Will there be enough vaccine for everyone?
The rate of vaccine administration across the US has increased since January 20th when President Biden first committed to 100 million vaccines in 100 days. According to the CDC’s COVID vaccine data tracker, as of February 7th, 59.3 million doses have been delivered and 42.4 doses have been administered. 9.5 million people have received their 2nd dose. The average number of new doses administered was 1.3 million per day this past week. On February 2nd, President Biden announced additional steps his administration is taking to increase vaccine supply and administration capacity to states. Distribution of 10.5 million doses per week to states, tribes and territories has been promised, up 22% since January 20th. Starting on February 11th, select pharmacies across the country will begin administering vaccine through the Federal Retail Pharmacy Program for COVID-19 Vaccination. Finally, FEMA will retroactively fully reimburse states for FEMA-eligible services – including masks, gloves, emergency feeding actions, sheltering at risk populations and mobilization of the National Guard – backdating to the beginning of the pandemic in January 2020, an estimated to cost of $3-5 billion. This is considered a small share of the resources that states will need to fight this pandemic – including resources for testing, genomic sequencing, and mass vaccination centers. Biden is requesting $350 billion from Congress to fully support states’ needs to contain the pandemic and vaccinate their populations.
Health officials appear confident that everyone who needs a second dose will get it. In a January 21st update to the CDC’s Advisory Committee on Immunization Practices (ACIP)’s recommendations, the CDC has added some limited flexibility to current guidelines regarding timing of the second dose and interchangeability of mRNA vaccines, for times of unexpected high demand or supply bottlenecks. While the CDC continues to recommend that people get their second dose of COVID-19 vaccine as close to the recommended interval as possible (3 weeks for Pfizer-BioNTech, and 1 month for Moderna), the updated guidance allows for second dose administration up to 6 weeks after the first if it is not feasible to adhere to the recommended interval, noting that data from clinical trials supports this range. In regard to interchangeability of vaccines, the CDC’s updated guidance allows that in exceptional circumstances, in which the first dose vaccine product cannot be determined or is no longer available, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the COVID-19 vaccination series.
Dr. Anthony S. Fauci, the president’s special advisor for the coronavirus, has said patients should try to schedule their second dose on time, but local conditions may warrant a delay. “What the C.D.C. is saying, sometimes, the situation is stressed where it’s very difficult to be exactly on time,” Dr. Fauci said. “So we’re saying, you can probably do it six weeks later, namely, two additional weeks. Quite frankly, immunologically, I don’t think that’s going to make a big difference.”
We have heard of no issues with our patients having prompt access to their second dose of mRNA vaccine at our local vaccination centers. With Pfizer-BioNTech and Moderna reportedly on track to deliver up to 18 million doses a week, having pledged to deliver 200 million doses by the end of March, a vaccine roll-out meeting the 100 vaccines by 100 days pledge appears feasible. For those patients in later phases, rest assured – Pfizer and Moderna have each committed to supply another 100 million doses by the end of July and have suggested they likely can provide even more. In mid-January, Pfizer and BioNTech, its German partner, increased their global production target for the year to two billion doses from 1.3 billion doses. A new vaccine is expected to begin adding to national supply within the next month, with the FDA emergency use authorization panel set to meet regarding the Johnson & Johnson vaccine (a one-shot vaccine) on February 26th. J&J has said it would be ready to ship some vaccines as soon as the FDA allows EUA, and expects to supply 100 million doses to the US by the end of June.
While we expect no shortage of vaccines for second doses in the Bay Area, we do recommend our patients schedule their second vaccine administration appointment as soon as possible after their first, ideally while they are still at that first vaccine appointment. If you have any issues securing a timely second vaccine appointment, please let us know right away so that we can assist in finding other vaccination locations.
Jennifer Abrams, MD, February 8, 2021