Second-dose skippers? CDC says 8 percent of people getting first shot missed the next one

North Carolina

RALEIGH, N.C. (WNCN) — The Centers for Disease Control and Prevention says about 8 percent of people who got their first doses of COVID-19 vaccine may have missed their second dose — a number that, if extrapolated solely to North Carolina, could approach the population of Cary.

“That’s a significant percentage, the 8 percent that are not getting a second dose, and that’s a real risk,” said Dr. Thomas Holland, an associate professor at Duke University’s school of medicine.

According to CDC data through April 9, more than 5 million people across the country who received the first dose of either the Moderna or Pfizer vaccines missed their second doses. The agency’s count covers people who received their first Moderna dose by March 7 or their first dose of the Pfizer vaccine a week later.

The North Carolina Department of Health and Human Services data show about 1.7 million people in the state received at least one dose of the two-dose vaccines in the same time frame, by March 7, but does not break down how many received each brand. Eight percent of that number comes out to about 135,000 — about 30,000 shy of Cary’s estimated population of 165,000.

The CDC’s rate is more than double what it was in February, when it was 3.4 percent.

Of course, the rate isn’t the same everywhere. Elizabeth Ramsey, the director of the vaccine clinic at the University of North Carolina’s Friday Center, says the no-show rate for second doses there is less than 1 percent — in large part because of a system that contacts those who don’t show up and rebooks their appointments.

“I definitely think that that helps to ensure that patients are receiving both doses,” Ramsey said.

There are many possible explanations. Some might be too busy for those second appointments. Others might be apprehensive of side effects that can be stronger following the second shot. Still, others aren’t no-shows at all — they could get their shots at different locations that failed to link their data due to technical issues.

Yet others might think one shot is good enough.

“There is, you know, a little bit of concern that patients are comfortable after receiving that first dose,” Ramsey said.

A CDC study found a surprisingly high efficacy rate — 80 percent — two weeks after the first shot of the two-dose vaccines. That jumps to 90 percent two weeks after the second dose.

“The first dose acts like a primer, and then the second dose acts like a boost,” Holland said. “You have some immune response, and people make some antibodies to the first dose, and then that really takes off with the second dose. And so we think that, that protection against COVID will be better and will be more durable, once you’ve had both doses. So it really is important to get both both ends of that match set.”

Even with more people missing their second doses, there are still more second doses than first ones being given across the state. 

In each of the past four weeks, second doses have outnumbered first doses — last week by a more than 2-to-1 margin.

Source: NCDHHS data dashboard.

That’s further evidence of the drop in demand, the experts say.

“We reached the point where the patient population that is hesitant, is really going to need to make a decision on if they’re comfortable getting a vaccine,” Ramsey said. “And I think that part of it now is just going to be getting to that patient population and increasing our education and awareness of the safety of the vaccine, the efficacy of the vaccine, and trying to reach those hesitant patient populations. And it’s going to be, you know, an uphill battle for the remainder of the patient population.”

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