Two-shot covid vaccine therapy makes it difficult to vaccinate Americans

“It will definitely be an iterative process,” Howell said, increasing these problems through prisons, group homes, and homeless shelters, wasting valuable doses if someone didn’t show up as expected on the second shot. Thinking about how not to, a valuable vial in the refrigerator.

“Do you use a second dose for the first dose?” Howell speculated.

Public health authorities like her may have the urgency of a pandemic, immunity from previous exposures, as the country prepares to vaccinate tens of millions of Americans with the new coronavirus. We are facing a new dilemma caused by the fact that we have sex. Vaccines are available at each site, and shot intervals vary by manufacturer.

They need to track people who have taken a single dose in order to send a reminder about the need to return after a few weeks. They are worried that the first vaccine may make people feel sick and never want to go through the challenges again. And if, for example, you take your first dose at Walgreens and go to CVS for the second time, or worse, if you cross state boundaries and move from one health department registration system to another, the problem is. I expect it to happen.

“Two doses more than double the logistical challenges of vaccination,” said Jeffrey Dutin, a public health officer in Seattle, Washington and King County.

Two or three dose plans are routine to build immunity to many diseases, but within a few months the public health goal is to reach herd immunity and stop viral immunity. When it comes to vaccination of 60-70%, there is no precedent in a pandemic. Expansion.

“This is the only time we have faced a serious and imminent threat to the entire population in need of a double vaccination,” said the Vaccination Action Union, which was the director of the Tennessee program in 2009 during the H1N1 pandemic. Said Kelly Moore. I remember her relief when she learned everyone, but one shot is enough for young children.

This was possible because, unlike covid-19, which is caused by a new virus, an H1N1-like flu had previously spread to humans, giving many people partial immunity. Clinical trials have shown that a single injection provides protection.

According to Moore, there are both single- and double-dose vaccines for Ebola, and experts are best deployed both at and around the outbreak, depending on the availability of supplies. I’m thinking about a method.

It is not uncommon for vaccines to require re-up for the immune system to react more effectively. According to Moore, the classic schedule for a vaccine that targets proteins such as the spike protein on the surface of the coronavirus is three shots of “prime, prime, and boost,” with the second and third shots first. It takes place 1 and 6 months after the injection. The first two shots each stimulate the immune system, usually followed by a moderate decrease in antibody. The third shot can usually provide long-term protection by enhancing the memory cells of the immune system, at least 6 months after the first shot. At that point, these memory cells are mature and ready to respond.

It is not yet clear whether any of the new coronavirus vaccines in the pipeline will ultimately work optimally with a third shot that can enhance long-term protection.

“Memory cells grow gradually over a period of at least 6 months,” said Claire Angie Christo, a professor of vaccine science at the University of Geneva and head of the World Health Organization’s Center for Vaccine Immunology Cooperation. .. The urgency of increasing infection rates and mortality has led to the promotion of immediate two-shot solutions.

“In a pandemic epidemic where efficacy needs to be elicited as quickly as possible, it is most rational to give two primary vaccines and then see if and when booster immunization is needed. It’s a choice, “she said.

It may also prove that lower doses are sufficient.

“As far as we know, all of these double dose vaccines can work with a single dose,” Duchin said.

Data is collected when the population is vaccinated and provides detailed information on the best way to defeat this particular disease.

“I think we need to learn what it takes to maintain immunity,” said Bruce Gellin, president of Global Vaccination at the Sabin Vaccine Institute, fine-tuning strategies and policies based on evolving science and in the future. He said there was a possibility of re-vaccination. Just like the annual flu vaccine.

“There are a lot of missing data points,” said John Brownstein, Chief Innovation Officer at Boston Children’s Hospital. He runs Vaccine Finder, a system developed by Google 10 years ago to support the introduction of the H1N1 vaccine.

The Vaccine Finder is designed to help you find vaccine providers near your place of residence, from influenza to shingles. However, the system does not collect personal data. This is needed, for example, to send a reminder to an individual about the second coronavirus shot.

“For now, this is a one-way push,” said Brownstein, who explained his ambition to rebuild the infrastructure so that people could get the latest information and information about scheduled vaccines. Stated.

Sacramento County Health Director Peter Bayrenson said the challenge of registering an individual and electronically reminding him of a second shot can be daunting. ..

A two-shot emergency schedule will overturn the way many health departments have organized mass vaccination programs in recent years. Vanderbilt University School of Medicine has been developing a program to vaccinate students, faculty, staff and volunteers against influenza for 10 years. This is a one-shot completed transaction that successfully vaccinated as many as 15,000 people. in a day.

Many of these efficiencies are not possible with a two-shot regime.

Vanderbilt’s chief infectious disease, Thomas Talbot, said it “affects staffing” when healthcare workers are already lean.

Coronavirus vaccines can cause headaches, fever, and other unpleasant symptoms. All of these are good signs that the body’s immune system is functioning, but Talbot is concerned that it may prevent people from returning to a second dose.

Moore, who studied another painful vaccine (a double-dose shingles shot), returned to the majority of people who were educated about what to expect from a second dose, despite discomfort. He says he is moved by the way he comes.

“Our experience at Shingrix is ​​very encouraging to come back as long as motivated people are properly prepared,” Moore said.

And while future challenges are difficult, Howell said he was happy to be able to ponder them with other experts.

“It’s comforting that we are all in the same position,” she said. “We are all trying to understand this.”