Second-strike crisis leaves many without full immunizations to COVID-19



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Almost a month after the ramp-up of vaccination campaigns in the United States to deliver COVID-19 injections to more than a million people per day, their second doses are due, forcing states to deploy and leave some without full vaccination.

In Texas alone, nearly 6,000 people were late for their second injection in early February. Washington state officials said earlier this week that some mass vaccination clinics would only issue follow-up doses. And a Michigan hospital system canceled last-dose appointments last week after its supply was cut.

“Everything I have on hand is enough to get me through today and tomorrow,” Carolyn Wilson, chief operating officer of Beaumont, Michigan Health System, said earlier this week in an interview.

U.S. health officials warned last year that two-shot regimens would increase the difficulty of COVID-19 vaccinations and initially withheld second doses to ensure they would be available as recommended three to three times. four weeks after the premiere. As President Joe Biden ramps up purchasing and distribution in a bid to secure protection for nearly all Americans by the end of the summer, critical weaknesses in the system are starting to emerge.

“For the first six weeks or so of this program, we were only giving the first few injections, and now we kind of have to pay the bagpiper,” said Eric Toner, senior researcher at the Johns Hopkins Center for Health Security.

The timing of doses is considered a key factor in effective vaccination. Moderna Inc. says injections should be given four weeks apart to ensure effectiveness, while the partnership between Pfizer Inc. and BioNTech SE recommends a three-week break. A task force of advisers from the Centers for Disease Control and Prevention is considering recommendations to extend that gap, Bloomberg News reported, although it’s still unclear what effect this might have on protection.

Only a small percentage of people vaccinated did not receive their second dose within six weeks of the first, and most received it within the recommended three or four week interval, the CDC said in an email. . The agency declined to share more detailed figures.

Meanwhile, more data is emerging that supports a delay between doses. AstraZeneca Plc, whose vaccine has not been licensed in the United States, says its injections work best when given 12 weeks apart. Israeli researchers have found that the Pfizer-BioNTech vaccine offers 85% protection against symptoms after a single dose. Pfizer doesn’t think a dose will work, CEO Albert Bourla said at a Michigan factory where he appeared with Biden on Friday, although the company is looking into the issue.

About 41 million people nationwide have received at least one injection, and about 40% of them – 16 million – have had two. About 1.6 million vaccines are given each day, according to Bloomberg’s Vaccine Tracker. Each state has different criteria for determining who should be vaccinated first, but together 202 million Americans fall into priority groups – people over 65, essential workers, and adults with high-risk illnesses.

State-by-state data indicates a number of successes in fully immunizing people. Well over half of those vaccinated in West Virginia have completed the series, but a third or less in California and Illinois, according to a Bloomberg analysis of CDC data. These rates could be influenced by the speed with which States administered the doses and the reporting timelines.

People who need second doses compete for a limited supply and millions more are trying to get the first. States have expanded eligibility and opened immunization clinics in sports arenas and retail pharmacies. Although a significant increase in shots is expected soon, the total weekly supply has only increased modestly yet.

Houston’s troubles began even before Texas was hit by a crippling storm: the health department just started giving second doses in early February, director Stephen L. Williams said in an interview earlier this month. . The city doesn’t yet have the technology to book follow-up appointments when people get their first injection, but Williams said he hoped an upgrade in the coming weeks would change that.

Williams has said the city is sending text messages and emails with links to sign up, but he realizes not everyone will use them. “Our call center has been criticized,” he said, with a list of 70,000 people to be called to make appointments.

Beaumont, a health system of eight hospitals, followed instructions from Michigan health officials to administer most of its supply without holding reserves, said Wilson, the chief operating officer, but the resupply did did not arrive in time to administer the second doses. Beaumont and the Michigan Department of Health both say they are working to make up the difference between the state’s allowance and what the hospital expected.

When the vaccines became available in December, federal officials withheld a reserve of second doses. In January, the Trump and Biden administrations urged to speed up the campaign by shipping most of the supply as soon as it became available. But states are taking different approaches to using second doses: some automatically assign second doses, while others require providers to order them.

“Each jurisdiction approaches the issue differently,” said Jessica Daley, vice president of strategic supplier engagement at Premier Inc., which provides purchasing and other services to more than 4,000 hospitals.

Pennsylvania health officials said this week that some providers inadvertently gave injections meant to act as a booster for the first doses. Hospitals followed authorities’ orders to use available supplies, based on the state’s commitment that second doses would be available when needed, the Pennsylvania Hospital Association said. The confusion can lead to delays in follow-up shots, but not beyond the six weeks recommended by the CDC.

For people trying to get their second fix, the quest can be thwarted by the same tech hiccups and logistical issues that made the initial rollout bumpy.

Wayne Sadin received his first dose of Moderna vaccine on January 7, his 68th birthday, at the Bayou City Event Center in Houston. Health workers said they would be in touch with a follow-up appointment.

“It was a little scary,” Sadin said.

Four weeks later, the IT consultant had not received a response and could not reach the health service. His doctor’s office said he had to return to the center for his second shot. Finally, he tweeted to the health department that he was on hold with his call center. He got a slot on a Saturday afternoon, 30 days after his initial dose.

“I don’t know why they don’t communicate better,” he says.

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