Houston residents worry about second vaccine doses
Three weeks ago, Jim Lober became one of the lucky few to receive a first dose of the Moderna COVID-19 vaccine at Bayou City Event Center. Lober, a 69-year-old attorney, left the venue where thousands would wait in lines wrapping around the building with the beige card indicating he’d received the vaccine on Jan. 8 and was due back in four weeks for the final shot.
At first, the Houston Health Department told him to call back the week before his second shot; but when he checked the city’s website, he learned he should wait for the department to reach out to him for scheduling. Now, with one week left before Lober should receive the second dose of Moderna, he has no clue when or where to go.
He’s not the only one. As the first of Texas’ 1B group returns for their second doses, many worry that reported vaccine shortages and scheduling problems could hamper their chances of being fully immunized.
“My wife said to be grateful to get the first vaccine, but the consequence of a busted second dose could be serious,” Lober said.
Across the globe, people are cold calling and crashing websites in hopes of scoring a coveted COVID-19 vaccine appointment. Pfizer and Moderna, the two pharmaceutical giants behind the vaccines on the market, agreed to send 200 million doses to the U.S. by the end of March.
What’s in a second dose?
When a person gets the first dose of the COVID-19 vaccine, it’s about 52 percent effective in preventing COVID-19 symptoms , according to the New England Journal of Medicine. The mRNA in the vaccine shows the body what the virus looks like, preparing the immune system to attack any similar cells. The second dose of the COVID-19 vaccines bring effectiveness up to 95 percent and strengthens the immune system’s response to COVID-19.
The second dose of the Pfizer-BioNTech vaccine must be given after a minimum of a three-week period; the Moderna vaccine after a minimum of a fourweek period.
People can wait up to six weeks after the first dose of the COVID-19 vaccine to receive their second shot, according to updated guidance from the Centers for Disease Control and Prevention.
“There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window,” the agency wrote. “If the second dose is administered beyond these intervals, there is no need to restart the series.”
Pfizer has manufactured all the second doses intended to pair with first doses already shipped to the U.S., said Eamonn Nolan, a company spokesperson.
“We have provided the U.S. government with a specific schedule and we foresee no issues in delivering on the commitments we have made,” Nolan said.
Recently, the Food and Drug Administration gave vaccine providers the OK to draw six doses out of every Pfizer vial, which can be difficult for some clinicians to do and requires a special syringe. Those extra doses will count toward Pfizer’s contract to supply the U.S. with 200 million doses by the summer.
Anna Nagurney, a professor who studies supply chains at the University of Massachusetts-Amherst, said all the recent information on extra doses per vial and extending the time to get a second shot points toward potential vaccine supply shortages.
“That to me is a signal they’re concerned they won’t be able to meet demand, and demand is huge,” Nagurney said.
Moderna did not respond to a request for comment.
Timing is key?
Representatives from the Houston Health Department, Memorial Hermann and Houston Methodist, the three largest COVID-19 vaccine providers in Houston, said that they will be administering second doses as scheduled.
Most vaccine providers are still trying to shoehorn patients into the three or four-week window for vaccines, rather than ask patients to wait.
Researchers in the U.S. understand the push to vaccinate more people with first doses and push back second doses, but don’t agree with it, said Roberta Schwartz, executive vice president of Houston Methodist Hospital and overseer of the hospital system’s COVID-19 response. “We believe that people should be vaccinated as close to on schedule as they can,” she said.
The Houston Health Department has 28,000 people in its database who need to return for the final shot, while Memorial Hermann still has to administer 25,000 second doses. Houston Methodist will provide second doses for at least 25,000 people next week, with thousands more set to receive them in the weeks following.
Providers recommend patients stick with the same location for both shots; each provider receives vaccines based on how many first shots they’ve administered. They also note that patients should not mix-and-match the type of vaccine they receive — those who received a first dose of Pfizer should not switch to Moderna, and vice-versa.
Scheduling conflicts
As the global COVID-19 infection rate eclipsed 100 million cases on Tuesday, people are losing confidence they’ll be fully vaccinated if they haven’t set up a time for a second appointment.
Some who received their first COVID-19 vaccines at Kroger and the Houston Health Department said they haven’t gotten any communication on when to come back for the second dose.
Kingwood residents Virginia and Richard Murray got their first shots at a Kroger pharmacy in Galveston in early January after their daughter, a pharmacy technician at the store, booked their appointments. The Murrays, who are both over 75, haven’t heard back on when or where to book their second.
“We don’t want to jump the gun and be afraid,” Virginia Murray said. “But what if that two-week time frame comes and goes?”
Kroger did not respond to a request for comment.
However, the reports of shortages that have plagued other hospitals nationwide won’t affect second doses, vaccine providers said.
“We’ve been hyper disciplined about ensuring that we have adequate supply for the second dose,” said Dr. James McCarthy, chief physician executive at Memorial Hermann.
In its first batch of vaccinations, Memorial Hermann did not immediately assign return appointments, but that has been fixed, McCarthy said. The health system says it has the capacity to provide second doses within the threeto four-week period.
As of Jan. 20, the Houston Health Department expects to vaccinate the 28,000 people due for a second dose within the same time frame, said Scott Packard, a department spokesperson.
“We would prefer to schedule the second with the first but initially are unable to do so because of the flux with supply timelines and locations,” Packard said.
Department staff will call everyone about second doses, and are urging the public not to call unless it’s 48 hours before the due date.
Lober, who got his vaccine from the Houston Health Department, has resigned himself to wait for the city’s call to schedule his next appointment. He can’t help but worry he will be only partially immunized against COVID-19 if he doesn’t get a second shot.
“If things are a total bust, then you’ve wasted hundreds of thousands of people’s efforts,” he said.