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On March 25, President Joe Biden set a goal of 200 million shots administered in his first 100 days. The United States has now reached that goal with time to spare.

The White House says the U.S. will have enough vaccine supply to cover every American adult by the end of May,

and the pool of people qualified to give vaccines has been expanded to include paramedics, physician assistants, and dentists, among others.

Top White House adviser Anita Dunn Sunday defended President Joe Biden over his continued use of a mask outdoors – even though the practice appears to conflict with new and relaxed administration guidelines for fully vaccinated citizens.

The Republican National Committee, for instance, blasted Biden for “breaking” US Centers for Disease Control and Prevention guidance, and the issue has become one of the latest culture war flashpoints for right-wing talk show hosts.

Republicans are seizing on the controversy over masks to bolster their wider narrative that Biden and Democrats are too politically correct and using the power of government to infringe on the freedoms of Americans – a conceit that works for them on taxes to guns and public health to climate change.

The United States has fully vaccinated more than 100 million people against Covid-19, according to the US Centers for Disease Control and Prevention -- a milestone that comes with optimism about the future.

"I think we can confidently say the worst is behind us,"

"We will not see the kinds of sufferings and death that we have seen over the holidays. I think we are in a much better shape heading forward."

MUMBAI, India — The second wave of Covid-19 in India is here. The country of more than one billion people already has 11.3 million cases and more than 158,000 deaths. After a low weekly average of less than 11,000 cases per day in the second week of February, the cases have risen to a weekly average of more than 18,000 cases per day. On Friday, India reported more than 23,000 new cases.

Amid the pandemic, on Jan. 30, India carried out its annual polio immunization campaign, inoculating over 110 million children in three days. Around 700,000 vaccination booths were staffed with 1.2 million health workers — many of them Accredited Social Health Activists, or ASHA workers, who for $50 per month check on mothers and children at bus terminals and bazaars to ensure the immunization program is a success.

India managed to vaccinate only 14 million of the 30 million health care and other frontline workers it intended to between Jan. 16 and March 1, the first phase of the drive.

Pål André Holme, a professor of hematology and chief physician of the Oslo University Hospital who headed an investigation into the Norwegian cases, said his team had identified an antibody created by the vaccine that was triggering the adverse reaction.

“Nothing but the vaccine can explain why these individuals had this immune response,” Prof. Holme said.

In Germany, 13 cases of CVST were detected among around 1.6 million people who received the AstraZeneca vaccine. Twelve patients were women and three died.

The B.1.1.7 variant, first spotted in the UK, is not only more easily transmitted, but it also appears to be more deadly.

It was first spotted in Colorado

"Since then it has been detected in 50 jurisdictions in the United States

A year after the pandemic shut down the country, a growing number of infectious disease experts, epidemiologists, public health officials and others have started to entertain a notion that has long seemed out of reach: The worst of the pandemic may be over for the United States.

No one thinks that's guaranteed by any means. There are many ways the pandemic could resurge. But many say it's becoming increasingly possible that the end may finally be in sight.Even experts who have raised the alarm about the severity of the COVID-19 crisis nonstop for more than a year are optimistic.

Now, to be clear, more than 50,000 people are still getting infected daily with the coronavirus and hundreds are dying. So there's a great deal of sickness and suffering still in store for the country before the pandemic ends.

There are more shots available. The challenge is getting people to take them.

On Thursday, there were more than 73,000 slots to be had on the state’s scheduling website, up from 68,000 on Tuesday.

But public health experts say the pileup of unclaimed appointments in Mississippi exposes something more worrisome: the large number of people who are reluctant to get inoculated.“It’s time to do the heavy lifting needed to overcome the hesitancy we’re encountering,” said Dr. Obie McNair, an internal medicine practitioner in Jackson, the state capital, whose office has a plentiful supply of vaccines but not enough takers.

Dr. Walensky’s comments hinted that protection was complete. “Our data from the C.D.C. today suggests that vaccinated people do not carry the virus, don’t get sick,” she said. “And that it’s not just in the clinical trials, it’s also in real-world data.”Dr. Walensky went on to emphasize the importance of continuing to wear masks and maintain precautions, even for vaccinated people. Still, the brief comment was widely interpreted as saying that the vaccines offered complete protection against infection or transmission.

“If Dr. Walensky had said most vaccinated people do not carry virus, we would not be having this discussion,”

“What we know is the vaccines are very substantially effective against infection — there’s more and more data on that — but nothing is 100 percent,” he added. “It is an important public health message that needs to be gotten right.”

The CDC had wanted to start helping states plan in June how to get people vaccinated. But officials at Operation Warp Speed rebuffed the agency’s plan for distributing vaccines. They adopted a similar plan in August only after exploring other options—and then held the release of the CDC’s playbook for states for two weeks for additional clearance and to put it out with another document

Operation Warp Speed was supposed to be a high-water mark of the Trump administration’s coronavirus response, but it stumbled at the finish line because of problems in federal planning and foresight

“They didn’t plan for the last inch of the last mile, the part that matters most—how you’re going to actually vaccinate that many people quickly,”

this gets to a weird aspect of disease and transmissibility. If you get really sick, you actually don’t transmit the virus all that well because you’re really sick and you don’t interact with the same number of people, whereas a virus that causes less disease might actually be more transmissible in a sense, because, since you don’t feel as bad, you’re more likely to transmit it to other people.

So there’s a bit of a dichotomy in how viruses spread. This particular COVID-19 is kind of this Goldilocks of viruses. If it was a little bit more severe, it would be easier to control. If it was a little bit less severe, it wouldn’t be as disruptive.

