A version of this story appeared in the April 19 edition of CNN’s Coronavirus: Fact vs. Fiction newsletter. Sign up here to receive the need-to-know headlines every weekday.

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“If wealthy countries say they are only going to have ‘gold standard’ with the most expensive vaccines and then say AstraZeneca is not good enough for us in the global north, but it is good enough for the global south, it could reduce uptake of the vaccine and hamper efforts to vaccinate the world,” said Dr. Peter Drobac, Director of the Skoll Centre for Social Entrepreneurship at Oxford Saïd Business School.

India typically produces more than 60% of all vaccines sold globally, and is home to the Serum Institute of India (SII), the globe’s largest vaccine maker.  

This vast manufacturing capability is why the country is a major player in COVAX, the global vaccine-sharing initiative that provides discounted or free doses for lower-income countries.  

Under an initial agreement announced last year, the SII would manufacture up to 200 million doses for up to 92 countries. But the situation in India has changed dramatically since then, Jessie Yeung and Esha Mitra write. 

A second pandemic wave that began in March has quickly surpassed the first in terms of case numbers. On Monday, the country reported almost 274,000 new infections, its highest single-day figure so far, and 1,619 new deaths, the highest in almost 10 months. It has recorded more than 1 million cases in the past five days alone and topped 15 million total cases on Monday, second only to the United States globally.  

States and cities are imposing new restrictions, including weekend and nighttime curfews in the capital region of Delhi, home to 19 million people.  

Through it all, vaccine supplies have dried up on the ground, with at least five states reporting severe shortages and urging India’s federal government to act. To date, only 14.3 million people have been fully vaccinated – just over 1% of the country’s population of 1.3 billion, according to Johns Hopkins University. 

In the face of crisis, the government and SII have shifted focus from supplying vaccines to COVAX to prioritizing their own citizens at home. 

India’s health care system and other essential services are close to collapse as a second coronavirus wave that started in mid-March tears through the country with devastating speed. 

YOU ASKED. WE ANSWERED.

Q. How do I get my Covid-19 vaccination added to my medical record?

A. The EMA has said that a particular combination of unusual blood clots with low blood platelet counts should be listed as a side effect of the AstraZeneca vaccine.

“Experts do not yet know how long someone is protected from getting sick again after recovering from COVID-19.” 

In some cases, a vaccine might give stronger protection than antibodies produced after being infected, epidemiologist Dr. Larry Brilliant said. . Young people can also transmit the virus to more vulnerable people. Here’s what else to know about Covid-19 vaccines.

Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges you’re facing: +1 347-322-0415.

WHAT’S IMPORTANT TODAY

But the tables are somewhat turning, Julia Hollingsworth writes, as the US and UK are leading the world in their mass vaccination campaigns, while Australia and New Zealand, as well as other Asia-Pacific nations, are lagging way behind. The situation differs for each country, but experts say one reason is where they are in the queue – these countries just didn’t sign agreements with manufacturers for vaccines as early as others. Some leaders are defending their slow rollout, saying there’s value in waiting to see how the vaccines work in other countries that need them more, but experts are urging them to speed up immunization or risk being left behind.

Vaccine providers in some parts of the United States are reporting a sharp drop in the demand for Covid-19 shots, especially among younger Americans and in rural communities. Experts estimate somewhere between 70-85% of the country needs to be immune to the virus to suppress its spread. But the US is nowhere near those levels yet and the slowing demand means getting there might be a taller task than some local officials expected. 

That’s why President Joe Biden and former President Barack Obama joined a slate of celebrities last night in urging Americans to get vaccinated during an hour-long NBC special.  

To do their bit in boosting the uptake, pop and rock stars including Selena Gomez, Jennifer Lopez, Eddie Vedder, Foo Fighters, J Balvin, and H.E.R. are planning a global broadcast and streaming special to support equal vaccine distribution. 

Researchers at Stanford Medicine told CNN they have begun testing the Pfizer/BioNTech vaccine in children aged 2 to 5 in a Phase 1 trial of the shot. The group will trial the shot in 144 children across five sites in the United States, while Cincinnati Children’s Hospital began administering the shots in kids aged 2 to 4 on Monday, and plans to give the shot to some 340 children.

Doctors are zeroing in on the cause of blood clots that may be linked with certain coronavirus vaccines. Even though the link is not yet firm, they’re calling the condition vaccine-induced immune thrombotic thrombocytopenia or VITT. 

A team led by Dr. Marie Scully, a hematologist at University College London Hospitals, studied 22 patients who developed rare blood clots after receiving AstraZeneca’s vaccine, and found they had an unusual antibody response. These so-called anti-PF4 antibodies had only been seen before as a rare reaction to the use of the common blood thinner heparin. 

If vaccination can cause the condition, it would be important to recognize that and treat it appropriately – because the usual treatment for blood clots is not recommended for VITT. Patients should be given anti-clotting drugs, but not heparin, and infusions of a blood product called intravenous immunoglobulin may replace the depleted platelets. 

The surge is mainly because of a low base effect, as China had shut down large swaths of its economy in early 2020 to contain the coronavirus outbreak. Still, the figures speak to a heathy recovery after a tumultuous year.

Brazil has warned women to postpone pregnancy until the worst of the pandemic has passed, saying that the variants of the coronavirus in the country have had a bigger impact on pregnant women. 

“We do not have a national or international study, but the clinical view of experts shows that the new variant has a more aggressive action on pregnant women,” Secretary of Primary Health Care of the Brazilian health ministry Raphael Camara said Friday.   

ON OUR RADAR

Queen Elizabeth II takes her seat for the funeral service of her late husband Prince Philip at Windsor Castle in England.
  • Mexican President Andrés Manuel López Obrador got his first AstraZeneca shot on a livestream yesterday, as he urged the country to trust vaccines.
  • Economic recovery from the Covid-19 crisis is unsustainable, says the International Energy Agency, as it estimates that carbon emissions from energy use are on track to spike by 1.5 billion tons in 2021.
  • A national nightly curfew in the Netherlands, designed to reduce social contact, will end on April 28, Prime Minister Mark Rutte announced. The curfew has been in place since January 23 and runs from 10 p.m. to 4:30 a.m.
  • As US health officials race to get more Covid-19 shots into arms to control the virus, experts warn the country will run into another challenge in the next few weeks: vaccine supply will likely outstrip demand.
  • Russia’s President Vladimir Putin urged all citizens to get vaccinated against Covid-19, in his annual address to the nation on Wednesday. “It is the only way to stop the deadly pandemic,” Putin said.

TODAY’S TOP TIP

Check the fit on that double mask if you want to be better protected against Covid-19.

The extra protection that double-masking provides isn’t so much about adding layers of cloth, but eliminating any gaps or poor-fitting areas of a face covering, according to a new study published Friday in JAMA Internal Medicine.

TODAY’S PODCAST

“You get vaccinated to protect yourself, but if enough people get vaccinated, the virus can’t circulate as much, not as many mutations will develop, and we won’t have to worry about the variants either.” — Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent   

How afraid should we be of these new virus variants? Dr. Gupta explains how variants arise, why they’re a threat, and which ones are most common in the US right now. Listen now.