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Illustration: Eniola Odetunde/Axios

New research is bolstering the case for delaying second doses of coronavirus vaccines.

Why it matters: Most vulnerable Americans remain unvaccinated heading into March, when experts predict the more infectious virus variant first found in the U.K. could become dominant in the U.S.

By the numbers: Around 41% of adults 65 and older have been vaccinated, per KFF. Millions more Americans with underlying health conditions also remain vulnerable to severe disease.

Driving the news: An analysis of the real-world outcomes of the Pfizer vaccine in Israel, released earlier this week in the New England Journal of Medicine, found that the vaccine was 60% effective at preventing documented coronavirus infection 21 to 27 days after the first dose, and 92% effective 7 or more days after the second dose.

  • But one shot was much more effective at preventing severe disease and hospitalization during the same time period, with respective efficacies of 80% and 78%. Two doses were 92% effective at preventing severe disease and 87% effective at preventing hospitalization.
  • An analysis published in The Lancet of the AstraZeneca vaccine, which isn't yet authorized for use in the U.S., found that a longer interval between doses actually gives more protection than a shorter interval.
  • And a growing body of research suggests that people who have previously been infected with COVID are sufficiently protected by only one dose, per the NYT.

The Food and Drug Administration this week released its findings on the efficacy of the one-shot Johnson and Johnson vaccine, which increased over time.

  • After 28 days, the shot was 85.9% effective at preventing severe disease in the U.S.

What they're saying: There's now enough data to support delaying second doses of the Pfizer and Moderna vaccines, in order to give more people more protection faster.

  • And the variant makes doing so urgent, a group of public health experts argue in a white paper, released this week, calling for the FDA and the CDC to review the data.
  • "There is a narrow and rapidly closing window of opportunity to more effectively use vaccines and potentially prevent thousands of severe cases, hospitalizations, and deaths in the next weeks and months," the paper, published by the University of Minnesota’s Center for Infectious Disease Research and Policy, argues.
  • The writers suggest giving people 65 and older vaccine priority, deferring second doses until after the predicted virus surge, deferring second doses for people with confirmed previous COVID infections and authorizing the use of half-doses of the Moderna vaccine.

The other side: Scottish researchers released a preprint of a study that suggests protection from a single dose may decline after five weeks, Insider reports.

  • "I think delaying the second dose for a considerable period of time is a mistake," Paul Offit, the director of the Vaccine Education Center at Children's Hospital of Philadelphia, told Insider.

Go deeper

Most COVID-19 survivors can weather risk of reinfection, study says

Illustration: Sarah Grillo/Axios

COVID-19 survivors tend to have a roughly tenfold increase in protection against the virus, according to a government-funded study published Wednesday.

Why it matters: There have been some documented cases of reinfection leading to concern survivors don't gain any immunity. While there remain questions on how much or how long immunity lasts and what the impact of variants will be, this large set of observational data bolsters evidence there's some protection.

Updated Nov 26, 2021 - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: U.S. to mandate vaccines for anyone who crosses borders starting in January — Shots lagged data by months — The next big bottleneck in the global vaccination effort.
  2. Health: The Thanksgiving bouncers — Axios-Ipsos poll: Thanksgiving roulette — Experts criticize CDC's language on vaccine boosters — America's Thanksgiving gamble.
  3. Politics: Biden administration asks appeals court to reinstate vaccine mandate — Michigan recommends face masks for all residents amid surge.
  4. Education: A COVID strategy backfires at schools — Schools across the U.S. offer vaccine drivesBenefits of in-person school outweigh risks, study finds.
  5. World: EU drug regulator recommends Pfizer COVID vaccine for kids — Italy announces new COVID restrictions for unvaccinated people — European health agency urges expanding booster shot access.
  6. Variant tracker: Where different strains are spreading.
Feb 25, 2021 - Health

"This is a race": Fauci urges Americans to take whatever COVID vaccine is available

Dr. Anthony Fauci Photo: Oliver Contreras/Sipa/Bloomberg via Getty Images

Dr. Anthony Fauci is encouraging Americans to take the coronavirus vaccine if it becomes available, regardless of which one it is.

Why it matters: The Johnson & Johnson vaccine, which will be administered in a single shot instead of two doses as required by the Moderna and Pfizer vaccines, is expected to soon receive emergency authorization. Fauci said people should not wait to take the marginally more effective vaccines if the Johnson & Johnson shot becomes available to them.