Nearly a month after vaccination campaigns in the United States increased to give injections of COVID-19 to more than one million people a day, their second doses are coming, which hampers the state’s implementation and leaves some without complete immunizations.
In Texas alone, nearly 6,000 people were late for their second dose in early February. Washington state officials said earlier this week that some mass vaccination clinics would only deliver follow-up doses. And a Michigan hospital system canceled last-dose appointments last week after its supply was cut.
“Everything I have in hand is enough to get through today and tomorrow,” said Carolyn Wilson, head of operations for the Beaumont healthcare system in Michigan, earlier this week in an interview.
US health officials warned last year that two-dose regimens would increase the degree of difficulty with COVID-19 immunizations and originally contained the second doses to ensure they were available as recommended three to four weeks after the first. As President Joe Biden accelerates purchasing and distribution in an effort to gain protection for almost all Americans by the end of the summer, the system’s critical weaknesses are beginning to show.
“During the first six weeks of this program, more or less, we were just taking the first steps, and now we have to pay at least once,” said Eric Toner, senior researcher at the Johns Hopkins Center for Health Safety.
The right timing of doses is considered a key factor for effective immunization. Moderna Inc. says vaccines should be administered four weeks apart to ensure effectiveness, while the partnership between Pfizer Inc. and BioNTech SE recommends a three-week break. A working group at the Center for Disease Control and Prevention is considering recommendations to extend this range, Bloomberg News reported, although it is not yet clear what effect this may have on protection.
Only a small percentage of those vaccinated did not receive their second dose six weeks after the first, and most received it within the recommended interval of three or four weeks, the CDC said in an email. The agency declined to release more detailed figures.
In the meantime, more data is emerging that supports a delay between doses. AstraZeneca Plc, whose vaccine has not been released in the United States, says that its injections work best when administered 12 weeks apart. Israeli researchers found that the Pfizer-BioNTech vaccine offers 85% protection against symptoms after just one dose. Pfizer does not think a dose will work, said CEO Albert Bourla on Friday at a plant in Michigan, where he worked with Biden, although the company is analyzing the problem.
About 41 million people across the country have already received at least one injection and about 40% of them – 16 million – have achieved two. About 1.6 million injections are given every day, according to Bloomberg’s vaccine tracker. Each state has different criteria for who should be vaccinated first, but together 202 million Americans fit into priority groups – people over 65, essential workers and adults with high-risk medical conditions.
State-by-state data indicates a series of successes in fully immunizing people. Well over half of those vaccinated in West Virginia completed the series, but a third or less did in California and Illinois, according to data analysis from Bloomberg’s CDC. These rates can be influenced by how quickly you report doses administered and report delays.
People who need a second dose are competing for a scarce supply, with millions more trying to get the first. States have increased eligibility and opened immunization clinics in sports stadiums and retail pharmacies. Although a large dose increase is expected soon, the total weekly supply has still increased modestly.
Houston’s problems started even before Texas was hit by a devastating storm: the health department started administering second doses in early February, director Stephen L. Williams said in an interview earlier this month. The city still doesn’t have the technology to schedule follow-up appointments when people get their first chance, but Williams said he hopes an update in the coming weeks will change that.
Williams said the city is sending text messages and email with links to register, but he realizes that not everyone will use them. “Our call center is full,” he said, with a list of 70,000 people who need to be called to schedule appointments.
Beaumont, a health care system with eight hospitals, followed instructions from Michigan health officials to manage most of its supply without retaining reserves, said Wilson, the COO, but refueling did not arrive in time for second doses. . Beaumont and the Michigan Department of Health say they are working to bridge the gap between the state’s allocation and what the hospital expected.
When vaccines were first made available in December, federal authorities maintained a reserve for second doses. In January, the Trump and Biden administrations insisted on accelerating the campaign by sending most of the supply as soon as it was available. But states take different approaches to using second doses: some automatically allocate second doses, while others ask the providers who order them.
“Each jurisdiction is approaching this differently,” said Jessica Daley, Premier Inc.’s vice president of strategic supplier engagement, which provides procurement and other services to more than 4,000 hospitals.
Pennsylvania health officials said this week that some providers have inadvertently given some injections designed to increase the first doses. Hospitals followed orders from authorities to use available supplies, relying on the state’s promise that a second dose would be available when needed, the Pennsylvania Hospital Association said. The confusion can lead to delays in follow-up, although not beyond the six weeks recommended by the CDC.
For people trying to get their second shots, the search can be thwarted by the same technology hiccups and logistical obstacles that made the initial launch bumpy.
Wayne Sadin received his first dose of the Moderna vaccine on January 7, his 68th birthday, at the Bayou City Event Center in Houston. Health professionals said they would be in touch about a follow-up appointment.
“That was a little stressful,” said Sadin.
Four weeks later, the IT consultant did not have an answer and was unable to contact the health department. His doctor’s office said he needed to go back to the center for the second injection. Finally, he tweeted to the health department that was on hold with the call center. He got a spot on a Saturday afternoon, 30 days after his initial dose.
“I don’t know why they are not communicating better,” he said.