A new approach to COVID-19 vaccination, adopted in the United Kingdom, is gaining ground in America, but is shared by public health experts.
In an effort to eliminate as many vaccine doses as possible, British officials will no longer retain the second of the two doses.
Instead, they will prioritize giving the people the first dose and delay the second shot by up to three months.
“Everyone will continue to receive the second dose and it will be within 12 weeks of their first. The second dose completes the course and is important for longer-term protection, “the British government said in a statement.
“With two vaccines approved now, we will be able to vaccinate more people at higher risk, protecting them from disease and reducing mortality and hospitalization.”
Each of the two vaccines currently authorized in the United States requires two doses, given every three to four weeks.
According to the current distribution plan, the administration’s Operation Warp Speed provides states with only half the required number of doses per week. The other half remains in a reservoir, retained to ensure that there is sufficient intake for the second dose.
With the US vaccination campaign heading for the gate and more than 3,000 people dying of COVID-19 every day, supporters of British policy do not understand why the administration does not use every vaccine it has.
“Why not vaccinate as many people with a single dose as possible, with the intention that you should fill the second dose later?” said Christopher Gill, professor of global health at Boston University School of Public Health.
“I only feel at home, we suffer from a lack of creativity here to think about the most effective way to protect the population, rather than the most effective way to protect the individual. For me, this is the fundamental flaw in this regard, “said Gill.
Anthony Fauci
Anthony FauciBidens honors New York frontline workers: “We owe them, we owe them, we owe them” US debates over whether the UK’s approach to vaccinations is better COVID-19 Will bring 2021 America’s happy ending needs? MORE, the top doctor in infectious diseases in the country, said on Thursday that “the idea of pushing the first dose to everyone is being considered”.
“I still think that if done correctly, you can do a single dose, you can book doses for the second dose and you can do the job, but there is a lot of discussion about whether or not you want to spread the initial vaccination by vaccinating more the first round, “Fauci told NBC’s” Today Show. “
The logistical problems have affected the Trump administration’s distribution efforts, with much of the crucial “last mile” going to underfunded local health departments.
Federal health officials have promised that 20 million vaccines will be given by the end of the year, but on the last day of 2020, the Centers for Disease Control and Prevention said only about 2.8 million people have been vaccinated. Less than 13 million doses were administered.
These figures are probably insufficient due to data gaps, but the final figures are still a fraction of the administration’s objectives.
Former Food and Drug Administration Commissioner Scott Gottlieb, who is on Pfizer’s board of directors, has been a supporter of vaccinating as many people as possible even before the UK changed its policy.
“I feel very strongly that we should get as many shots in our arms right away,” Gottlieb told USA Today in early December. “The reality is that a dose is partially protective. I don’t think we should hold on to supply now, anticipating that something is wrong. “
Gottlieb explained in a post on Twitter that he is not advocating for delaying or giving up the second dose. What he wants is for the government to push more supply now, rather than withhold 50% of what is available.
But there is a supply risk. If the second dose is not initially withheld, companies will need to produce more doses and then distribute them until the second dose is needed.
In addition, clinical trials have not studied what happens if doses are spread beyond the three- or four-week interval or how much immunity is provided with a single dose.
While partial protection against the vaccine appears to begin as early as 12 days after the first dose, “two doses of vaccine are needed to provide maximum protection against the disease, a 95% effectiveness of the vaccine,” Pfizer said in a statement. . “There is no evidence that protection after the first dose is sustained after 21 days.”
Moncef Slaoui, chief scientific adviser for Operation Warp Speed, said he did not support a policy without evidence behind it.
“It is very important, I think, to use a vaccine based on the way you studied it. For me, the biggest concern if we were to extend the time between the first and second dose is what happens to the persistence of protection, “Slaoui told reporters on Wednesday.
“You know, I would really advise not to do something that we don’t have any characterization of,” Slaoui added.
Natalie Dean, an assistant professor of biostatistics at the University of Florida, said she believes the delay in a second dose will undermine public confidence because people who have already received the first blow have their second dose canceled or rescheduled.
“Here I make choices that deviate from the standard. It reflects the fact that it is an emergency, but we do not have complete evidence in front of us, we do not have these discussions or deliberations. And I think they would be better served with a more transparent process, “said Dean.
Fauci said he understands why people support the spread of the second dose.
“We know from the clinical study that the optimal time is to offer it in one day, then for Moderna 28 days later and for Pfizer 21 days later. If you want to stay with the data, that’s what you should do “, said Fauci.
“But you can argue, and some people are, about expanding the doses, offering a single dose everywhere and hoping that you get the second dose in time to give to individuals,” Fauci said.