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Debate rages over whether to stretch out the second COVID-19 vaccine dose

Posted at 4:22 PM, Jan 05, 2021
and last updated 2021-01-05 16:23:36-05

CHICAGO — Public health officials have been debating whether it may be more effective to get more people their first dose of the COVID-19 vaccine and delaying the second round of shots that are needed for the highest immunity.

Last month, social media was flooded with images of frontline health care workers proudly rolling up their sleeves to get their first dose of the COVID-19 vaccine.

But a slow rollout, a surge in cases, and the emergence a of a new, more contagious strain of the coronavirus have increased the urgency of the vaccination campaign.

“I think there is an urgency to getting people vaccinated in the best way possible quickly,” said Dr. Benjamin Singer, an assistant professor pulmonary and critical care at Northwestern University’s Feinberg School of Medicine

In the UK, public health officials say prioritizing first doses will delay the interval of the second dose up to 12 weeks.

Pfizer, which is set to deliver 200 million doses of its vaccine to the U.S. by August of 2021, says it has tested their vaccine’s efficacy only when the two doses were administered 21 days apart. Moderna’s two-shot vaccine must be administered 28 days apart.

“Ninety, 95 percent efficacy, I mean, that's an amazing number, but the only way that we know with certainty to get to that level is with that two doses, three to four-week schedule,” said Singer.

Delays in administering the vaccine are already being reported across the U.S. There are now looming questions about what to do if a second dose has to be postponed.

“It could seem premature to begin discussing some of these contingency plans,” said Singer. “But I think it's an appropriate time to at least begin having the discussions.”

According to the Centers for Disease Control and Prevention (CDC), as of Monday morning, of the 15.4 million doses distributed, only 4.6 million people got their first dose.

“Right now, our problem isn't so much having the right number of doses, it's getting those doses into the arms of people,” said Singer.

In recent days, some health experts have suggested delaying the second dose could actually be a strategy to inoculate more people. In a Washington Post op-ed this weekend, Drs. Robert Wachter and Ashish Jha write: “Giving 100 million people — particularly those at high risk — a single shot that is 80 to 90 percent effective will save far more lives than giving 50 million people two shots that are 95 percent effective.”

“There's also some discussion about whether you could stay on the two-shot schedule but give a half dose inject you know half the volume and achieve somewhat of a similar response.”

But late Monday, in a strongly-worded statement, the FDA dismissed the idea of altering dosages and the timeline saying, “…making such changes that are not supported by adequate scientific evidence may ultimately be counterproductive to public health.”

The first doses of the vaccines in the U.S. were administered in mid-December, which means many are due for their booster shot this week.