A new approach to the newly adopted COVID-19 vaccination in the UK is gaining momentum in America, but it is dividing public health experts.
In an effort to inject as many doses of the vaccine as possible, British officials will no longer retain the second of the two doses.
Instead, they will prioritize giving people the first dose and postponing the second injection for up to three months.
“Everyone will still receive the second dose and this will happen 12 weeks after the first. The second dose completes the course and is important for long-term protection, ”said the UK government in a statement.
“With the two vaccines already approved, we will be able to vaccinate a greater number of people who are at greater risk, protecting them from disease and reducing mortality and hospitalization.”
Each of the two vaccines currently authorized for use in the United States requires two doses, administered three or four weeks apart.
According to the current distribution plan, the government’s Operation Speed Warp delivers only half the number of doses required to states each week. The other half remains in a tank, retained to ensure that there is sufficient supply for a second dose.
With the United States’ vaccination campaign coming out of the gate and more than 3,000 people dying from COVID-19 every day, British policy advocates don’t understand why the government isn’t using all the vaccines it has.
“Why not vaccinate as many people as possible with a single dose, with the intention of filling the second dose later?” said Christopher Gill, professor of global health at the Boston University School of Public Health.
“I feel like a state, we are suffering from a lack of creativity here to think about the most efficient way to protect the population, instead of the most efficient way to protect the individual. For me, that’s the fundamental flaw in that, ”said Gill.
Anthony Fauci
Anthony FauciBidens honors frontline workers in NYE speech: ‘We owe them, we owe them, we owe them’ US debates whether the UK approach is better with vaccines COVID-19 Will 2021 bring the happy ending does America so desperately need? MORE, the country’s top infectious disease doctor, said on Thursday that the idea of distributing the first dose to everyone is “under consideration”.
“I still think that, if done correctly, you can take a single dose, reserve doses for the second dose and still do the job, but there is a lot of discussion about whether or not you want to spread the initial vaccination, even vaccinating more people in the first round. , ”Said Fauci on NBC’s“ Today Show ”.
Logistical problems have affected the Trump administration’s distribution efforts, with much of the crucial “last mile” of work falling on local underfunded health departments.
Federal health officials have promised that 20 million vaccines would be administered by the end of the year, but on the last day of 2020, the Centers for Disease Control and Prevention said only 2.8 million people had been vaccinated. Less than 13 million doses have been delivered.
These numbers are likely to be underestimated due to data delays, but the final numbers are still a fraction of the government’s goals.
Former Food and Drug Administration commissioner Scott Gottlieb, who sits on the board of Pfizer, has advocated vaccinating as many people as possible, even before the UK changes its policy.
“I strongly believe that we should hit as many shots as possible immediately,” Gottlieb told USA Today in early December. “The reality is that a dose is partially protective. I don’t think we should keep supplying now, predicting that something will go wrong. “
Gottlieb elaborated in a post on Twitter that he is not advocating the postponement or abandonment of the second dose. What he wants is for the government to expel more supply now, instead of retaining 50% of what is available.
But there is a risk of supply. By not retaining the second doses initially, more doses will need to be manufactured by the companies and then distributed when the second doses are needed.
In addition, clinical trials have not studied what happens if doses are distributed beyond the three or four week window, or how much immunity is provided with a single dose.
Although partial protection of the vaccine appears to begin 12 days after the first dose, “two doses of the vaccine are needed to provide maximum protection against the disease, a vaccine effectiveness of 95 percent,” said Pfizer in a statement. “There is no data to show that protection after the first dose is maintained after 21 days.”
Moncef Slaoui, chief scientific adviser to 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 how you studied it. For me, the biggest concern if we are going to extend the period of time between the first and the second dose is what happens with the persistence of protection, ”Slaoui told reporters on Wednesday.
“You know, I would really advise not to do something that we don’t characterize,” added Slaoui.
Natalie Dean, assistant professor of biostatistics at the University of Florida, said that postponing a second dose will damage public confidence because people who have already received the first dose are having their second dose canceled or rescheduled.
“They are making choices here that are deviating from the standard. This reflects that it is an emergency, but we do not have all the evidence before 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 distribution of the second dose.
“We know from the clinical trial that the ideal time is to administer it in one day and then to Moderna 28 days later, and to Pfizer 21 days later. If you want to keep the data, this is how you should do it, ”said Fauci.
“But you can make an argument, and some people do, about stretching doses, giving a single generalized dose and hoping to receive the second dose in time to give it to individuals,” said Fauci.