Millions skipping 2nd vaccine dose
Reasons vary, but rising trend troubles some state officials
Millions of Americans are not getting the second doses of their COVID-19 vaccines, and their ranks are growing.
More than 5 million people, or nearly 8% of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccine campaign.
Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, health authorities are confronting an emerging challenge of ensuring that those who do get inoculated are doing so fully.
The reasons vary for why people are missing their second shots.
In interviews, some said they feared the side effects, which can include flulike symptoms. Others said they felt that they were sufficiently protected with a single shot.
Those attitudes were expected, but another hurdle has been surprisingly prevalent. A number of vaccine providers have canceled second-dose appointments because they ran out of supply or did not have the right brand in stock.
Walgreens, one of the biggest vaccine providers, sent some people who got a first shot of the Pfizer or Moderna vaccine to get their second doses at pharmacies that only had the other vaccine on hand.
Several Walgreens customers said they scrambled, in some cases with
help from pharmacy staff, to find somewhere to get the correct second dose. Others, presumably, gave up.
Jim Cohn, a spokesperson for Walgreens, said that the problem affected “a small percentage” of people who had booked their appointments online and that the company contacted them to reschedule “in alignment with our vaccine availability.”
He said that nearly 95% of people who got their first shot at Walgreens have also received their second shots from the company.
From the outset, public health experts worried that it would be difficult to get everyone to return for a second shot three or four weeks after the first dose. It is no surprise that, as vaccines are rolled out more broadly, the numbers of
those skipping their second dose have gone up.
But the trend is troubling some state officials, who are rushing to keep the numbers of partly vaccinated people from swelling.
In Arkansas and Illinois, health officials have directed teams to call, text or send letters to people to remind them to get their second shots. In Pennsylvania, officials are trying to ensure that college students can get their second shots after they leave campus for the summer. South Carolina has allocated several thousand doses specifically for people who are overdue for their second shot.
Mounting evidence collected in trials and from real-world immunization campaigns points to the peril of people skipping their second doses. Compared
with the two-dose regimen, a single shot triggers a weaker immune response and may leave recipients more susceptible to dangerous virus variants. And even though a single dose provides partial protection against COVID-19, it is not clear how long that protection will last.
“I’m very worried, because you need that second dose,” said Dr. Paul Offit, a professor at the University of Pennsylvania and a member of the Food and Drug Administration’s vaccine advisory panel.
The stakes are high because there is only one vaccine authorized in the United States that is given as a single shot — and that is made by Johnson & Johnson. That vaccine was paused this month after it was linked to a rare but
serious side effect involving blood clotting. Federal health officials Friday recommended restarting use of the vaccine, but the combination of the safety scare and ongoing production problems may make that vaccine a viable option for fewer people.
The CDC’s count of missed second doses is through April 9. It covers only people who got a first Moderna dose by March 7 or a first Pfizer dose by March 14.
While millions of people have missed their second shots, the overall rates of follow-through, with some 92% getting fully vaccinated, are strong by historical standards. Roughly three-quarters of adults come back for their second dose of the vaccine that protects against shingles.
In some cases, problems with shipments or scheduling may be playing a role in people missing their second doses.
But in other cases, though, access to vaccines is not the sole barrier; people’s attitudes contribute too.
Basith Syed, a 24-yearold consultant in Chicago, nabbed a leftover Moderna vaccine at a Walgreens in mid-February.
But when the time came for his second shot, he was busy at work and preparing for his wedding.
After the first shot, he had spent two days feeling drained.
He did not want to risk a repeat, and he felt confident that a single dose would protect him.
“I didn’t really feel the urgency to get that second dose,” Syed said.