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U.S. COVID-19 vaccination revamp may not be enough

Recently the president-elect proposed releasing all available vaccine supplies now as opposed to holding onto a portion to ensure enough doses are available to give a second dose to those who received their first.

It’s an idea that was initially rejected by the Trump administration but has since adopted. Last week, HHS Secretary Alex Azar announced plans to make available the rest of the vaccine supply that was being held and recommended states provide shots to everyone age 65 and older and to those with preexisting medical conditions.

“We now believe that our manufacturing is predictable enough that we can ensure second doses are available for people from ongoing production,” Azar said last week about the policy change. “Everything is now available to our states and our healthcare providers.”

The change in distribution carries a potential risk of making the vaccinations of those who received an initial dose less effective or even ineffective if production issues lead to supply shortages that delay people from receiving their second dose in time. The coronavirus vaccines have an efficacy rate of more than 90{f771d91d784324d4be731abc64bffe0d1fd8f26504ceb311bcfd8e5b001778f4} when two shots are given 21 days apart for the Pfizer-BioNTech vaccine, and 28 days apart for the vaccine produced by Moderna. While a Food and Drug Administration analysis showed a single dose of the Pfizer-BioNTech vaccine had a protection rate of 82{f771d91d784324d4be731abc64bffe0d1fd8f26504ceb311bcfd8e5b001778f4}, it cautioned not enough information was known about whether a single dose provided protection past 21 days.

Despite the urgent need to increase vaccinations, Wen does not favor releasing all available supplies unless there are guarantees enough would be available to vaccinate patients in the way the vaccine was intended to be used. “People who receive the first vaccine dose have a reasonable expectation that they should receive the second in a timely manner,” she said.

In defending the Trump administration’s vaccination strategy, Azar said last week in a meeting with reporters an average of more than 700,000 vaccinations had been conducted over the past several days and projected an average of 1 million vaccinations a day would be reached over the following week to 10 days.

Azar blamed the slow vaccine rollout on states adhering too strictly to federal guidance that recommended front-line healthcare workers and staff and resident of long-term-care facilities receive the vaccine first.

“This is just moving to the next phase of the vaccine program,” Azar said. “We’ve had so much success with quality and predictable manufacturing and almost flawless distribution of the vaccine, but we have seen now that the administration in the states has been too narrowly focused.”

Azar also announced the administration was moving forward on plans to open more channels to administer the vaccine that included local pharmacies and community health centers. HHS plans to deploy teams to provide technical assistance to states in their efforts. “It has been overly hospitalized so far in too many states,” Azar said.

But Dr. Carmen Rexach, an infectious disease expert and a spokeswoman for the Infectious Disease Society of America, said a key component that has yet to be addressed involves effectively communicating with the public the benefits of taking the vaccine. Biden’s plan includes launching a mass public education campaign to bolster confidence in the vaccine’s safety and efficacy.

The lack of a robust public education campaign about the vaccine thus far has led to a sizable portion of the public remaining hesitant to get vaccinated. A survey conducted last month by the Kaiser Family Foundation found more than a quarter of the public said they would not get the COVID-19 vaccine. The share of those who said they would not get vaccinated was higher among Black adults and essential workers, despite the fact that both groups have been disproportionately impacted by the pandemic.

Rexach said raising adherence, particularly among the highest-risk populations, is crucial to stem COVID-19’s spread.

“I think people are so afraid of COVID that they’re more likely to be willing to get a vaccine than they are to get an MMR (measles, mumps and rubella vaccine),” Rexach said. “What (the Biden administration) might do that would help even more is actually show people how this vaccine works and how it is different from other types of vaccines.”


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