Ashish Jha calls for delaying the second vaccination and making the first vaccination more widespread

Dr. Ashish Jar argues that the United States must seriously consider delaying the second dose. COVID-19 (new coronavirus infection) (# If there is no character limit, add parentheses when it first appears Instead, as a national vaccine deployment, choose to give more people the first shot Stagger, And more infectious strains of the virus are expected to spread.

The Dean of Public Health at Brown University, along with Dr. Robert Wachter, Dean of Medicine at the University of California, San Francisco, has filed a proceeding to renew the vaccination rollout. At the Washington Post..

“As Mike Tyson famously said,’everyone is planning until they are hit in the mouth,'” the two doctors wrote on Sunday. op-ed.. “For COVID-19, we’ve been beaten over and over again. It’s time to change our plans. That is, now people are vaccinated once and more. The second vaccination should be postponed until the vaccine is available. “

England Already selected Delaying the second dose of the Pfizer and Oxford University / AstraZeneca vaccine is a way to quickly provide more people with the first protection that the first shot provides.

Jha and Wachter have fewer approved vaccines than expected by early 2021, bottlenecks in the distribution of shots, infecting hundreds of thousands of people in the United States and killing thousands daily. Insisted that there was. A new variant of the spreading virus, You need to take action immediately.

“We need to vaccinate as many people as possible as soon as possible to save most lives,” they write.

According to doctors, in clinical trials of the Pfizer and Moderna vaccines, the first shot was effective about 10 days after administration, and by the time the second shot was given about 1 month later, the initial dose was already about 80- 90% effective against COVID-19. However, they said the second dose could increase efficacy and make immunity from the vaccine “more durable.”

At the “Today” show on Monday, Jha said data from clinical trials show that delaying a second dose can still be “very effective.”

“Given the crisis we are facing, I think it’s at least worth investigating,” he said.

Talked to @SavannahGuthrie on @TODAYshow

More contagious viruses are a big problem: exponential growth means more infections, hospitalizations and deaths

And a proposal for a 1/2 dose or a second delayed dose of Moderna

Neither is ideal. However, it is not expected that 100,000 people will die in the next 4-6 weeks. https://t.co/5qJiIVswUD

— Ashish K. Jha, MD, MPH (@ashishkjha) January 4, 2021

Jha and Wachter emphasized in their editorial that people did not insist that they should not receive both shots, but acknowledged that the proposal was at risk.

“I don’t know if and when the immunity from the first shot will begin to weaken,” they write. “But, for example, Moderna’s data are encouraging. They show a strong immune response four weeks after the first shot, and most experts have weakened immunity by the 8th or 12th week after a single shot. I think it’s very unlikely to be. Another concern is that some people may forget to get the second shot late. Track people and do it. Efforts will be needed to remind them to receive. “

However, the reality is that 50,000 to 100,000 Americans will die of COVID-19 in January alone.The pandemic is already More than 350,000 lives Experts predict that Americans will experience a surge in cases and deaths following holiday gatherings before and after Christmas and New Year.

On Twitter, Jha said the current plan is that most 75-year-olds will not be vaccinated for “more weeks”, but most 64-year-olds will not be vaccinated for months. Emphasized.

By that time, he said, new variants of the virus could prevail.

So far, it does not appear to be more deadly at the individual level, but the potential for high infectivity means causing more cases, and thus more hospitalizations. Jha and Wachter write that it means death.

“The people we can protect now are those who are unlikely to get infected tomorrow and die in four weeks,” Jha wrote on Twitter. “The bottom line is that you want something at risk, but don’t ignore the risk of not doing this at all.”

Obviously, if you want to stick to the trial (reasonable position), keep the standard spacing

But soon we will face the question — will we give some people a second shot or more people a first shot?

Is there evidence of clinical trials that a single dose can help?

Yes

2 / n

— Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021

It may not be certain, but that doesn’t mean we don’t know

This is one of the most professional immunologists in our country, @VirusesImmunity Lay out her assessment of delayed vs. immediate second dosehttps://t.co/BN7k4Xxx5C

4/9

— Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021

An additional 50,000 to 100,000 Americans will die of COVID in January.

And in February that number again

Most 75-year-olds do not take their first dose for weeks to come

And most 64 years old don’t do it for months

And in the meantime the new variant will dominate

6/9

— Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021

And for us, the answer is to get the first dose right away

When available at the end of winter, put a second dose on your arm

Now it makes sense to make some exceptions like the resident of a nursing home where you want to maximize protection

However, when I heard Operation Warp Speed

8/10

— Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021

The people we can protect now are those who are unlikely to get infected tomorrow and die in four weeks.

In conclusion, I realized that I was looking for something at risk

But the risk of not doing this at all should not be ignored

This is another editorial

the endhttps://t.co/UWAj9cY08N

— Ashish K. Jha, MD, MPH (@ashishkjha) January 3, 2021

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