President-elect Joe Biden is preparing to accelerate the schedule of COVID-19 vaccines. Is it safe and does it impact vaccine effectiveness?


President-elect Joe Biden is preparing to accelerate the schedule of COVID-19 vaccines. Is it safe and does it impact vaccine effectiveness? His aides have said Biden will release more details about his plan next week.

“The President-Elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible. He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans’ arms now,” said Biden spokesman T.J. Ducklo to CBS News.

Is It Safe?

People who are saying this plan is ludicrous have two basic complaints. First, supply chain issues making the second dose late. Their second complaint, getting the second vaccine dose within the 3 week period.

Both of this complaints come down to a flawed understanding of how supply chain distribution works and how the vaccine effectiveness works. We will tackle both

What If There Are Supply Issues?

People against Biden’s method are concerned that if we were to give all the vaccines we have available, we wouldn’t have enough for people to get their second dose. Will it impact the schedule of COVID-19 vaccines? There are two major flaws with this conspiracy type theory. First, yes, we will still be having amounts of the vaccine in reserve. This means that if there are shortages in the supply chain from manufacturing, then it can be made up with the supply in reserve. No further discussion needed.

If there were a supply chain issue, it would not halt production to zero. It would be in maters of percentage points of potential production. So, even if a massive supply chain issue were to occur, you are still able to provide the Two doses needed by delaying the first dose. For example. If we are producing 1 million shots a day, half go to first dose and half go to second dose. If supply drops in half; then the 2nd dose people get their dose and the first dose people are delayed. Simple easy fix to the insane supply chain conspiracy theories from those who have never worked in JIT manufacturing (Just In Time). No one is going without their 2nd dose. And supply chains will NEVER have that much of a decrease as explained in our example.

Effectiveness of Covid-19 Vaccine if 2nd Dose is Missed/Delayed?

Lets say for arguments sake that production falls to zero for weeks and the schedule of COVID-19 vaccines is threatened. This will never happen, but lets pacify the skeptics. What if they never get that second dose or if it is delayed. A common passed number is that the first dose of the vaccine provides 52% protection The 52% protection figure is flat wrong. It is based on a misguided interpretation of the data.

It takes about 10 days for your body to build up immunity after getting immunized. Look at the infection curve from the Pfizer and Moderna vaccine data. You can see that the vaccine vs placebo curves are nearly identical until around day 10 or 11. We see similar data in other vaccines, and it is consistent with our understanding of immunology.

The 52% protection figure includes all infections that occur in people within the first 10 days, before we would expect people to have any protection from the virus. If you exclude infections that occur during that time, the protection you get from a single shot of the vaccine is closer to 90+%. How long the immunity lasts after a single shot is a question of active debate.

Here’s a statement by the UK’s Joint Committee on Vaccination and Immunization which touches on this: https://app.box.com/s/iddfb4ppwkmtjusir2tc/file/759357623956

Proof in The Data of of COVID-19 Vaccine Schedule

The Moderna data has numbers on page 28. If you take all cases after the first dose the effect is “only” 80%. But most of the remaining infections were in the first two weeks. Starting 14 days after the first dose the protection is 92%.

If you want, here is a link to the raw study of the Moderna vaccine. Of specific interest for the question is page 35 of the appendix (table S16).

As the study was not designed to figure out if a single dose was effective, the data has a much lower confidence level, however it shows a 95% reduction in cases (11 vs 225 cases) over the entire study group, though the reported efficiency is normally the bottom of the confidence range, which was 91.2%. This includes one person who was showing symptoms when the first dose was administered and includes through the end of the study when nearly all of the group had received two doses.

Do They Need To Be 3 Weeks Apart?

It’s shorter than the shortest MINIMUM interval for any other vaccine as scheduled according to, say, the CDC: https://t.co/rdb6TIHWPl

Please do not try to imply that this is a hard requirement, or optimal, or even chosen for any reason other than being the shortest interval they could use to complete the PhIII ASAP. That’s it.

Is Biden’s Schedule Safe?

We can yell at each other over what is optimal until we are blue in the face & we all hate each other for no reason, or……We can accept that we are in an out-of-control pandemic where there is, on average right now one person dying of COVID-19 somewhere in this world every seven second. Realize that delaying doses is fundamentally not immunologically unsound. Getting needles in arms is of our utmost concern. Stop making it political.