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Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, discusses the CDC's new school guidelines, the potential dangers of new COVID-19 variant strains, and vaccines.
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Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, discusses the CDC's new school guidelines, the potential dangers of new COVID-19 variant strains, and vaccines.
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Biden admin has bumped up the number of vaccine doses distributed from 11 million a week to 13.5 million. link
At two doses per person that is about an additional 1.25 million persons per week. In a month that is 5 million more people, roughly - 1/6 of the population over 65 (not including any for persons with serious underlying conditions).Comment
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CDC Advisers Weigh Second-Shot Delay to Quicken Vaccine Uptake
By
Anna Edney
February 16, 2021, 10:28 AM EST- States seek advice on potential dose-stretching strategy
- U.S., some drugmakers have so far rejected extended interval
U.S. public health advisers are weighing recommendations for extending the interval between the first and second doses of Covid-19 vaccines, a potential strategy for quickly getting protection to more people amid the spread of new variants.
A working group of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has debated the idea, according to a person familiar with the discussions. It hasn’t been decided if the full committee will take up the issue and provide official guidance, the person said. Jose Romero, chairman of the committee and Arkansas health secretary, declined to comment because the deliberations are confidential.
U.S. health officials have rejected a dose-stretching policy adopted by the U.K. that allows up to 12 weeks between Covid shots. Most drugmakers have concurred, saying that policies should follow the protocols used in the shots’ testing, in which the intervals were set at three or four weeks. As dangerous variants threaten to boost U.S. cases in coming weeks, however, some states are asking what they can do to widen protection.
more...
https://www.bloomberg.com/news/artic...?sref=i4qXzk6dComment
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bump thisComment
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BNT162b2 is the Pfizer vaccine....
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
February 17, 2021
DOI: 10.1056/NEJMc2036242
snip
Even before the second dose, BNT162b2 was highly efficacious, with a vaccine efficacy of 92.6%, a finding similar to the first-dose efficacy of 92.1% reported for the mRNA-1273 vaccine (Moderna).3
With such a highly protective first dose, the benefits derived from a scarce supply of vaccine could be maximized by deferring second doses until all priority group members are offered at least one dose. There may be uncertainty about the duration of protection with a single dose, but the administration of a second dose within 1 month after the first, as recommended, provides little added benefit in the short term, while high-risk persons who could have received a first dose with that vaccine supply are left completely unprotected. Given the current vaccine shortage, postponement of the second dose is a matter of national security that, if ignored, will certainly result in thousands of Covid-19–related hospitalizations and deaths this winter in the United States — hospitalizations and deaths that would have been prevented with a first dose of vaccine.
Danuta M. Skowronski, M.D.
British Columbia Centre for Disease Control, Vancouver, BC, Canada
danuta.skowronski@bccdc.ca
Gaston De Serres, M.D., Ph.D.
Institut National de Sant? Publique du Qu?bec, Quebec City, QC, Canada
Dr. De Serres reports having received grant support from Pfizer for an unrelated study of meningococcal antibody seroprevalence. No other potential conflict of interest relevant to this letter was reported.
This letter was published on February 17, 2021, at NEJM.org.
Comment
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FluTrackers does not endorse any vaccine. We certainly do not endorse any of the suggested dosing protocols. We are just presenting information as this is a discussion forum. We do not have preconceived conclusions. It is entirely possible that the strategy of delaying the 2nd dose so that more vulnerable people can be vaccinated with a 1st dose is a good one, or not. We do not know. We offer the discussion as a public service only.Comment
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The problem with dose stretching is that we do not have any data to show what effect delaying the second shot will have on the duration of protection. Under normal circumstances it would be safest to stick with what we know works rather than what we think will probably work. Needless to say the circumstances are hardly normal.
So what do we know about the immune response. For the first 12 days after the first shot there is little difference in protection between the vaccinated and unvaccinated after which there is almost no serious illness in the vaccine group. The second shot should be due after 3 or 4 weeks but if you follow the antibody titers they have not peaked at this point and once they do they fall slowly so there is a very wide window of opportunity to use the booster dose and still have plenty of B & T cells to get boosted. Second booster doses are often given at the front end of the available window as most are not as effective as these SARS-CoV-2 vaccines so the protection does not cut in until after the boost. Earlier in the US program vaccine supply outstripped demand, or at least the ability to administer it, so stretching the dose was not needed now we are overtaking the supply, so dose stretching needs to be considered. Given that one dose seem to stop serious illness from day 12 and the antibodies will go on rising for a few more weeks and will subside even more slowly the it should take a couple of months at least before the one dosers drop below that protection level, by which time we will have much better date on the antibody decay curve. Also the J & J Ad based vax's EUA review is due shortly so there may well be a new supply which will relieve the problem in the middle term. If this ends up being the case then a delay to 6 weeks may by enough time to bridge the supply gap without stretching the window too far from the hard trial data.
Just my thoughts on the subject so my reasoning, although based on hard data, may be wrong - caveat emptor.Comment
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