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About 238,000 Virginians have received a coronavirus vaccine that requires two shots but haven’t returned for their second doses.
To take a closer look at how many people might be missing their boosters, the Virginia Department of Health pulled data on residents who received a first dose of Pfizer or Moderna but, more than six weeks later, still hadn’t come back to complete the regimen.
Initially, they found close to one in 10 Virginians who got first shots were overdue for their second ones, a concerning trend for public health officials who say those individuals won’t be considered fully vaccinated unless they receive both.
After some additional “public messaging” about the importance of second doses, that rate has declined to about 7% as of this week, said Dr. Danny Avula, the state vaccination coordinator.
All states have an uphill climb to reach “herd immunity,” thought to be when 75 to 80% of the population is inoculated against COVID-19. A large segment remains skeptical of vaccines entirely, and states face yet another challenge: getting their partially vaccinated residents to finish what they started.
Right now about 36% of Virginians are considered fully vaccinated, either with two doses of Moderna or Pfizer or one dose of Johnson & Johnson, which is just a single shot.
The state’s rate of people skipping second doses is similar to a national study, which estimated 8% of Americans have not returned to complete the vaccine series.
Infectious disease experts say failing to follow through on a two-dose series could leave partially vaccinated people at higher risk of contracting one of the more aggressive or contagious variants of COVID-19.
Dr. Anthony Fauci, the nation’s leading infectious disease expert, stressed the importance of getting the second dose during a recent White House press briefing, citing several scientific studies, including a U.S. Centers for Disease Control and Prevention report that found the messenger-RNA vaccines were 64% effective at preventing hospitalizations in seniors after one shot, but 94% effective after two.
He also pointed to a study of health care workers at the University of Texas Southwestern, published in the New England Journal of Medicine. Though partially vaccinated employees had fewer infections than unvaccinated people, there was a big reduction in disease between those who had one shot versus the entire series, according to the report.
“You do much better if you’re partially vaccinated,” Fauci said, “but there’s a 36-fold difference of getting fully vaccinated versus partially vaccinated.”
Virginia public health officials believe the residents who haven’t come back fall into two main categories. Some of them may have experienced unpleasant side effects, such as flu-like symptoms, and others may have essentially fallen through the cracks.
“Some of that is a reality that people who may have not been that enthusiastic about getting vaccinated in the first place, they did, maybe they had some symptoms, it was going to be that much harder for them to come back and get a second dose,” Avula said, “especially when a lot of the reporting is saying a lot of people’s personal experience is that the second dose actually has worse side effects.”
Responsibility also falls on the health care providers who administered those initial vaccines, Avula said. At the beginning of the rollout, state public health officials urged vaccinators to immediately schedule second doses when someone received their first shot.
“That was not happening universally across all providers,” he said.
Reasons varied for why clinics didn’t always book the follow-up appointments. Some were worried they wouldn’t have enough doses or the right brand of supplies a few weeks out.
The recommended intervals between the messenger-RNA vaccines are three weeks for Pfizer and four weeks for Moderna. Vaccinators are not allowed to mix and match the brands for first and second doses.
Sentara Healthcare, which has vaccinated thousands of Virginians, tries to ensure people don’t miss their second doses. After receiving a first dose from one of its clinics, an individual will get an email reminder to register for the next appointment. If the person doesn’t respond, the individual will get another email 24 to 48 hours later.
For people who don’t have email addresses, Sentara has its own call center, helping people schedule first and second dose appointments. Kelly Kennedy, a Sentara spokeswoman, said though the call center doesn’t track down people who are overdue, the operators also will assist callers if they’ve missed their dose or want help rescheduling.
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Similar to other findings, Sentara had about a 7% no-show rate between March 12 and May 7, Kennedy said. That was based on shots administered at a first-dose clinic compared to those at the second-dose clinic.
The CDC have advised if it’s not feasible for a person to get the second dose in the recommended time frame, they can get their vaccine up to six weeks later. Beyond that period, scientists don’t know how effective the vaccines are because of limited data.
The state health department is trying to track down people who have missed their second doses. They’re going to use operators from the vaccination call center to contact individuals they’ve identified as overdue for their final shots.
Regardless of whether people have passed the grace period, Avula said people can still get the booster. Ongoing studies have shown that second shots, given even more than 42 days after the first, may still be “very effective.”
“In some cases, more effective,” he said.
Public health officials say people who do receive their second shot later than recommended don’t need to restart the vaccine series.
Elisha Sauers, 757-839-4754, elisha.sauers@pilotonline.com