These variants we’re seeing haven’t been pushed to evolve away from antibodies yet.

One, first identified in southeast England, has now shown up in at least 50 countries and appears to be spreading more efficiently than older variations of the virus. Its appearance has frightened political leaders, who have closed borders and imposed travel restrictions in attempts to curb its spread.

So far, none has done what scientists most fear and mutated to the point that it causes more severe disease, or evades the protection provided by vaccination. While some of the new variants appear to have changes that look like they could affect immune response, it's only by a matter of degree.

At the top of the list for researchers in the US is the B.1.1.7 variant first seen in Britain. The US Centers for Disease Control and Prevention warned last week it could worsen the spread of the pandemic.

CoronaVac, unlike some of the other vaccines, relies on older technology that uses chemicals to weaken or kill the virus, which is then put into a vaccine to spark antibodies in the recipient. But the process of killing the virus can weaken a vaccine’s potency, resulting in an immune response that could be shorter or less effective.

The lower efficacy announced Tuesday would mean it would take longer for countries that used CoronaVac’s vaccine to reach “herd immunity,” the point at which enough people are resistant to the virus — roughly 70 percent, many scientists have said — that it is vanquished in a population. By contrast, the vaccines made by Moderna and Pfizer-BioNTech have been shown to have an efficacy rate of about 95 percent.

“This was one of the reasons the Americans and Europeans didn’t go with this older technology,” said John Moore, a vaccine expert at Cornell University. “A well-maintained Ford Model T would probably get you from Wuhan to Beijing, but personally I would prefer a Tesla.”

Most Americans will wait months to get immunized, and poorer countries are scrambling to find any vaccines at all.

The goal of Pepfar, as it’s called, was to ensure that people in countries with limited resources could get medication to treat H.I.V. Pepfar has received consistent bipartisan support and is recognized as one of the most successful global health initiatives ever implemented, responsible for saving an estimated 18 million lives to date, according to the U.S. government.

The promise and possibility of Pepvar are rooted in the type of Covid-19 vaccines now being distributed in the United States. The Pfizer-BioNTech and Moderna shots use genetic material called mRNA, and their technology is based on teaching human cells to make proteins that trigger a strong and protective immune response to a virus or other pathogen. The other leading Covid vaccine candidates use different technologies, like engineered adenovirus and inactivated coronavirus.

There's one from the U.K., which is more contagious and already circulating in the United States. There's one from South Africa, which is forcing Moderna and Pfizer to reformulate their COVID-19 vaccines and create "booster" shots, just to make sure the vaccines maintain their efficacies.

A variant called P.1, which emerged in early December in Manaus, Brazil, and by mid-January had already caused a massive resurgence in cases across the city of 2 million people.

"Manaus already had 75% of people infected [in the spring of last year]."

As a country of 9 million with a relatively small elderly population, Israel has inoculated most older residents and begun vaccinating the wider public. The government is preparing “green passports” for those who have received both doses, which would exempt them from quarantine and eventually grant them access to public places like theaters and restaurants.

Health-care administrators announced Monday that the vaccine may be even more effective than the 95 percent level found during trials.

Maccabi, one of Israel’s four HMOs, reported preliminary findings that just 0.015 percent of people became infected with the coronavirus in the week after receiving their second shot. Among the positive cases, none exhibited severe symptoms.

The first case of Covid-19 in the United States was reported 11 months ago, on January 20, 2020. Since that time, more than 18 million Americans have been diagnosed and more than 329,000 have died.

The trouble started first in the Northeast during the spring, and then spread in other major urban areas, quickly overwhelming hospitals and nursing homes. High death rates were due in part to a lack of knowledge on how to treat the infection.

This last upturn in cases, unlike the first two, has not waned. Instead, the spread of the virus has only accelerated, with the nation going into Covid-19 overdrive in the last month. The rate of new cases and deaths across the country makes it impossible now to attribute a single cause to the alarming surge.

No matter how encouraging the news, growing numbers of people said they would refuse to get the shot.

But over the past few weeks, as the vaccine went from a hypothetical to a reality, something happened. Fresh surveys show attitudes shifting and a clear majority of Americans now eager to get vaccinated.

In polls by Gallup, the Kaiser Family Foundation and the Pew Research Center, the portion of people saying they are now likely or certain to take the vaccine has grown from about 50 percent this summer to more than 60 percent, and in one poll 73 percent — a figure that approaches what some public health experts say would be sufficient for herd immunity.

The only notable thing about her medical history was that the woman, who declined to be interviewed but allowed Dr. Goueli to describe her case, had become infected with the coronavirus in the spring. She had experienced only mild physical symptoms from the virus, but, months later, she heard a voice that first told her to kill herself and then told her to kill her children.

At South Oaks, which has an inpatient psychiatric treatment program for Covid-19 patients, Dr. Goueli was unsure whether the coronavirus was connected to the woman’s psychological symptoms. “Maybe this is Covid-related, maybe it’s not,” he recalled thinking.

“But then,” he said, “we saw a second case, a third case and a fourth case, and we’re like, ‘There’s something happening

Denmark, which has invested in genetic surveillance, discovered the variant afflicting Britain in multiple Danish regions and recently tightened restrictions. The health minister compared it to a storm surge, predicting that it would dominate other variants by mid-February.

And as countries go looking, they are discovering other variants, too.

With the world stumbling in its vaccination rollout and the number of cases steeply rising to peaks that exceed those seen last spring, scientists see a pressing need to immunize as many people as possible before the virus evolves enough to render the vaccines impotent.