YRMC pledges to administer second dose vaccines within CDC’s window
Last week, the Centers for Disease Control and Prevention (CDC) extended its recommended timeline for second dose inoculations of the Moderna COVID-19 vaccine to a 42-day interval for situations in which eligible individuals are unable to receive their second dose within 28 days of their preliminary dose of the vaccine.
Initially, individuals were urged to wait a 28-day interval between inoculations; while the recommendation still stands, if an unavoidable delay occurs that prevents individuals from receiving their second dose within that time frame, the CDC now says the second dose of the Modern COVID-19 vaccine can be administered up to 42 days (six weeks) after the first dose.
“The reason it expanded was because of concern – what if you don’t get vaccinated at the 28 day mark, what happens then? You still want to make all the efforts to get the vaccine,” said YRMC Chief Medical
Officer Dr. Bharat Magu.
Should 60 days lapse between the first and second dose, however, it’s possible that the patient would be deemed a “new candidate” and need to restart the series in order to guarantee maximum effectiveness, as the CDC notes there is limited data supporting the efficacy of Moderna vaccines administered beyond this window.
“We don’t know how effective the second dose is after (an interval of) 60 days,” said Magu. “We know it is effective; the question is should we, at that point onward, start the whole series over with dose number one or still consider the second dose. There are a lot of unknowns.
Effectiveness is something which happens in real people; efficacy is something that comes from the labs and original research. We know the efficacy of both doses of the vaccine, given within 42 days, is up to 90%. Effectiveness is something we’ll know once we have concrete data for our population.”
Magu said he’s certain more data will become available, as information is frequently changing and updating.
“Vaccine data is evolving; that adds a layer of complexity to our current process,” he said.
The question on the table right now is whether to shift the hospital’s focus to administering just one dose of the vaccine or both.
“Even with one dose, Moderna is very, very effective in preventing serious disease, preventing hospital stays and preventing deaths,” said Magu. “But it’s not reliable immunity, meaning it doesn’t last very long without the second dose. We are having very active discussions about how much effort we are going to put in the stock for first doses and how much of that stock will be dedicated for second doses. We are currently making efforts to dedicate some stock – not all of it, but some – to second doses while focusing on giving the first dose to as many people as possible.”
Until a consensus is reached, Magu said YRMC will make “all efforts to vaccinate within the 42 day window provided by the CDC. If a few are left out in that window, we still want to vaccinate them and will continue the effort to get them a vaccine.”
With two new COVID-19 vaccines pending approval from the U.S. Food and Drug Administration (FDA) – one being a single-dose injection created by Johnson and Johnson – Magu said there may be more opportunities for individuals to receive a vaccine.
“The CDC is saying you can interchange those in the extreme event that you are not able to get the second dose of the Moderna vaccine,” Magu said. “So that is also another option.”
In terms of herd immunity in the Yuma community, Magu said that is also unclear at this time.
“The question is what amount of people need to be vaccinated against COVID in order to achieve immunity; we don’t know that,” he said. “A substantial percentage of the population would need to be vaccinated, and that differs from big metros to rural areas like us. We don’t know the exact number; if we have 200,000 people here, would (vaccinating) 150,000 achieve herd immunity? We don’t have that information yet.”
Magu noted that individuals who have already contracted COVID-19 are estimated to maintain immunity to the virus for at least four to five months.
“The vaccine provides additional immunity,” he said.
YRMC is slated to host second dose vaccination clinics during the first week of March pending allocations, as shipments have been delayed due to winter storms on the East Coast. In an attempt to create a “seamless process,” eligible individuals due for their second dose of the vaccine will be contacted by the hospital via the YRMC MyCare patient portal, text or phone call to schedule an appointment.
Stock for first dose inoculations are expected to arrive on Tuesday, Magu said, enabling the hospital to resume those vaccinations next week.
“We are really grateful to our community for their enthusiasm in wanting this vaccine,” said YRMC Director of Marketing Shay Andres. “We are just as excited as they are to get our lives back to some sense of normalcy. We wish we had more (vaccines), but we are strongly advocating with the state to try to get more vaccines to our community.”