center on Staten Island; and the Rochdale Village Community Center in Queens. Based on state data, the vaccination rates in those ZIP codes ranges from about 40 to 54 percent.

Locations in Huntington Station on Long Island, Schenectady and Rochester will be open on Sunday. One site, in Buffalo, opened on Friday.

U.S. Revises Plan to Send AstraZeneca Doses Abroad Amid Production Issues 1
Seb Agresti

Although travelers last summer enjoyed the retro appeal of wide-open roads relatively free of crowds, this summer is likely to have distinctly 21st-century levels of traffic.

According to Transportation Security Administration checkpoint numbers, a survey of more than 1,000 respondents by a tire company shows that more than half of Americans plan to vacation only by car this summer, and that nearly 80 percent feel safer in a car than they do on a plane.

Here are a few things to keep in mind:

Pandemic laws — and culture — still vary from place to place. Several online tools can help clarify destination-specific rules about masks, distancing, capacity restrictions and more, including the Centers for Disease Control and Prevention’s Travel Planner and the AAA’s Covid-19 Travel Restrictions map.

Rental cars are scarce. Spokeswomen from Enterprise Holdings and Hertz both acknowledged the high demand and limited availability that have spawned a widespread rental car shortage.

In short: Research well, book in advance and brace for closures.

And prepare for what could be long stretches in the car. The $1.9 trillion stimulus bill that President Biden signed into law in mid-March, the American Rescue Plan, has allocated funds to state and local governments for transportation and infrastructure investments, so roadwork may be jamming up the highways. Distractions are in order; be sure to download the newest audiobooks and podcasts.

Police officers checking cars in Suva, Fiji, in late April. The island nation, with a population of about 900,000, now has more than 1,000 known active cases of the coronavirus.
Leon Lord/Agence France-Presse — Getty Images

The Pacific archipelago nation of Fiji has asked Australia to deploy a medical support team to its capital, Suva, as it battles one of the fastest-growing coronavirus outbreaks in the region.

James Fong, Fiji’s health secretary, said at a news conference this week, “The Australians will provide for contingency beyond our current surge preparations.”

“We have extra space to deploy for field hospitals, and we have extra critical-care capacity we have yet to activate,” he added. “They come to help us plan beyond that.”

Australia has not publicly responded to the request, but Fiji’s needs are acute: After months of virtually no community transmission, the country has been pummeled over the past eight weeks by the highly contagious coronavirus variant known as Delta.

A single infection in an isolation center has fueled a major outbreak after infected people attended funerals, weddings and kava ceremonies, at which people customarily drink from the same bowl, that turned into superspreader events.

Fiji, with a population of about 900,000, now has more than 1,000 known active cases, with five people having died from the virus, according to a New York Times database. The authorities on Friday reported 91 new cases.

About 26 percent of Fijians have received at least one dose of an AstraZeneca vaccine, with doses acquired through the Covax global vaccine initiative or donated by Australia and New Zealand.

The government in Fiji has resisted calls for a 28-day national lockdown, citing concerns about the economic effects, and instead imposed targeted local restrictions, including locking down hospitals, closing Parliament and restricting travel between urban areas.

In a televised address last week, Prime Minister Frank Bainimarama said that the risks of a lockdown were too great. “People’s jobs may never return,” he said. “We’d suffer structural unemployment through the permanent loss of industries and I cannot allow that to happen, and I will not.”

Already, some Fijians face shortages of food and medical supplies, leading to anti-lockdown protests in the region of Nadi. Humanitarian workers from Save The Children Fiji said that children were going hungry or surviving on canned fish and biscuits because their parents were unable to work.

“Many families have told us they are exhausted,” Shairana Ali, the organization’s director, said in a statement. “Many parents are going hungry to stretch out whatever little food they have to be able to feed their children.”

Administrating a vaccine this month to a farmer in the village of Minnar, north of Srinagar, in the Indian-controlled part of Kashmir.
Mukhtar Khan/Associated Press

SRINAGAR, Kashmir — As the Indian government struggles to expand a Covid-19 vaccination program dogged by shortages and bureaucratic missteps, its health workers in Kashmir are facing another challenge: attacks by residents.

In recent weeks, health workers in the Indian-controlled part of the region have reportedly been attacked multiple times for taking videos of vaccinations, including inside people’s homes. Many Kashmiris said that they did not want to be filmed because appearing in videos could indicate support for the Indian government and its policies.

Kashmir, a largely Muslim region of about eight million people, is claimed by both India and Pakistan, and many people in the restive part controlled by India have become disillusioned and angry toward the Hindu-controlled government in Delhi.

The Indian authorities have kept Kashmir under strict lockdown for much of the past two years, starting in August 2019 when the government revoked its semiautonomous status, and more recently because of the coronavirus.

The attacks, fueled by deep distrust of India’s policies, have threatened the vaccination campaign.

“It is as if they are not coming to vaccinate people, but to do P.R. for India,” said Imad Ahmad Reshi, a college student in the northern Kashmir town of Baramulla. He noted that the Indian government had previously blocked internet access in the region and had filed terrorism charges against Kashmiris for critical social media posts.

“Then they upload these videos and pictures on the same social media,” he added. “Everyone wants to get vaccinated, but why film it?”

India’s clampdown has disrupted daily life, with tourism and agriculture, the mainstays of Kashmir’s economy, taking a huge hit. Across the Kashmir Valley, roads are blocked with coils of glistening concertina wire.

Residents said that rumors on social media claimed that the Indian government was using images of vaccinations for “propaganda purposes.” Misinformation that the vaccines cause impotence also began to spread.

In one video captured by a vaccination team, a Kashmiri woman is heard telling a health worker that her husband would not get the vaccine. “Why are you shooting the video?” she asked. “Don’t take the video.”

As India tries to emerge from a devastating second wave of the coronavirus, officials say that they have vaccinated about 1.9 million people in Kashmir. Dr. Mir Mushtaq, an official with the health department of Kashmir, acknowledged that some health workers had taken videos and said that they had been instructed not to do so from now on.

But he said that most residents supported the vaccination campaign.

“We have ordered that no one should take videos or upload them on social media,” he said. “These are isolated incidents, and we have advised our people they should be sensitive to rights and privacy of the people.”