Delaying second vaccine dose and vaccine after covid

CMAAO CORONA FACTS and MYTH

Dr K Aggarwal , President CMAAO, HCFI, With input from Dr Monica Vasudev

India

healthysoch

New Delhi, January 05,2021 :

There is a proposal to delay administration of the second dose of COVID-19 vaccines — suggested as a strategy to boost the number of people who get some degree of protection from a single immunization with the Pfizer/BioNTech or Moderna vaccines
Proponents argue that getting some degree of protection to a greater number of Americans is worthwhile, particularly as case numbers and hospitalizations continue to rise and with the emergence of a more contagious variant.
Opponents raise concerns about diverting from the two-dose schedule evaluated in clinical trials, including a lack of data on long-term protection from a single dose. They also suggest a longer interval between dosing could increase resistance of SARS-CoV-2 virus.
The experts state that supply constraints, distribution bottlenecks, and hundreds of thousands of new infections daily prompted them to change their stance on administering COVID-19 vaccines according to the two-dose clinical trial regimen. Furthermore, they cite a study in the New England Journal of Medicine that suggests 80% to 90% efficacy for preventing SARS-CoV-2 infection following one dose of the Moderna vaccine.
After one dose “the immune system is learning, but it’s not ideal. That’s why you need the second dose
Another proposed strategy to extend the current supply of COVID-19 vaccines to more Americans involves splitting the current dosage of the Moderna vaccine in half.
Mike Tyson famously said: Everybody has a plan until they’ve been punched in the mouth. When it comes to covid-19, we’re being punched in the mouth over and over again. It’s time to change the plan; namely, we should give people a single vaccination now and defer their second shot until more doses of vaccine become available.
the clinical trial results for the Pfizer and Moderna vaccines are reassuring. While they were designed to test the effectiveness of two shots given about a month apart, both showed that the first shot had a substantial benefit beginning around 10 days afterward. In both trials, by the time of the second shot, the first was already 80 to 90 percent effective in preventing covid-19 cases.

Should a person who has recovered from COVID receive a vaccine?

A brief review of vaccine history reveals that new vaccine development has a success rate of about 7%.
There are over 200 vaccines in or ready for clinical trials, at least 14 vaccines should be clinically successful.
To date, Pfizer, Moderna, AstraZeneca, Novavax, Johnson & Johnson, GlaxoSmithKline, and CNBG in China have reported that 80%-95% of people taking their vaccines are protected from COVID.
While one company may not be capable of producing enough vaccines for all of its customers, the fact that so many companies are reporting successful vaccine development is a tremendous outcome.
From an immunological and bioethical perspective, providing a vaccine to a Post COVID person would be no different from a person who has recovered then been re-exposed or re-infected. In both cases, that individual will mount a rapid immune response and either will be asymptomatic or present with mild, manageable symptoms. In fact, re-exposure to the SARS-CoV-2 virus or receiving a vaccine might even enhance that person’s immunity to future COVID infections.
The immune system contains an immunological library in our lymphatic system that stores memory lymphocytes that have been programmed to respond to almost any past infection that a person has encountered. If we are exposed a second or third time to one pathogen, these memory lymphocytes move out of retirement and rapidly prevent re-infection.
Since a vaccine is designed to mimic a viral exposure without eliciting a dangerous viral infection, these resident memory cells only re-ignite the immune system and mitigate the infection – they don’t cause illness.
Upon re-exposure to a virus or receiving a vaccine, our immune system could generate even better memory lymphocytes to fight future infections. For example, it is known that the HPV vaccine Gardasil triggers a stronger immune response than exposure to the natural virus. Similarly, the tetanus vaccine triggers a more robust immune response than exposure to tetanus bacteria.
Vaccines can elicit protection against several other viruses. There are a lot of data showing that people who were vaccinated against measles, influenza, or TB generate lymphocytes that even help protect them against COVID.
We have no clinical evidence from other viruses to show that people who have recovered from one infection and are vaccinated will develop any harmful side effects.
All medically competent individuals should get vaccinated as soon as possible. In non-pandemic times, each individual should have his or her autonomous right to choose which vaccine to receive and whether to be vaccinated, even if they have been exposed to a pathogen. In this pandemic, we must let our healthcare providers stop the infections by vaccinating as many medically competent people as possible. This will accelerate the time it takes to achieve herd immunity and will return our lives to a point where we won’t need to wear masks, social distance, or quarantine.