With new coronavirus cases rising sharply in the Upper Midwest this has sparked a debate among vaccine specialists about how long to wait before receiving the second and third doses. Although it would be faster to protect a person with a single shot of coronavirus, experts are concerned that it could cause dangerous new variants.
The two-dose vaccines are given in the United States three to four week apart. This matches what was seen in clinical trials. To reach more people faster, British health authorities have delayed the doses for up to 12 weeks. In Canada, where there are few vaccines, a government advisory panel recommended that second doses of vaccines be delayed for up to four more months.
Some experts suggest that the United States should adopt this approach. Dr. Ezekiel Emanuel from the University of Pennsylvania is co-director of Healthcare Transformation Institute. He suggested that, for the next few days, all U.S. shots should be administered to the first time recipients.
In an interview, he stated, “That should suffice to quell the fourth wave, especially in places such as Michigan or Minnesota.” In an op-ed published by USA Today, Dr. Emanuel along with his coworkers the proposition.
But opponents, including health advisers to the Biden administration, argue that delaying doses is a bad idea. They warn that it will make the country vulnerable to different variants. These include those that are already being circulated as well as those that might develop in the bodies of people who have not been vaccinated.
Dr. Luciana Borio (ex-acting chief scientist at the Food and Drug Administration) stated that it was a dangerous idea to delay the second dose. Dr. Anthony S. Fauci was the nation’s leading infectious-disease expert. “Let’s use what we know is optimal protection,” he said.
The seeds for the debate were planted when clinical trials allowed scientists to get their first clear look at how the vaccines performed. For example, two weeks after receiving the second dose of the Pfizer BioNTech vaccine, volunteers were protected by Covid-19. Researchers found that volunteers who received the placebo were less sick than those who received the second dose.
In the same month, Britain experienced a surge of cases caused by a new, highly transmissible variant called B.1.1.7. After the British government allowed two vaccines (from Pfizer BioNTech & AstraZeneca) it decided fight the variant by delaying both the second and third doses of each formulation by 12 weeks.
Researchers in January lobbied for the United States of America to follow Britain’s lead.
“I think right now, in advance of this surge, we need to get as many one doses in as many people over 65 as we possibly can to reduce a serious illness and deaths that are going to occur over the weeks ahead,” Michael T. Osterholm of the University of Minnesota said on Jan. 31 on NBC’s “Meet the Press.”
But the government stayed the course, arguing that it would be unwise to veer off into the unknown in the middle of a pandemic. The clinical trials showed some protection starting with the first dose. However, it was not clear how long this partial protection would last.
“When you’re talking about doing something that may have real harm, you need empirical data to back that,” said Dr. Celine R., an infectious-disease expert at Bellevue Hospital Center who is also a member Mr. Biden’s coronavirus advisory committee. “I don’t think that you can logic yourself out of this.”
Proponents of delaying doses, however have been able in recent weeks to point to mounting evidence that a dose that is given at once can provide effective protection that lasts for several weeks.
The Centers for Disease Control and Prevention reported that two weeks after a single dose of either the Moderna or the Pfizer-BioNTech vaccine, a person’s risk of coronavirus infection dropped by 80 percent. Researchers in Britain also found the persistence of first-dose protection for at most 12 weeks.
Dr. Emanuel stated that Britain’s push to get first doses to more people was responsible for the 95 per cent drop in cases after their peak in January. Dr. Emanuel expressed his amazement at the results.
He points to data like this as further evidence that the United States should stretch out vaccinations. According to his colleagues, 47,000,000 more people would be vaccinated if there had been a 12-week period between the launch of the program and April 5.
Sarah E. Cobey of University of Chicago was an evolutionary biologist and epidemiologist. She stated that she believed the United States had lost an opportunity to save lives by using such a strategy. She stated that the United States has “missed a window” and people have already died.
Dr. Emanuel stated that it is worth waiting to get the next dose. The United States currently distributes about three million vaccines every day. Nearly half of these are going out to people who have only received one shot. He claimed that the nation’s entire supply should be directed to first-timers.
If that happened, it would take two or three weeks for the United States to catch up with Britain, according to his team’s calculations. This extra protection would save lives and help to reduce the spread of the virus to others who have not yet been vaccinated.
However, scientists disagree with the idea of crediting Britain’s decline in cases to the delayed vaccination schedule.
What you need to know about Covid-19 booster shots
F.D.A. The F.D.A. has approved booster shots for millions who have received the Pfizer-BioNTech or Moderna vaccines. Moderna recipients and people over 65 are eligible for a booster. Younger adults who are at risk of severe Covid-19 due to their medical conditions and where they work are also eligible. The booster is available to eligible Moderna and Pfizer patients within six months of the second dose. All Johnson & Johnson beneficiaries will be eligible to get a second shot two months after the last.
Yes. Yes. The F.D.A. Although regulators do not recommend any vaccine as a booster, they have never recommended that one vaccine be preferred over another. They have not said whether it is better for patients to stay with the same vaccine if possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. Workers whose work exposes them to potentially infectious people were authorized boosters. C.D.C. According to the C.D.C., this group includes emergency medical workers, education workers, food and agriculture workers, manufacturing workers, corrections workers, U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. The C.D.C. explains that the Covid vaccine might be administered regardless of the time of other vaccines. Many pharmacy websites now allow customers to schedule a flu shot in conjunction with a booster.
“They’ve done a few other things, like shut down,” Dr. Fauci said.
Dr. Gounder stated that “I think the real test is whether we see a rebound of cases now that U.K. has reopened.”
Critics argue that it is better to be serious about preventive measures, such as wearing masks, than experiment with vaccine schedules. Dr. Borio stated that it was crucial that we didn’t reopen as a national party.
She and others are also worried by recent studies that show that a single dose of Moderna or Pfizer-BioNTech does not work as well against certain variants, such as B.1.351, which was first found in South Africa.
John P. Moore of Weill Cornell Medicine said, “Relying only on one dose Moderna and Pfizer to stop variants is like using the BB gun against a charging rhinoceros.”
Dr. Moore stated that he was also concerned about the possibility of vaccine resistance spreading by delaying vaccinations. Coronaviruses may replicate within the bodies of vaccine-vaccinated patients, creating mutations that can allow them to evade antibodies.
Dr. Cobey said she’s not worried about delayed doses creating more viruses. She said, “I would bet it having the opposite effect.”
She and her colleagues published last week a comment in Nature Reviews Immunology to defend delaying doses. Their argument was that increasing vaccination rates could have a greater impact on the spread and spread of the virus in a community, even if there were less people with stronger protection. It would also save more lives. Variants also would have a lower chance to develop and spread.
She stated that variants are less common in infected individuals.
Dr. Adam S. Lauring was a University of Michigan virologist who did not participate in the commentary. He said that he believed Dr. Cobey had presented a convincing case. He stated that the arguments in that piece “really resonate with me.”
While it may seem unlikely that the United States will change course, its north neighbor has adopted a delayed strategy for dealing with a booming pandemic as well as a limited supply of vaccines.
McGill University, Montreal’s Dr. Catherine Hankins, a Public Health Specialist, endorsed the decision based in part on emerging evidence about single-doses. She said she was also open to the idea that other countries, with even worse shortages, should also consider it.
Dr. Haskins added, “I’ll be advocating at a global level that all countries take a serious look at Canada’s strategic plan and think seriously.”