Experts were divided over postponing the second dose of the Covid-19 vaccine. Here’s why

“My opinion is that the weight of the evidence suggests that we would probably save more lives by delaying second doses than by insisting on the schedule that was tested in the tests,” he said.

However, not all experts agree that changing dosing schedules is a good idea.

“Secondly, we really don’t know if delaying the second dose too long will give you the same degree of protection,” he said. In other words, there is not much research, since Covid-19 vaccines have been developed recently.

Meanwhile, as debates over postponing the second dose continue in the United States, so does the slow release of the vaccine, more deaths from Covid-19 and the spread of newly identified coronavirus variants that appear to be more transmissible. .

Getting a second dose is the priority, but ‘there is some room for maneuver’

It is still recommended that people take their second dose of the Covid-19 vaccine on time, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention in the United States, during a virtual meeting at the White House on Monday.

“Until we have more data,” said Walensky, people should continue to follow the test data, continuing the scheme of receiving two doses 21 days apart for the Pfizer / BioNTech vaccine and 28 days for the Modern vaccine. These are the two vaccines currently authorized for emergency use in the United States.

“The policy is that we certainly want everyone who receives the first dose to receive the second,” said Dr. Anthony Fauci, chief medical consultant to President Biden and director of the National Institute of Allergy and Infectious Diseases, during the Monday briefing. market.

But also on Monday, during a meeting of the International AIDS Society, Fauci said that if you are only a few weeks late, there is no reason to worry. “There is some leeway,” he said. “It’s not the end of the world if you are a little late. If you want to be six months late, it’s different.”

Changes to the coronavirus vaccine schedule would not start with the FDA, says the agency

Delaying second doses would go against vaccine schedules that have been authorized by the U.S. Food and Drug Administration.

In January, the FDA made it clear that it does not plan to change the dosing schedules for the coronavirus vaccine – and for such adjustments to occur, the vaccine manufacturer would have to specifically ask the agency to adjust the authorization.

CNN confirmed with the FDA in January that if a manufacturer requests a change in its emergency use authorization, the manufacturer will need to send data to the FDA to support the requested change.

Some experts argue that there is evidence to support a possible change.

‘We need to have a really comprehensive review and discussion of this’

Lipsitch, from Harvard University, is in favor of spreading the vaccine doses over a larger population, rather than doubling the doses to half that population. “If you can get at least half the benefit, then it is better to distribute it,” he said.

See how some of the main vaccines against coronavirus work

For the Pfizer / BioNTech vaccine, called BNT162b2, the data suggest that the vaccine is 52% effective after just one dose and provides 95% protection against Covid-19 after two doses.

In a Phase 3 study conducted at 99 sites in the United States, the data suggest that mRNA-1273 from the Modern vaccine showed efficacy after the first dose.

But trials have not been conducted to test single doses of mRNA vaccines.

Some evidence emerging in a pre-printed article, posted on the medrxiv.org online server on Monday, found that after receiving just one injection of the Covid-19 vaccine, people who were previously infected with the virus tended to have levels of antibodies that were equal to or greater than that of people who received both doses, but have never been infected before. The study does not specify which vaccines the participants received.
What we know about Moderna's coronavirus vaccine and how it differs from the Pfizer vaccine
For many other vaccines – such as chickenpox, HPV and measles, mumps and rubella – their second-dose booster vaccines are given several months later, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the CNN on Monday.

“At this point, everything we know about vaccines suggests that in fact protection can be increased by boosting several months after the first dose,” said Osterholm, who was a coronavirus advisor to the Biden transition team.

Osterholm pointed to a letter to the editor published in Clinical Infectious Diseases last week, in which Dr. Stanley Plotkin of the University of Pennsylvania and Dr. Neal Halsey of Johns Hopkins University calculated how many people could be protected against Covid -19 if single doses are administered.

The researchers hypothesized: “suppose that 1 million people are vaccinated, but only 1 million doses are available. If two doses are administered to each vaccinee and the effectiveness is 95%, 475,000 people will be protected. If single doses are administered and the effectiveness is 80%, 800,000 people will be protected. ”

Osterholm said that vaccinating people – even with just one dose for now – remains urgent as more coronavirus variants circulate, including variant B.1.1.7 first identified in the UK, B.1.351 first identified in South Africa, P .1 variant first identified in Brazil and the L452R seen for the first time in California.
Studies suggest that vaccinated people are protected from new variants of Covid-19

“We need to have a really comprehensive review and discussion of this as soon as possible because you know that this new variant B.1.1.7 can cause an increase in our cases within weeks,” said Osterholm. He described the emergence of these variants as resembling a hurricane approaching the horizon.

“I feel like I’m sitting here on a beautiful beach – the light breeze, the perfectly blue sky and everyone – and I’m telling them to start evacuating. People are saying, ‘Are you crazy?’ But I see that 450 miles to the south, there is a category five hurricane, “said Osterholm.” That is the challenge. How do you get people to act? ”

Other experts, however, argue that having a longer period of time between doses of the vaccine may carry the risk of becoming more vulnerable to the new coronavirus and its variants.

Overall, Fauci said on Monday that being vaccinated against Covid-19 may help prevent more coronavirus variants in the future.

“You need to be vaccinated when it is available as quickly and expeditiously as possible,” said Fauci during the briefing at the White House on Monday, adding that viruses cannot mutate unless they replicate.

White House concerned about suppliers withholding doses

The Biden government expressed concern on Monday that health care providers could be basically accumulating doses of the Covid-19 vaccine for the second injections that could be administered in the first injections.

The White House warns suppliers against withholding vaccine doses
“We believe that some healthcare providers are regularly withholding doses that are intended as first doses and instead keeping them in reserve for second doses for patients,” said Andy Slavitt, senior consultant at Covid-19 White House, in the virtual briefing on Monday. “We want to make it clear that we understand why health professionals did this, but that it doesn’t have to happen and it shouldn’t happen.”
As of Monday, nearly 50 million doses of the coronavirus vaccine were distributed in the United States and about 32 million doses have been administered so far, according to the CDC.

CDC data shows that about 26 million people have received at least one dose so far – but among them, almost 6 million have received their two doses.

“On January 20, states managed 46% of their stocks. Today, that number is 62%. We are focused on that every hour of every day,” said Slavitt on Monday.

Slavitt suggested that in some cases, patients’ appointments for the first dose are being canceled and urged the urgency to deliver the first doses as soon as possible. He said the government’s decision last week to provide a three-week window for vaccine delivery plans was intended to allay concerns that second doses might be withheld.

CNN’s Jen Christensen, Amanda Sealy, Michael Nedelman and Betsy Klein contributed to this report.

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