ICYMI: COVID vaccine 2nd doses delayed in NH

In Case You Missed It, Seacoast Online reported that Granite Staters -- and an expert on infectious disease epidemiology -- are raising concerns about Governor Sununu’s vaccine rollout, which has significant delays between when those in Phase 1B can receive the first and second doses of the COVID vaccine, potentially reducing the effectiveness of the vaccine. In his press conference last week, Governor Sununu said it is okay for Granite Staters to wait for an “extended period of time” between vaccine doses, which is a claim that does not follow CDC guidance and is not backed by data.

Key points:

• “[Dr. Ben Locwin] said the ideal timeframe for receiving the second dose of the Moderna or Pfizer vaccine cannot be much longer than the 28- or- 21-day intervals. Anything beyond that touches the ‘outer reaches’ of becoming sufficiently immune to COVID-19, he said.”

• “As more of the general population receives the vaccine in the weeks and months ahead, Locwin said, the longer people are delayed in receiving the second dose, it will only prolong the window for COVID-19 to continue mutating into other strains. As is the case with newer strains discovered in the United Kingdom health officials warn are potentially more contagious than the original. British citizens are now waiting some 12 weeks in between COVID-19 vaccinations, according to published media reports.”

• “‘The best way to create new strains would be to delay receiving the second dose; the (intervals) in the clinical trials weren’t designed by accident, they’re principally based on the best practices of virology,’ Locwin said. ‘We don’t really have a good evidence-based study for the clinical trials of people who have received the second dose too far out of the prescribed window. Extending it to six weeks and beyond is ostensibly making the public guinea pigs.’”

• “[Suzanne] Garrison said she has concerns the state is not moving fast enough to establish a separate way to register for the second round of the vaccine.”

Seacoast Online: COVID vaccine 2nd doses delayed in NH. Here's what state is doing By Alexander LaCasse January 29, 2021 EXETER – Suzanne Garrison and her husband, Richard, received their first doses of the COVID-19 vaccine at Exeter High School Tuesday as part of the state's Phase 1B distribution. They immediately went home and logged onto the state's website to register to receive the second dose, only to find the earliest they could get another appointment was eight weeks out. The second dose is recommended to be administered within six weeks. The recommended timing for second doses for those receiving the Moderna vaccine, as the Garrisons did, is 28 days after the first dose. It's 21 days for the Pfizer vaccine. “What’s happening is these appointments are available to everyone (in Phase 1B) and they can’t differentiate between people needing their first or second shot, which is time-sensitive," Garrison said. "There's so much anxiety around getting the vaccine and we ourselves are getting a little OCD about getting the second round in time." [...] Impact on efficacy of vaccine? According to the Centers for Disease Control and Prevention, what is most critical is people receive the same company’s vaccine (either Moderna or Pfizer) for both doses. The 28-day interval for Moderna and 21-day interval for Pfizer are based on patients' first and second doses in the vaccines’ clinical trials, according to the CDC. The CDC now says it is OK to receive the second dose within 42 days. However, there is not sufficient data to know if the efficacy of the vaccine is diminished or not. The agency considers doing so beyond the 21- or- 28-day interval “permissible risk." Dr. Ben Locwin, of Portsmouth, is an expert on infectious disease epidemiology. He is also a member of a volunteer New Hampshire medical and scientific task force that advocated for a statewide public mask mandate last summer to prevent the spread of COVID-19 long before Gov. Chris Sununu issued one by executive order in November. Locwin said the ideal timeframe for receiving the second dose of the Moderna or Pfizer vaccine cannot be much longer than the 28- or- 21-day intervals. Anything beyond that touches the “outer reaches” of becoming sufficiently immune to COVID-19, he said. As more of the general population receives the vaccine in the weeks and months ahead, Locwin said, the longer people are delayed in receiving the second dose, it will only prolong the window for COVID-19 to continue mutating into other strains. As is the case with newer strains discovered in the United Kingdom health officials warn are potentially more contagious than the original. British citizens are now waiting some 12 weeks in between COVID-19 vaccinations, according to published media reports. “The best way to create new strains would be to delay receiving the second dose; the (intervals) in the clinical trials weren’t designed by accident, they’re principally based on the best practices of virology,” Locwin said. “We don’t really have a good evidence-based study for the clinical trials of people who have received the second dose too far out of the prescribed window. Extending it to six weeks and beyond is ostensibly making the public guinea pigs.” New Hampshire's process [...] Garrison said she has concerns the state is not moving fast enough to establish a separate way to register for the second round of the vaccine. “Every day people are getting the vaccine now, it’s just going to pile up if they don’t do something soon,” Garrison said. “We’re just checking every day to try to find something sooner and to see if there are cancellations.”

###