Sun Sentinel Palm Beach Edition
Figures show more than 40,000 overdue for second dose
A total of 40,661people in Florida are overdue for their second shot of the COVID vaccine, a figure that has grown steadily through the week.
The two vaccines approved for use in the United States each require a booster shot after either three or four weeks, depending on the vaccine. While 79,552 people in Florida have received both shots, the number of people who failed to obtain the second shot has nearly quadrupled over the past four days, according to figures released Friday by the Florida Department of Health.
The issue, so far, has not been one of availability. Florida has received nearly 2 million doses, according to the U.S. Centers for Disease Control. The state has administered 849,317, counting second doses.
Jason Salemi, associate professor of epidemiology at the University of South Florida in Tampa, said it’s difficult to gauge the significance of the number of people overdue for the shots without knowing the reasons. If there were communications issues or the person due for the second shot couldn’t get there in time, there may be systemic problems. Otherwise, it could simply be a lag in reporting that doesn’t
make a difference.
“Without knowing the ‘why’ here, it is challenging to know whether it should be concerning,” he said. “Right now, I’m not concerned, but if that number continues to grow, becomes a higher percentage of all persons in whom the second dose should already be administered, or the reasons for missing the second dose are concerning (e.g., no doses available, people unable to make it to their appointments in a timely manner), then I’d be brainstorming effective solutions.”
Jason Mahon, spokesman for the Florida Department of Health, did not respond to questions about why people were overdue or whether there was concern about it among state officials.
But he said everyone receiving a first dose is immediately scheduled for a second dose. More than 80% of the people due for a second dose have received it, he said. And he pointed out that this week has seen the largest number of COVID vaccinations in Florida yet, with more shots given than in all previous weeks combined.
The Pfizer vaccine requires a second dose after 21 days, the Moderna vaccine after 28 days.
The two doses are spaced out the body can tolerate the amount needed to protect against COVID while minimizing side effects, said Dr. Joshua Lenchus, chief medical officer of Broward Health Medical Center in Fort Lauderdale.
After the 21-day or 28-day period following the first dose, there is a four-day window for the optimum administration of the second doses, and it’s unclear whether the second dose would be as effective outside that window, he said. People tend to experience more of a reaction after the second dose, including fatigue, fever and chills, he said.
If someone misses the second dose within the window, he advises getting it late.
“I would suggest still getting it,” he said. “I would not walk around with one shot feeling protected.”
A debate over the second dose
While no one disputes the importance of the second dose, there’s been debate over whether everyone should get the initial shot first before anyone gets a second shot, since the first shot is thought to confer some protection.
Dr. Glenn Morris director of the Emerging Pathogen Institute at University of Florida, said he favors the United Kingdom strategy of inoculating more people with the first dose before giving out the second dose, particularly considering the high number of new cases in Florida.
“To optimize the level of protection you definitely need the second dose, but on the other hand, a case can be made for getting the vaccine into as many people as possible and not reserving the second dose,” he said. “I think that’s reasonable when you continue to see surging case numbers.”
Gov. Ron DeSantis said Thursday he is committed to the two-dose approach.
“While there is talk at the federal level regarding how to distribute vaccine doses and whether booster shots should be ‘held back,’ Florida is committed to the two-dose regimen for both the Pfizer and Moderna vaccines,” he said in a statement issued by his office.
“One dose seems to provide some protection, but the 95 percent efficiency has only been shown to be attained by taking the booster shot. This means that while the manner of distribution may change, the necessity of the booster shot will not. Florida wants all seniors to receive booster shots at the appropriate time.”
Florida Surgeon General Dr. Scott Rivkees said Florida tracks first and second doses in its FloridaSHOTS database. Most people receive a card at the time they are vaccinated telling them when to come back for the second dose.
“How compliant are people going to be?” he asked. “We certainly hope they are and that is something we are able to track.”
At Memorial Healthcare System, which is administering about 1,200 COVID shots a day, vaccine recipients receive automatic online and telephone reminders, said Kerting Baldwin, spokeswoman for the hospital system.
Bernie Fisher, 75, said he felt relieved after receiving his booster shot Thursday through Memorial Regional Hospital in Hollywood. After his first dose, the day after Christmas, Fisher said his arm felt sore. But never, ever, did he consider not going back for round two. “It’s mind-boggling that anyone would not get their second shot. Maybe they felt ‘Gee, my arm was sore.’ ”
Fisher said the hospital gave him an appointment for the booster shot when he arrived to get the first dose. In the interim, he received a text message and email through the healthcare system’s MyChart software program.
Although he still plans to be cautious, Fisher said he and his wife, Helaine, who also received the vaccine, can now visit their family.
“We’ve been locked up for 10 months. We have a grandchild who has had operations and we have had to be careful. We have been overly careful. Now we feel a little better but we will still be careful.”