NASHVILLE — Public health departments have held vaccine clinics at churches. They have organized rides to clinics. Gone door to door. Even offered a spin around a NASCAR track for anyone willing to get a shot.
Still, the United States’ vaccination campaign is sputtering, especially in the South, where there are far more doses than people who will take them.
As reports of new Covid-19 cases and deaths nationwide plummet and many Americans venture out mask-free, experts fear the virus could eventually surge again in states like Alabama, Louisiana and Mississippi, where fewer than half of adults have had a first shot.
“I don’t think people appreciate that if we let up on the vaccine efforts, we could be right back where we started,” said Dr. Jeanne Marrazzo, the director of the Division of Infectious Diseases at the University of Alabama at Birmingham.
A range of theories exist about why the South, which as of Wednesday was home to eight of the 10 states with the lowest vaccination rates, lags behind: hesitancy from conservative white people, concerns among some Black residents, longstanding challenges when it comes to health care access and transportation.
The answer, interviews across the region revealed, was all of the above.
“There’s no magic bullet. There’s no perfect solution,” said Dr. W. Mark Horne, president of the Mississippi State Medical Association.
Time is of the essence, both to prevent new infections and to use the doses already distributed to states. Coronavirus variants are spreading, especially the highly transmissible and increasingly prevalent Delta variant, first detected in India. And millions of Johnson & Johnson vaccine doses will expire nationwide this month, prompting some governors to issue urgent pleas that health providers use them soon.
From rural Appalachia to cities like Birmingham and Memphis, the slowdown has forced officials to refine their pitches to residents. Among the latest offerings: mobile clinics, Facebook Live forums and free soccer tickets for those who get vaccinated.
RIO DE JANEIRO — Officials at the World Health Organization on Wednesday repeated their calls for the world’s governments to accelerate plans to distribute coronavirus vaccines to hard-hit nations, warning that many countries in Latin America continued to see rising caseloads.
“Across our region, this year has been worse than last year,” said Dr. Carissa F. Etienne, the director of the Pan American Health Organization, which is part of the W.H.O. “In many places, infections are higher now than at any point in this pandemic.”
The comments came as President Biden prepared to announce that his administration would buy 500 million doses of the Pfizer-BioNTech vaccine and donate them among about 100 countries over the next year, according to people familiar with the plan. Mr. Biden could announce the arrangement as early as Thursday, as he begins his first trip abroad as president.
It is not yet clear which countries the 500 million vaccine doses would be supplied to, but Latin America is among the regions where the need is urgent. Eight of the 10 countries with the highest rate of Covid deaths per capita are in Latin America and the Caribbean, according to the Center for Systems Science and Engineering at Johns Hopkins University.
And even as hospitals in Argentina, Chile, Uruguay and other nations where the virus continues to spread aggressively have created overflow facilities, health care systems in several nations in the region are struggling to cope, Dr. Etienne said during the W.H.O.’s virtual news conference on Wednesday morning.
“Despite the doubling or even the tripling of hospital beds throughout the region, I.C.U. beds are full, oxygen is running low and health workers are overwhelmed,” she said.
Most governments in Latin America are struggling to acquire enough doses to quickly inoculate their people, which will delay their ability to fully reopen economies, officials said.
Last week, Mr. Biden said that the United States would distribute 25 million doses this month to countries in the Caribbean and Latin America; South and Southeast Asia; Africa; and the Palestinian territories, Gaza and the West Bank. Those doses are the first of 80 million that Mr. Biden pledged to send abroad by the end of June.
Dr. Etienne said that only a more equitable distribution system would put an end to the pandemic in the foreseeable future.
“Today we’re seeing the emergence of two worlds, one quickly returning to normal and another where recovery remains a distant future,” Dr. Etienne said. “Unfortunately, vaccine supply is concentrated in a few nations while most of the world waits for doses to trickle down.”
She singled out the vaccine shortage in Central America, home to more than 44 million people, where just over two million have been inoculated. Fewer than three million people have been vaccinated in nations in the Caribbean, which has a population of just over 34 million.
global round up
The Singaporean government said on Thursday that it would ease some social restrictions after nearly a month of tough measures to contain a coronavirus outbreak fueled in part by the Delta variant, first detected in India.
The city-state also said that it would expand its vaccination campaign, allowing Singaporeans ages 12 and older to register for shots beginning on Friday and extending eligibility to the rest of the population in the coming months.
The announcement came a day after the nation of 5.7 million recorded just two new coronavirus cases, the lowest number in months. In mid-May, after an outbreak at Singapore’s international airport led to dozens of infections, the government banned dining in restaurants and gatherings of more than two people.
“We have slowed down the chains of transmission and reduced the number of community cases, and are now in a position to ease the tightened measures,” the Health Ministry said in a statement on Thursday.
Beginning on Monday, people will be allowed to gather in groups of up to five, and restaurants and gyms will be permitted to reopen to customers the following week if cases remain low, the ministry said.
About a third of Singaporeans are fully vaccinated, one of the highest rates in Asia, but the country has kept cases low by requiring masks, strictly tracing contacts and eliminating most overseas travel. Officials have said that lifting further restrictions will depend on many more people getting vaccinated.
In other news around the globe:
Abu Dhabi, in the United Arab Emirates, will restrict access to shopping malls, restaurants, cafes and other public places to those who have been vaccinated against the coronavirus or who have recently tested negative, starting on Tuesday, Reuters reported. The new rules were announced late on Wednesday and come as the United Arab Emirates has seen daily cases rise during the past three weeks. The restrictions will also apply to gyms, hotels, public parks, beaches, swimming pools, entertainment centers, cinemas, and museums, Abu Dhabi’s media office said.
