A new approach to COVID-19 vaccination that has just been adopted in the UK is gaining ground in America, but it divides public health experts.
In an effort to expel as many doses of the vaccine as possible, British officials will no longer withhold the second of two doses.
Instead, they will prioritize giving the first dose to people and postponing the second admission for as long as three months.
‘Everyone will still receive their second dose and it will be within twelve weeks after their first dose. The second dose completes the course and is important for long-term protection, “the British government said in a statement.
“With two approved vaccines, we will be able to vaccinate a greater number of people at greatest risk, protect them from the disease and reduce deaths and hospitalization.”
Each of the two vaccines currently in use in the United States requires two doses, given three or four weeks apart.
Under the current distribution plan, the government’s Operation Warp Speed delivers only half of the required doses to states each week. The other half stays in a warehouse, held back to ensure there is enough stock for a second dose.
While the U.S. vaccination campaign is crawling out of the gate, killing more than 3,000 people daily on COVID-19, proponents of British policy do not understand why the government is not using every vaccine it has.
“Why not vaccinate as many people with a single dose as possible, with the intention of refilling that second dose later?” says Christopher Gill, a professor of global health at Boston University School of Public Health.
‘I just feel like a state party; we suffer here from a lack of creativity to think of the most effective way to protect the population, rather than the most effective way to protect the individual. For me, this is the fundamental mistake in this, “said Gill.
Anthony Fauci
Anthony FauciBidens honors front-line workers at NYE address: ‘We owe them, we owe them, we owe them’ US debates on whether the UK approach is better over COVID-19 vaccinations Will 2021 bring the happy ending that America so urgently needs need? MORE, the country’s leading doctor in infectious diseases, said on Thursday that the idea of giving the first dose to everyone was ‘under consideration’.
‘I still think, if you do it right, you can do a single dose, discuss doses for the second dose, and still do the job, but there are a lot of discussions about whether you want to spread the initial vaccination, by vaccinate more people in the first round, “Fauci said on NBC’s” Today Show “.
Logistical problems plagued the Trump administration’s proliferation efforts, and much of the important “last mile” work came under local health departments.
Federal health officials have promised that 20 million vaccines will be administered by the end of the year, but by the last day of 2020, the Centers for Disease Control and Prevention said only about 2.8 million people had been vaccinated. Less than 13 million doses were delivered.
These figures are likely to be an understatement due to overdue data, but the final numbers are still a fraction of the government’s targets.
Former Food and Drug Administration Commissioner Scott Gottlieb, who sits on Pfizer’s board, was in favor of vaccinating as many people as possible even before the UK changed its policy.
“I feel very strongly that we need to get as many shots as possible right away,” Gottlieb told USA Today in early December. ‘The reality is that one dose is partially protective. I do not think we should hold the stock now and expect something to go wrong. ”
Gottlieb elaborated in a Twitter post that he does not plead for the delayed or waiver of the second dose. What he wants is for the government to issue more bids now, rather than withholding 50 percent of the available amount.
But there is an offer risk. By not initially holding back the second doses, more doses must be produced by the companies and then distributed by the time the second doses are needed.
In addition, clinical trials have not studied what happens when doses are spread outside the window of three or four weeks, or how much immunity is provided with a single dose.
While partial protection against the vaccine appears to begin as early as 12 days after the first dose, “two doses of the vaccine are needed to provide maximum protection against the disease, a vaccine efficacy of 95 percent,” Pfizer said in a statement. said. “There is no evidence to show that protection is maintained after the first dose after 21 days.”
Moncef Slaoui, chief scientific adviser to Operation Warp Speed, said he did not support a policy with no evidence behind it.
‘I think it’s very important to use a vaccine based on how you studied it. “For me, the biggest concern is if we extend the period between the first and second dose, what happens to the persistence of protection,” Slaoui told reporters on Wednesday.
“You know, I would really advise not to do something we have no attribute to,” Slaoui added.
Natalie Dean, an assistant professor of biostatistics at the University of Florida, said delaying a second dose would undermine public confidence because people who had already received their first survey canceled their second dose appointments or rescheduled.
‘They make choices here that deviate from the standard. It does reflect that it is an emergency, but we do not have the full evidence before us, we do not have these discussions or deliberations. And I think they will be better served with a more transparent process, ‘Dean said.
Fauci said he understands why people are distributing the second dose.
‘We know from clinical trials that the best time is to give it on one day, and then for Moderna 28 days later and for Pfizer 21 days later. If you want to keep up with the data, you have to do it, ”Fauci said.
“But you can make an argument, and some people are going to stretch the doses by giving a single dose across the board and hoping that you will get the second dose in time to give to individuals,” he said. Fauci said.