For the past several months I have counted on my personal protective equipment to create a necessary barrier between me and my patients. Several patients have tested positive for COVID-19, even though they had no clear symptoms at the time of the visit.
But although I will continue to wear PPE, the risk to me and my patients will diminish. This is not because COVID-19 is going away (the opposite is true), but because I have received the Pfizer-BioNTech vaccine.
Ten days after being vaccinated, I am starting to gain some immunity, which probably means that if I do acquire COVID from one of my patients or elsewhere it will be a milder case, although this has yet to be proven.
What has been shown in clinical trials is that the first shot may offer me just over 50% protection against COVID-19 in advance of my taking the second shot. This is a statistical calculation and by no means a certainty. This means that in the clinical trials those who tested positive for COVID-19 were over 50% less likely to have received the actual vaccine versus a placebo (more than twice the number of COVID cases occurred in the placebo group
With there being a slow rollout of the new COVID-19 vaccines both in the U.S. and around the world, I understand the impulse to give only one dose of the Pfizer-BioNTech, the Moderna, or the Oxford-AstraZeneca vaccine in Britain, in order to vaccinate millions more people in the legitimate hope that this decreases the risk of severe illness and hospitalization at a time when hospitals are overwhelmed with COVID-19 cases.
But this hope is not purely science. I believe we should keep to the two-dose schedule as studied. Keep in mind that the clinical trials were all conducted with careful dosing regimens and the conclusions drawn are based entirely on these two-dose protocols.
The Food and Drug Administration’s emergency use authorization for vaccinations is conditional. The United Kingdom and its National Health Service are taking a risk in three ways by delaying the second vaccine dose for three months so more people can get the first dose.
First, the degree of immunity may well diminish over the three-month period. Second, there is no direct proof yet that the initial dose alone will decrease hospitalizations. And third, there is no guarantee that the second dose will even be available in three months. Once there is an expectation on the part of the general public that their first dose is in the offing, this demand may get in the way of the second dose for others for several months.
With over 14 million doses of the Pfizer and Moderna vaccines having been distributed in the U.S and just over 3 million doses having been administered here, it is clear that a good part of the delay is occurring at the state level.
It is crucial that all of our most vulnerable populations, beginning with the elderly (who account for over 80% of COVID deaths) be immunized as soon as possible.
I expect the numbers vaccinated in the U.S. to increase exponentially in January, as over 40,000 pharmacy sites (Walgreens, CVS, Costco) receive their doses and begin vaccinating.
Keep in mind that by one measure the rollout (albeit much slower than expected) has been a big success. As we have gone from thousands vaccinated in clinical trials to millions vaccinated under the emergency use authorization, the number of significant side effects (mostly allergies) has been extremely small. This bodes well for the future of both vaccine compliance as well as usefulness.
Whereas more than 1 million Israelis have already received a COVID-19 vaccine (11% of the population, well above the global average of 0.13% according to data from Oxford University), we in the U.S. still lag far behind.
But if we think of this as a race we are losing it will be far too easy NOT to see it for what it really is: the greatest accomplishment in vaccine science in history.
I will never forget the moment of awe and raw emotion when I received my first COVID-19 shot. I intend to receive my second shot on schedule. It will be happening for you soon too.
As I wrote in my book, “COVID: The Politics of Fear and the Power of Science,” the last thing we need is for political posturing and blame to impede the vaccine rollout.
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