A new approach to the newly adopted COVID-19 vaccination in the UK is gaining strength in America, but it is dividing public health experts.
In an effort to eliminate as many doses as possible from the vaccine, British officials will stop withholding the second of two doses.
Instead, they will prioritize giving people the first dose and delay the second vaccine by up to three months.
“Everyone will still receive their second dose and it will be within 12 weeks after the first. The second dose completes the course and is important for long-term protection, “the UK government said in a statement.
“With two vaccines now approved, we will be able to vaccinate more people at higher risk, protecting them from the disease and reducing mortality and hospitalization.”
Each of the two vaccines currently authorized for use in the U.S. requires two doses, administered three or four weeks apart.
Under the current distribution plan, the administration’s Warp Speed operation only delivers half the number of doses needed to the states each week. The other half remains in a warehouse, retained to ensure there is enough supply for a second dose.
With the U.S. vaccination campaign slipping through the door and more than 3,000 people dying from COVID-19 every day, advocates of British policy do not understand why the administration does not use all the vaccines it has.
“Why not vaccinate as many people with a single dose as possible, with the intention of refilling that second dose later?” said Christopher Gill, a professor of global health at Boston University School of Public Health.
“I feel like in the state, we’re suffering from a lack of creativity in thinking about the most efficient way to protect the population, rather than the most efficient way to protect the person. For me, that’s the fundamental flaw in that.” , said Gill.
Anthony Fauci
Anthony FauciBidens pays tribute to front-line workers in New York: “We owe them, we owe them, we owe them” to U.S. debates over whether the UK’s approach is better for COVID-19 vaccines. MONTH, the country’s leading infectious disease doctor, said on Thursday that the idea of taking the first dose to everyone is “under consideration”.
“I still think that if done correctly, you can do a single dose, reserve doses for the second dose and still get the job done, but there’s a lot of discussion about whether or not you want to distribute the initial vaccination to make more people vaccinated. in the first round, “Fauci told NBC’s” Today Show. “
Logistical problems have affected the Trump administration’s distribution efforts, and much of the decisive “last mile” of work goes to underfunded local health departments.
Federal health officials 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 about 2 had been vaccinated. 8 million people. Less than 13 million doses have been administered.
These figures are likely to be lower due to delays in the data, but the final figures remain a fraction of the administration’s targets.
Former Food and Drug Administration Commissioner Scott Gottlieb, who is part of Pfizer’s board, has advocated vaccinating as many people as possible even before the UK changed its policy.
“I feel very strongly that we should get as many gunshots as possible,” Gottlieb told USA Today in early December. “The reality is that a dose is partially protective. I don’t think we should take the supply now, anticipating that something is wrong. “
Gottlieb explained in a Twitter post that he does not advocate delaying or giving up the second dose. What he wants is for the government to kick out more supply now, instead of withholding 50 percent of what is available.
But there is a supply risk. By not initially slowing down the second doses, companies will have to manufacture more doses and then distribute them when the second doses are needed.
In addition, clinical trials did not study what happens if doses are extended beyond the three- or four-week window or the amount of immunity that is provided with a single dose.
Although partial vaccine protection appears to begin as early as 12 days of the first dose, “two doses of the vaccine are required to provide maximum protection against the disease, a 95% effectiveness of the vaccine,” Pfizer said. 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 does not support a policy without evidence.
“I think it is very important to use a vaccine depending on how you have studied it. For me, the biggest concern if we extend the time period between the first and second dose is what happens to the persistence of protection, “Slaoui told reporters on Wednesday.
“You know, I would really advise not to do something that we don’t have any characterization of,” Slaoui added.
Natalie Dean, an assistant professor of biostatistics at the University of Florida, said she believes delaying a second dose will hurt public confidence, as people who have already received the first vaccine have reportedly canceled or rescheduled the appointment of the second dose.
“Here they are making decisions that deviate from the norm. It reflects that it is an emergency, but we don’t have the full evidence ahead, we don’t have those discussions or deliberations. And I think it would be better served with a more transparent process,” Dean said. .
Fauci said he understands why people support the spread of the second dose.
“We know from the clinical trial that the best time is to give it in one day and then for Moderna 28 days later and for Pfizer 21 days later. If you want to keep the data, this is how you should do it. said Fauci.
“But it can be argued, and there are people who are, to stretch the doses by giving a single general dose and in the hope that you will get the second dose in time to give it to people,” Fauci said.