Why the second COVID vaccine dose is important, especially to healthcare workers

There is a movement afoot promoting the potential benefits of testing a one-dose COVID-19 vaccine strategy instead of the two dose vaccination currently recommended in the United States under emergency use authorization.

The positions promoting the value of one dose versus two, and vice versa, are well documented in the public arena, however, the science and data right now only supports administering two doses of the vaccine for maximum efficacy and protection against the virus. Moreover, proprietary research and data modelling of a subset of healthcare workers indicates 94 percent came back for the second dose of the vaccine within 28 days, underscoring the importance of the second dose on overall protection from COVID-19.

Since mid-December, more than 70,000 vaccine doses have been administered to healthcare workers and eligible individuals in northern Virginia by Inova Health System, the only health system in the country comprising more than three hospitals where all are 5 star quality rated by Centers for Medicare & Medicaid Services. Our vaccine clinic has administered doses to frontline workers, school teachers, bus drivers and all those eligible who are at the highest risk.

As more people become eligible to get vaccinated in the region, scarce supply of vaccines is also a growing issue, making it difficult to balance first and second dose vaccine requirements. Various scenarios, like administering only one dose of the vaccine, were considered and in the end, Inova's leadership chose to stand by the available scientific evidence at this time that supports the importance of two doses for maximum protection against COVID-19. Both the Food and Drug Administration and U.S. Infectious Disease Chief Dr. Anthony Fauci also advise against skipping or delaying the second dose of COVID-19 vaccines to speed immunizations.

In addition to the science currently available, Inova also built proprietary data models and forecasting to leverage predictive analytics to optimize our vaccine dosage distribution for first doses and determine where there may be issues with compliance for the second dose. Utilizing a weekly forecasting model relying on second dose patterns observed among nearly 10,000 frontline healthcare workers who received the Pfizer vaccine between Dec. 15 and Dec. 26, findings showed that:

94 percent came back for their second dose within 28 days
Almost all (88 percent) came back within the prescribed window of 17 to 21 days.

These findings suggest a promising trend: strong vaccine compliance among healthcare populations. It also shows that the original second dose vaccination strategy that has been tested in the clinical trials is viable in the real world, as long as supplies exist. It will be important to refresh and reassess the model regularly to reflect the latest behavioral patterns and see whether they change as vaccine eligibility expands to new groups. But the hope is, this model can help to better forecast, and plan around ongoing capacity needs amid allocation challenges.

More articles on the COVID-19 vaccine:
Execs from Cleveland Clinic, Baystate Health share challenges their vaccine programs are facing
8 most convincing messages to promote COVID-19 vaccines
J&J says its COVID-19 vaccine is 66% effective



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