Giving 1st and 2nd doses without delay complicates vaccine effort

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“It was frustrating – the waiting game and the conflicting information,” said Bouse, who is 26 years old and eligible due to a health condition. After hours of talking on the phone, she finally reached out to someone and planned the shot.

According to data from the Centers for Disease Control and Prevention, analyzed by The Associated Press, the US has administered an average of 900,000 first doses per day over the past month. Now, many of these people will have to take a second dose, and states are trying to give the first doses to an expanded pool of recipients.

“It’s really important and important to realize that there are still not enough doses to get around,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention.

To date, approximately 10% of the US population have received at least one dose of the vaccine and approximately 3% have received both doses, the AP analysis showed.

Health officials across Los Angeles County say limited supplies mean most vaccinations will be done for second doses this week. In the state’s Napa County, some first-can appointments were canceled last week to ensure there was enough for second cans.

“We get a lot of questions from community members who ask, ‘Is my second dose in danger?’ And at the moment we have no answer because it all depends on the inventory that comes in from the state, “said Alfredo Pedroza, a district manager.

Both COVID-19 vaccines marketed in the US require two syringes a few weeks apart to maximize protection. For Pfizer, the doses should be three weeks apart. It’s four weeks for Moderna. According to the CDC, which updated its guidelines late last month, the booster can be delayed for up to six weeks if necessary.

State and local health officials are now emphasizing this extended public news timeframe to alleviate concerns that people may not get their second shots in time. Federal officials have also said they are confident there will be enough doses to ensure people get their second shots.

In some places it is difficult to book the second dose. Although many places schedule the booster when the first shot is fired, others ask people to schedule it later for logistical reasons.

In Mississippi, health officials recognized that the process of planning a second shot could be challenging.

It was almost like trying to plan the first one with people having to re-enter all demographic information, said Jim Craig of the Mississippi Health Department.

Now the health department says people will receive an email with instructions on how to plan their second dose.

In New Hampshire, officials are abandoning the current scheduling system after thousands of people struggled to book their boosters within the recommended time – some were appointed two months later. People now get appointments for their second recordings when they get their first.

New Hampshire is one of several local jurisdictions that have signed up to use the CDC’s VAMS (Vaccine Administration Management System).

A different type of planning problem surfaced last week at the Las Vegas Convention Center in Nevada when the site opened as a clinic dedicated only to the second dose. When appointments became available online, people eager for their first doses grabbed slots.

“We had enough vaccine – we just have to sort of control the amount,” said JoAnn Rupiper of the Southern Nevada Health District.

People who had planned an initial dose on site had canceled their appointments, Rupiper said. To ensure that authorized people who have had problems evaluating appointments online receive their second recordings, the convention center allows walk-ins.

Despite the planning confusion, health officials and providers say their biggest challenge continues to be limited supply and variability in the distribution of doses from week to week. Despite the increase in shipments announced by President Joe Biden’s administration, local officials and vendors say they don’t have enough cans to meet demand.

The deficiency is one reason why Dr. Anthony Fauci, the nation’s leading infectious disease expert, identified the potential value of Johnson & Johnson’s one-shot vaccine, which recently applied for emergency approval. This shot is also cheaper to manufacture and easier to ship.

Pedroza said last week’s cancellations in Napa County, California came after a spike in shipments a few weeks ago led the county to believe it would continue to receive at least that many cans. But the top turned out to be a one-time stroke of luck, said Pedroza.

In Seattle, UW Medicine temporarily stopped new appointments in late January because supplies were limited and others had to get their second dose.

“If there was more supply, we would like to make more appointments for the first dose,” said Cynthia Dold, vice president of clinical operations at UW Medicine.


Contributors to this report were Associate Press Writer Nicky Forster in New York, Olga R. Rodriguez in San Francisco, Michelle R. Smith in Providence, Rhode Island, and Holly Ramer in Concord, New Hampshire.


The Associated Press Department of Health and Science is supported by the Department of Science Education of the Howard Hughes Medical Institute. The AP is solely responsible for all content.