As the pandemic death toll mounts, governments delay administration of second vaccine dose

Almost 1.9 million people around the world have thus far perished in the coronavirus pandemic. Since the beginning of December, a seven-day average of some 600,000 new cases has been registered worldwide each day, with little evidence of the current winter surge abating.

The United States is the global epicenter of the pandemic. It reported a single-day record of 3,738 deaths on Tuesday, with another 233,513 new cases pushing hospital admissions for COVID-19 to a new one-day high of 131,215. The case fatality rate hovers around 1.6 percent. But with infections at the present rate, the death toll will inevitably be even more ghastly.

In Los Angeles County, ambulance workers have been issued a memo by the county Emergency Medical Services Agency stating that “effective immediately, due to the severe impact of the COVID-19 pandemic on EMS and 911 receiving hospitals, adult patients in blunt traumatic and non-traumatic out-of-hospital cardiac arrest shall not be transported [if] return of spontaneous circulation is not achieved in the field.”

In short, if after 20 minutes of attempts to resuscitate a patient, the patient does not breathe spontaneously, he or she will not be transported to a hospital.

LA County Supervisor Hilda Solis told CNN: “Hospitals are declaring internal disasters and having to open church gyms to serve as hospital units. Our health care workers are physically and mentally exhausted and sick.”

The health crisis in the nation is projected to grow even more catastrophic. There have been 365,859 deaths in the US since the first death was reported in February of last year. According to the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, the death toll will hit around 502,600 by February 4. The IHME expects that another 135,000 people will die in the next four weeks, an average of 4,800 deaths a day.

Despite these dire statistics, state and local governments across the country are forcing teachers back to the classroom and falsely promising a safe environment for students and educators.

Governments around the world refuse to enact the broad-based public health measures—including the shutdown of all schools and non-essential businesses, with full income protection for workers and small businesses—that are required to contain the pandemic and save lives. In the face of the resulting explosion of infections and deaths, some countries are moving to stretch out the administration of COVID-19 vaccines, in short supply and poorly organized, by delaying the second dose of the two-dose regimen. Their position is that partially vaccinating more people more quickly will save more lives than offering fewer people the complete regimen.

Both in the UK and the US, public health officials and scientists have claimed that Pfizer-BioNTech’s mRNA vaccine offers a remarkable efficacy, above 90 percent after the 12th day following inoculation, with just a single dose.

The second dose of AstraZeneca’s vaccine, which was rolled out this week in the UK, will be administered 12 weeks after the first. The Wall Street Journal wrote, “An AstraZeneca spokesman said the UK regulator’s dosing advice was ‘supported by strong evidence,’ including the elimination of COVID-19 hospitalizations by one dose. The vaccine was about 70 percent effective at three weeks after the first dose and stretching the time of the second dose, the regulator said.”

The evidence for these assertions remains to be presented.

According to a comment published in the Lancet on the Oxford-AstraZeneca COVID-19 vaccine’s efficacy, the two-dose regimen given three to four weeks apart showed a 70.4 percent efficacy 14 days after the second dose. The half-dose followed by the full-dose regimen had shown 90 percent efficacy, which is being further evaluated in trials. The two standard doses given three to four weeks apart provided only 62 percent efficacy against COVID-19 infection.

Why suddenly a single standard dose of the vaccine should generate such a high efficacy rate remains unexplained.

Pfizer has gone on record saying that its vaccine has not been evaluated for delays in giving the second dose. The quoted 95 percent efficacy develops only 12 days after the second dose is provided. “There are no data to demonstrate that protection after the first dose is sustained after 21 days,” the company stated. A New England Journal of Medicine study published last week found only 50 percent efficacy after one dose of the Pfizer vaccine.

At the World Health Organization January 5 press briefing in Geneva, Dr. Alejandro Cravioto of the Strategic Advisory Group of Experts on Immunization (SAGE) explained that only under “exceptional circumstances” should the second dose of the Pfizer-BioNTech mRNA vaccine be given weeks after the scheduled second dose.

Dr. Joachim Homback, SAGE executive secretary, clarified these remarks, stating that these recommendations were based on limited clinical data on a delay in the second dose of around six weeks. Patients in the Pfizer phase three clinical trials were given the dose in the range between 19 and 42 days, though a majority received it within 19 to 28 days. Scientists have emphatically stated that evidence supporting a delay in the second dose of these vaccines beyond the six-week recommendation is lacking.

With regard to the Moderna vaccine, which will most likely receive emergency use authorization by the EU very soon, Moncef Slauoi, chief adviser to the US Operation Warp Speed vaccine program, stated this week that federal officials were considering halving the doses to overcome production and distribution bottlenecks. However, a Moderna company spokeswoman told the Wall Street Journal that its vaccine trial and emergency use authorization were “linked to two shots of its vaccine one month apart… it couldn’t comment on regulatory discussions involving other dosing options.”

In the case of Moderna’s vaccine, the author of another New England Journal of Medicine study, published on December 30, Lindsey R. Baden, MD, of Brigham and Women’s Hospital in Boston, reported that a secondary analysis demonstrated a 95.2 percent efficacy 14 days after the first shot of the vaccine. However, this was not the protocol for the trial and remains speculative, requiring additional studies to confirm such a one-dose regimen.

Shortcuts are often reactionary knee-jerk reactions, and scientists are no less immune to them than politicians and heads of state. In the present instance, they are a response to the ever-growing social crisis emerging from the refusal of governments, all of which are controlled by capitalist elites, to take the measures needed to protect and care for the population at large. Attempts to depart from the science behind the vaccine trials will only instill further distrust in the public and create new and unforeseen crises.