A new approach to COVID-19 vaccination just adopted in the UK is gaining traction in America but dividing public health experts.
In an effort to get as many doses of the vaccine out as possible, British officials will no longer withhold the second of two doses.
Instead, they prioritize giving people the first dose and delay the second injection for three months.
“Everyone is still getting their 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 UK government said in a statement.
“Now that two vaccines are approved, we can vaccinate a greater number of people at greatest risk, protect them from the disease, and reduce mortality and hospitalization.”
Two doses are required for each of the two vaccines currently authorized in the US, three or four weeks apart.
Under the current distribution plan, the government’s Operation Warp Speed delivers only half the number of doses needed to states each week. The other half stays in a warehouse, held back to make sure there is enough stock for a second dose.
With the US vaccination campaign creeping out of the gate and more than 3,000 people dying from COVID-19 every day, proponents of British policy don’t understand why the government doesn’t use every vaccine it has.
“Why don’t you vaccinate as many people with a single dose as you can, with the intention of supplementing that second dose later?” said Christopher Gill, a professor of global health at Boston University School of Public Health.
“I just feel in the United States, we suffer from a lack of creativity here when thinking about the most efficient way to protect the population, rather than the most efficient way to protect the individual. To me, that’s the fundamental flaw in this, ”said Gill.
Anthony Fauci
Anthony FauciBidens honors frontline workers at NYE address: ‘We owe them, we owe them, we owe them’ US debates whether UK approach is better for COVID-19 vaccinations Will 2021 bring the happy ending America so desperately needed has? LAKE, the country’s top infectious disease doctor, said Thursday that the idea of giving the first dose to everyone is “under consideration.”
“I still think that if done right you can do a single dose, reserve doses for the second dose and still get the job done, but there is a lot of debate about whether or not you want to distribute the first vaccination get vaccinated by more people in the first round, ”Fauci said on NBC’s“ Today Show ”.
Logistical troubles have plagued the Trump administration’s distribution efforts, with much of the crucial “last mile” of work ending up with underfunded local health departments.
Federal health officials promised 20 million vaccines would be administered by the end of the year, but as of 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 have been delivered.
Those numbers are probably under-graded due to data backlogs, but the final numbers are still a fraction of the administration’s goals.
Former Food and Drug Administration Commissioner Scott Gottlieb, who sits on Pfizer’s board of directors, was in favor of vaccinating as many people as possible even before the UK changed its policy.
“I have a strong feeling that we should get as many weapons as possible in our arms right away,” Gottlieb told USA Today in early December. “The reality is that one dose is partially protective. I don’t think we should keep supplying now, expecting something to go wrong. “
Gottlieb explained in a Twitter post that he is not in favor of delaying or forgoing the second dose. What he wants is for the government to push out more supply, instead of withholding 50 percent of the available supply.
But there is a delivery risk. By not withholding the second dose initially, more doses will have to be manufactured by the companies and then distributed by the time the second doses are needed.
In addition, clinical studies have not investigated what happens when doses are spread outside the three or four week window, or how much immunity is provided with a single dose.
Although partial protection against the vaccine appears to begin as early as 12 days after the first dose, “two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine effectiveness of 95 percent,” Pfizer said in a statement. “There are no data to demonstrate that protection is maintained after the first dose after 21 days.”
Moncef Slaoui, Operation Warp Speed’s chief science adviser, said he doesn’t support policies without evidence.
“It’s very important, I think, to use a vaccine based on how you’ve studied it. For me, if we extend the period between the first and second dose, the biggest concern is what happens to the maintenance of protection, ”Slaoui told reporters on Wednesday.
“You know, I would really advise against doing anything that we have no characterization of,” added Slaoui.
Natalie Dean, an assistant professor of biostatistics at the University of Florida, said she thinks delaying a second dose will undermine public confidence as their second dose appointments are reportedly being canceled or rescheduled.
“They make choices here that deviate from the norm. It does indicate that it is an emergency, but we don’t have the full evidence before us, we don’t have these discussions or deliberations. And I think they can be served better with a more transparent process, ”said Dean.
Fauci said he understands why people support spreading the second dose.
“We know from the clinical trial that the optimal time is to give it in one day, then 28 days later for Moderna and 21 days later for Pfizer. If you want to stick to the data, you have to do it like this, ”said Fauci.
“But you can argue, and some people are, about stretching the doses by giving a single dose across the board and hoping you get the second dose in time to give to individuals,” Fauci said.