One shot instead of two to speed up vaccination?

With the alarmingly late coronavirus vaccine rollout across the United States and a more contagious strain of the disease now spreading to at least three states, epidemiologists are in turmoil over a new strategy overseas: delaying the disease. second dose of the vaccine to attract at least more people. partially immune faster.

Earlier this week, UK officials announced they would prioritize partially immunizing more people rather than giving second vaccines three or four weeks later – which lively discussion among U.S. health experts desperate for faster vaccinations amid a nationwide surge.

But an infuriating patchwork of vaccination plans – not to mention scientific uncertainty over a delayed second dose – means such a change is unlikely to occur in the United States, epidemiologists say.

“I’m all for getting as many people vaccinated as possible for the benefit of the community,” said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco, where the president of medicine recently declared he supported a single dose plan. But given how piecemeal and confusing the deployment has already been, he said, “that would never be possible in the United States.”

The Pfizer and Moderna vaccines are both given in two doses, approximately three and four weeks apart, respectively. Although the vaccines are over 90% effective with two doses, it is not clear how delaying the second dose beyond the manufacturers’ recommendation would affect the population as a whole.

British officials have made the compromise in order to do “so much good for the greatest number of people in the shortest possible time,” British chief medical officers wrote in a letter on Thursday, citing data showing “the vast majority of initial protection against clinical disease. is after the first dose of vaccine. “

Dr Bob Wachter, chairman of the UCSF Department of Medicine, said in a series of tweets Thursday that the slow deployment and the new viral variant “requires that we turbocharge the process of protecting at least part of a large part of the population” in one fell swoop – especially as Americans tire of the precautions against the virus. pandemic.

“It seems increasingly clear that a strategy to get as many people (especially at high risk) their first shot will save far more lives than sticking to the two-shot plan,” he wrote. Wachter was not available on Saturday.

Nationally, however, the idea has yet to gain popularity. The director of the National Institute of Allergy and Infectious Diseases, Dr Anthony Fauci, said earlier this week that the strategy was “under consideration,” but clarified on Friday that the United States would not follow the example of Great Britain.

Because states are largely responsible for their own vaccine deployments after the federal government allocates the doses, they could theoretically make the switch on their own. The California Department of Public Health said in a statement on Saturday that it “continues to carefully review” the results of clinical trials in order to compare the potential benefits of vaccinating more people.

But Dr Kirsten Bibbins-Domingo, another UCSF epidemiologist, said California would be wise to stick with its current plan.

“Even though theoretically a single-dose strategy with a long lag could attract more immune people, we risk creating much more logistical hurdles to shift gears midway through with no benefit,” Bibbins-Domingo said. “It’s hard to imagine this is the right strategy.”

About 4.2 million people had received the first dose of the Pfizer or Moderna vaccine on Saturday, according to the Centers for Disease Prevention and Control – well below the 20 million the United States had targeted earlier this year.

Correcting those delays has taken on new urgency after a more contagious strain of COVID-19 was discovered in three states, including California. Although there is no evidence the strain is more deadly, scientists believe it is responsible for the recent spikes in England – meaning the United States faces the threat of even more infections in addition to the current winter flare.

In California, the seven-day case average has more than doubled since the start of December to exceed 39,000 new infections a day. The intensive care capacity of hospitals, meanwhile, remains at 0% in Southern California and the San Joaquin Valley, and has fallen to just 5.1% in the Bay Area. Overall, the state recorded 53,341 new cases on Friday and 386 new deaths, most of which were in southern California, where health experts were seeing signs of a post-vacation flare.

With the risk of infection appearing to be higher than ever, many anxious residents have recalibrated their expectations as to when, if at all, they could get the vaccine in the coming months.

Patricia Fuschetti, 78, an Oakland resident, exchanged information with friends in Boston and the Bay Area about their eligibility to no avail.

“Nobody knows, because there is no rhyme or reason for what is happening,” said the retired nurse, who would like to see President-elect Joe Biden’s administration come up with a nationalized vaccine response. “There is no centralized plan.”

The one-dose versus two-dose decision, she said, appears to be something else local and state governments could screw up without clear direction from the federal government.

“Think about the New Deal,” Fuschetti said. “Think about what works in the story and what needs to happen quickly.“