Dr. Ashish Jha argues that the United States should seriously consider delaying the second doses of the COVID-19 vaccine and rather give the first shot to more people as the country’s vaccination fluctuates through the country, and with a more contagious virus strain. to distribute.
The dean of the Brown University School of Public Health, with Dr. Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco, outlined the case for updating the vaccination in the Washington Post.
As Mike Tyson famously said, “Everyone has a plan until they are punched in the mouth,” the two doctors wrote in a Sunday headline. ‘As far as COVID-19 is concerned, we are constantly beaten in the mouth. It’s time to change the plan; We now need to give people just one vaccination and postpone their second survey until more doses of vaccination are available. ”
The United Kingdom already selected to delay the second doses of Pfizer and Oxford University / AstraZeneca vaccines as a way to more quickly provide a broader group of people with the first protection that the first admission offers.
Jha and Wachter argued that with fewer approved vaccines than hoped for in early 2021, bottlenecks in the spread of the shots, hundreds of thousands of people were infected and thousands died daily in the United States, and now a new variant of the spread of the virus, must be acted upon immediately.
“We need to vaccinate as many people as quickly as possible to save most lives,” they wrote.
According to the doctors, the clinical trials on the Pfizer and Moderna vaccines indicate that the first shot yielded benefits about ten days after administration, and by the time the second shot was given about a month later, the initial dose is already about 80 to 90 percent effective against COVID-19. But the second dose adds effectiveness and makes the immunity to the vaccine potentially ‘more durable’, they said.
At the ‘Today’ show on Monday, Jha said that the data from the clinical trials indicated that postponing the second dose could still be ‘fairly effective’.
“Given the crisis we are in, I think it’s worth investigating,” he said.
Chat with @SavannahGuthrie on @ TODAY show
A more contagious virus is a big problem: exponential growth means many more infections, hospitalizations, deaths
And suggestion of 1/2 dose Modern or delayed 2nd dose
Not ideal. But 100,000 deaths are not expected in the next 4-6 weeks either https://t.co/5qJiIVswUD
– Ashish K. Jha, MD, MPH (@ashishkjha) 4 January 2021
Jha and Wachter emphasized in their opinion that they are not arguing that people should not receive both shots, but they acknowledge that there is a risk in the proposal.
“We do not know if and when the immunity will begin to wane against the first shot,” they wrote. ‘But data from Moderna, for example, is reassuring. It shows a robust immune response four weeks after the first shot, and most experts believe it is highly unlikely that immunity will somehow drop by week eight or even week 12 after a single shot. Another concern is that some people with a delay may forget to get their second chance. It will take effort to locate people and remind them to receive them. ”
But the reality, according to doctors, is that between 50,000 and 100,000 Americans will die from COVID-19 in January alone. The pandemic has already claimed that the lives of more than 350,000 people in the United States, with experts predicting that there will be an increase in cases and deaths after holiday gatherings that took place around Christmas and New Year.
On Twitter, Jha stressed that most 75-year-olds with the current plan will not get their first dose of vaccine for many more weeks, while most 64-year-olds will not see them for months.
By that time, the new variant of the virus could become dominant, he said.
And while so far it has not proven to be more deadly on the individual level, it is potentially more contagious, meaning it will cause more cases, which in turn means more hospitalizations and deaths, Jha and Wachter write.
“Anyone who can protect us now is someone who is less likely to get infected tomorrow and die in four weeks,” Jha wrote on Twitter. “The bottom line is that I realize we’re striving for something at risk. But we must not ignore the risk of not doing so at all. ‘
Obviously, if you want to stay in the trials (reasonable position), then stay with the standard interval
But soon we will be faced with question – do we give a second shot to some people or a first shot to more people?
Is there evidence from clinical trials that 1 dose is useful?
Yes
2 / n
– Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021
But while we may not be sure, it does not mean we have no idea
Here is one of our country’s most knowledgeable immunologists, @VirusesImmunity her explanation of delayed versus immediate 2nd dose https://t.co/BN7k4Xxx5C
4/9
– Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021
We are on track to kill another 50 to 100,000 Americans on COVID in January
And this again in February
Most 75-year-olds still do not receive their first dose for many weeks
And most 64-year-olds will not do so for months
And the new variant will become dominant at that time
6/9
– Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021
And for us the answer is: take out first doses immediately
Get 2 doses in the arms as it is available later in winter
Now it is reasonable to make a few exceptions, such as residents of nursing homes where you want to maximize protection
But if you listen to Operation Warp Speed
8/10
– Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021
Anyone who can protect us now is someone who is less likely to get infected tomorrow and die in 4 weeks
The end result is that I realize we’re striving for something that risks
However, we must not ignore the risk of not doing so at all.
Here is the op-ed again
Finhttps: //t.co/UWAj9cY08N
– Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021
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