NEW DELHI — India’s coronavirus death toll shot up on Thursday after an audit unearthed thousands of uncounted fatalities in the northern state of Bihar, one of the largest and poorest states in the country.
The audit in Bihar showed that more than 9,000 people had died from Covid-related complications since March 2020, significantly higher than the 5,500 deaths originally reported.
The audit was ordered after a hearing on May 17 in the Bihar High Court in Patna, the state capital, in which a district commissioner reported that a single cremation ground had handled 789 bodies in a 13-day period in May. That number clashed sharply with the seven deaths in the whole of May that Tripurari Sharan, a top state-level official, had reported for that entire district.
The revised figures underline the doubts about the accuracy of the Indian government’s official coronavirus statistics. Even in normal times, only about one in five deaths in India is medically certified, experts say.
Opposition political parties in Bihar have accused the state’s top elected official, Nitish Kumar, and his administration of hiding the true death toll to mask failures to mitigate the deadly second wave that has battered India.
The high court in Bihar has been monitoring the state government’s pandemic response since early May after taking up a petition filed by an activist that complained of mismanagement.
But Bihar’s health minister, Mangal Pandey, told The New York Times that the updated numbers reflected a good-faith effort to uncover families eligible for monetary support from the government.
“The intention is to help everyone, not to hide the real death toll,” Mr. Pandey said. “We will leave no death unaccounted for.”
Elsewhere in India, such as in the western state of Gujarat, observers have reported a wide discrepancy between official coronavirus death numbers and the actual figures. While some states have issued revised numbers, no update comes close to Bihar’s. Still, experts say they believe that India’s total number, which because of the audit in Bihar rose by 6,148 deaths on Thursday to 359,676, is a vast undercount.
Emily Schmall reported from New Delhi, and Sameer Yasir from Srinagar, Kashmir.
Deaths from Covid-19 have dropped 90 percent in the United States since their peak in January, according to provisional federal data, but the virus continues to kill hundreds daily. By late May, there were still nearly 2,500 weekly deaths attributed to Covid-19.
With more than half of the U.S. population having received at least one vaccine dose, experts say that the unvaccinated population is driving the lingering deaths.
After seniors were given priority when the first vaccines were authorized for emergency use in December, the proportion of those dying who were 75 or older started dropping immediately.
Younger populations began to make up higher shares of the deaths compared with their percentages at the peak of the pandemic — a trend that continued when all adults became eligible for the shots. While the number of deaths has dropped across all age groups, about half now occur in people aged 50 to 74, compared with only a third in December.
More than 80 percent of those 65 and older have received at least one vaccine dose, compared with about half of those 25 to 64.
“I still think the narrative, unfortunately, is out there with younger people that they can’t suffer the adverse events related to Covid,” which is not the case, said Krutika Kuppalli, an infectious-diseases expert at the Medical University of South Carolina.
Still, those 50 and older make up the bulk of Covid-19 deaths. Among that cohort, white Americans are driving the shifts in death patterns. At the height of the pandemic, those who were white and aged 75 and older accounted for more than half of all Covid-19 deaths. Now, they account for less than a third.
Middle-age populations of all racial groups are making up a higher proportion of Covid-19 deaths than they did in December.
The extent of the drop in deaths, however, is not uniform, and cumulative vaccination rates among Black and Hispanic populations continue to lag behind those of Asian and white populations, according to demographic data from the Centers for Disease Control and Prevention.
The data shows that more work is needed to reach and vaccinate “rural populations, ethnic and racial minority populations, homeless populations, people who don’t access medical care,” Dr. Kuppalli said.
A Nevada man accused of stealing more than 500 blank Covid-19 vaccine cards from the Los Angeles vaccination site where he worked was charged on Wednesday with one felony count of grand theft, according to the Los Angeles County District Attorney’s office.
The man, Muhammad Rauf Ahmed, 46 of Las Vegas, had been arrested in April, but the charge was delayed as the police and prosecutors sought to determine the value of the cards, which was eventually judged to be “at least $15 apiece if illegally sold.”
Around the country, many bars, restaurants and businesses that operate under limited capacity have loosened restrictions for people who can prove that they have gotten the vaccine, creating an underground market for doctored or fraudulent vaccine cards.
In January, fake vaccine cards were being sold on eBay, Etsy, Facebook and Twitter, ranging in price from $20 to $60. In May, a California bar owner was arrested on charges that he sold fake vaccine cards for $20 a piece.
Mr. Ahmed was a nonclinical contract employee hired to work at the vaccination site at the Los Angeles County Fairgrounds, where nearly 4,000 vaccines are administered daily, the La Verne Police Department, in eastern Los Angeles County, said in a statement on Tuesday.
La Verne Detectives recover over 500 blank COVID-19 vaccine cards stolen from Fairplex Mega-POD.
— La Verne Police Dept (@LaVernePD) June 8, 2021
On April 27, the department was contacted after a security guard at the site spotted Mr. Ahmed leaving with a batch of the distinctive cards in his hand, Detective Sgt. Cory Leeper said in an interview on Wednesday.
Eventually, two staff members from the vaccination site confronted Mr. Ahmed at his car, the detective sergeant said. Mr. Ahmed told them that he liked to go to his car on his break and on that day, sought to “pre-fill” the cards with information that went to every recipient in order to get ahead of his workload, the detective sergeant said.
Officials recovered 128 cards from Mr. Ahmed’s vehicle, according to the police, and when questioned further, Mr. Ahmed acknowledged that he may have taken additional cards. The police found 400 blank cards in the hotel room where he was staying. Mr. Ahmed was arrested. Efforts to reach him by telephone on Wednesday were not successful.
“Selling fraudulent and stolen vaccine cards is illegal, immoral and puts the public at risk of exposure to a deadly virus,” George Gascón, the district attorney in Los Angeles, said in a statement on Wednesday.