Is One Shot for All Better than None for Some?


In this 2020 photograph, captured inside a clinical setting, a health care provider places a bandage on the injection site of a patient, who just received an influenza vaccine. (Photo by the CDC | Unsplash)

In this 2020 photograph, captured inside a clinical setting, a health care provider places a bandage on the injection site of a patient, who just received an influenza vaccine. (Photo by the CDC | Unsplash)

Is one shot for all better than none for some?

President Joe Biden used a prime-time address to the nation on Thursday to lay-out an encouraging timeline:  

All adult Americans will be eligible to get a vaccine no later than May 1. Let me be clear: that doesn’t mean everyone is going to have that shot immediately, but it means you’ll be able to get in line beginning May 1st.

But 7 members of the GOP Doctors Caucus say the US is missing an opportunity to save lives when it comes to vaccine strategy. They sent a letter to the acting Secretary of the US Department of Health and Human Services, asking they immediately review new data to “enhance and increase the current vaccine administration.” 

Specifically, they believe the Pfizer and Moderna vaccines were so effective that after just one dose, we should give one shot to as many people as possible and come back for a second dose as more vaccines are available. 

It’s an approach already being taken by our allies across the pond. While the vaccine manufacturers recommend waiting only about a month in between both doses, the UK took the step of extending the interval to around 12 weeks. Scientific advisers there said this would provide at least some protection to as many people as possible in the early stages of the vaccine rollout.

But in response to the Doc. Caucus letter, The Wall Street Journal  published a piece entitled: “US Government Scientists Skeptical of One-Shot Regimen for Pfizer, Moderna COVID Vaccines.” The lede said this:

 “US government scientists are pushing back against calls for one-dose regimens for two COVID-19 vaccines designed to be administered with two shots, saying there isn’t enough evidence that a single dose provides long-term protection.”

Among those quoted, Peter Marks, director of the Food and Drug Administration’s center that oversees vaccines, says:

“It is essential that these vaccines be used as authorized by FDA in order to prevent COVID-19 and related hospitalizations and death.”

Paul A. Offit of the Children’s Hospital of Philadelphia, who served on the FDA advisory panel that recommended the use of the Pfizer and Moderna vaccines, said those clinical trials “found a level of neutralizing antibodies [with one dose] that was significantly less than what they got with two doses.”

Senator Doctor Roger Marshall – also a signator on the orignal “Doc Caucus” letter – fired back with a Wall Street Journal op-ed entitled: “One Shot is Better than None.” His point:

“After every senior citizen and high-risk individual gets their two shots, applied science would suggest we could save tens of thousands of lives if we give one shot to as many people as possible and came back for a second dose as more vaccines are available.

Consider this: if you had 200 Pfizer vaccines and 200 family members, and it was up to you, how would you allocate them? The current emergency-use authorization tells you to give 100 people two shots. 

Assuming it will be 95% effective, only 100 people would be vaccinated, and 95 would be protected. Alternatively, you could give 200 people one shot, assuming 75% effectiveness, 150 people at a minimum would be protected.”

Much of the preliminary data on the effectiveness of one dose has not yet been peer-reviewed.  

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