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Why do so many people skip their second Covid shot – and why they shouldn’t

But health experts say the most surprising thing is how low this number is, and that it points to the need to inform people about the importance of this second shot for their own protection and that of others in a pandemic – and let them know it’s too late. get.

Two of the vaccines used in the United States – Pfizer / BioNTech and Moderna – require people to receive a second dose to get the maximum protection that vaccines can provide.

“I’m worried about anyone not coming back for a second shot, of course, but I’d actually think there would be a higher percentage of people not coming back,” said Dr. Leana Wen, a CNN medical analyst. . “Based on what we know from other vaccines, there are dropouts for a number of reasons.”


The CDC said the number of people who missed doses – 5 million – may not be accurate. If a person receives both doses from different reporting units – for example, first from a public clinic and then from a local health clinic – the two doses may not have been linked to databases, a CDC spokesman said.

“However, the reasons for the delayed or missed second doses require further analysis,” the spokesman said, and staff should work to see if this is due to access fluctuations or the vaccine.

Reasons and excuses that people give for missing the second dose

Several people reported receiving their second shot in a place other than the first, and administrators on the first site contacted them repeatedly to make an appointment for a second shot that had already been applied elsewhere.

But some people certainly miss their second dose. Fear of the side effects of the second dose – which in some cases are more severe than after the first dose for some people – along with problems in making an appointment and finding time for it are among the reasons why people indicated the lack of a second reception.

The second shot for the Pfizer vaccine is expected to be given 21 days after the first. For Moderna, the second dose is 28 days later.

Myths about the Covid-19 vaccine: These reasons not to make a shot do not stand.  In fact, they will bring the United States back

When Dr. Ashish Ja, dean of Brown University School of Public Health, received his second shot, “it was a day that was terribly uncomfortable and I tried to move it. They were like: You have to show up on this day at that time, “he said.

“My feeling is that a lot of it is hard to achieve. People miss appointments, people miss doctors’ appointments,” Ja told a news conference with reporters on Tuesday.

“I don’t think people are hesitant or don’t want to get it,” Ja said. “It’s hard to get these things and two shots in a row.”

One fix: Make the second shot easier

Wen agreed.

“I think what we really need to work on is to make vaccination an easy and convenient choice,” Wen said. “Everything we can do to get vaccines in doctors’ offices, in pharmacies, in the workplace, in schools, wherever people are, is really important.”

Within the St. Luke’s University Hospital Network in Pennsylvania, the success rate for receiving fully vaccinated people is 99%, said Dr. Jeffrey Jarre, an infectious disease expert there, in part because the network made it easier to get a second appointment. on the first shot.

The network then received multiple reminders of the meeting – five days, three days and then the day before – and those who were unable to attend the meeting received an “easy methodology for change,” Jarre said.

More than 43% of the US population has received at least one vaccine, and 30% have been fully vaccinated, according to the CDC. And in many places in the country, it is becoming easier to get vaccinated all the time, as supply increases and demand weakens.

Perhaps a more difficult solution: counteracting delusions

But another reason people miss the second dose is not understanding its importance or being misinformed. And that can be harder to fix.

Some people skip the second shot because they think the first one offers them enough protection, Wen said.

Some people say, “Oh, I’m fine. I’m not that at risk, so I only need one vaccine,” Wen said. “And then some people believe that one vaccine will give them some protection. The second is just a good measure. That’s not true.”

CDC data show that more Americans are missing their second dose of Covid-19 vaccine

“I don’t want them to walk around thinking they have immunity to Covid-19, when in fact they don’t, because they only got one dose,” Wen said.

In fact, most Americans may be misinformed about the timing of immunity after vaccination, according to a new comment published Wednesday in the New England Journal of Medicine.

The authors analyzed the results of a survey of 1,027 adults in the United States, conducted between February 11 and 15 through a panel set up by the National Center for Public Opinion Research.

About 20% of respondents believe that vaccines provide strong protection to recipients after the first dose, and another 36% are unsure.

Only 44% of vaccinated people reported that the vaccines provided “strong protection” one to two weeks after the second dose, as stated in the CDC guidelines.

“Despite current efforts, many Americans, including many who have already received the first dose of vaccine, remain confused about the timing of protection and the need for a second dose,” the authors write.

Earlier this year, there was a public debate among healthcare professionals about postponing second doses to focus on building partial immunity to the majority of the population before giving everyone a second dose. This debate may play a role in society’s misunderstanding of the importance of the second dose, the authors say.

One shot is not enough

In fact, the first dose simply “prepares the immune system, then the second shot strengthens it. This makes it a better option for immunity,” as CNN chief medical correspondent Sanjay Gupta explained when the vaccines were first allowed for emergency use. .

Although there is some protection after the first shot, it is not clear how long this lasts and is not close to what full immunization offers.

“There is a 36-fold difference between full vaccination and partial vaccination,” Dr Anthony Fauci told a news briefing on Friday.

And then the question arises whether the country can receive herd immunity – which means that 70% to 85% of the population is immunized – if the number of people who do not receive a second dose of vaccine continues to grow.

“I’m worried about that,” Jarre said. “To get durability, you need to have the second dose.”

And to get to where we want to be in terms of herd immunity, “you have to be resilient, you have to have resilience. And it’s very important that people follow that second dose,” Jarre said.

“It’s certainly a problem,” Wen said of the 8% who did not receive a second dose. “We need people to be fully vaccinated and to protect others.”

People should also know, according to Wen and others, that if you are among the 8% who have received only one shot of Moderna or Pfizer / BioNTech vaccine, it may not be too late to take that second shot.

According to the CDC, if “it is not possible to adhere to the recommended interval and a delay in vaccination is unavoidable”, the second dose of both Pfizer-BioNTech and Moderna can be given up to six weeks – or 42 days – after the first dose. .

CNN’s Ryan Prior contributed to this report.

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