CLEVELAND, Ohio — Northeast Ohio hospitals are keeping track of how many people don’t return for their second COVID-19 vaccine shot.
Recently, no-show rates for the second vaccine dose ranged from 1.5% at University Hospitals to 31% at the Cleveland Clinic, but numbers change daily as more people complete their second shots.
The second shot is necessary for full protection against COVID-19. If too many Ohioans miss their second vaccine shot, it could hinder the state’s efforts to reach herd immunity, and put more people at risk for severe COVID-19, health experts said.
Both the Moderna and Pfizer vaccines are designed to be administered in two doses, given a few weeks apart. The second dose may be given up to six weeks after the first dose, and the series does not need to be restarted if the second dose is given later than 21 days (Pfizer) or 28 days (Moderna), according to guidance from the U.S. Centers for Disease Control and Prevention.
Those who don’t complete the vaccination series are “working against herd immunity and they’re increasing their own personal risk,” said Dr. Robyn Strosaker, chief operations officer for University Hospitals.
Physicians are seeing many partially immunized patients get severe COVID-19, and it’s easier for them to spread the illness, Strosaker said.
The national vaccine rollout is reaching a point where demand will be lower than supply. A new poll from Quinnipiac University found that while nearly 70% of Americans plan to get or already have gotten a vaccine, nearly 30% say they don’t plan to be immunized.
Health experts say the country needs to reach much higher levels of vaccination to control the virus.
About 69% of Clinic patients are showing up for their second shots, the hospital system said in an email earlier this week. The number changes daily as more people go through the process, the Clinic said.
“The second doses will likely catch up as more people schedule,” a Clinic spokeswoman said via email. “Not everyone is getting the second one at exactly 3 or 4 weeks. It doesn’t mean those people aren’t coming back; it’s just where we are at the time.”
MetroHealth Systems says it had 98% of its patients return for second doses this week at its Northfield Road mass vaccination site in Maple Heights.
Western Reserve Hospital in Cuyahoga Falls reports it has administered more than 3,650 vaccines, and only 31 people missed their second dose.
UH has administered more than 100,000 doses to its employees and the public, and has a no-show rate of 1.5% for the second dose, the hospital system said in a statement.
Why do people skip the second dose?
A big reason is fear of side effects, and they or someone they know experienced strong side effects after the first dose. They’ve heard that the second dose hits even harder.
Side effects such as pain at the injection site, low fever and fatigue are expected and normal. True allergic reactions, such as anaphylaxis shock, are rare.
There’s also a perception that one shot is good enough, especially for people who had the illness, or were diagnosed after getting the first shot.
“Fortunately, we are hearing these concerns only as they are returning for their second dose, and our staff has done a great job educating and calming fears and anxieties,” Nealie D’Abate, vice president of organizational development and chief learning officer at Western Reserve Hospital, said in an email.
What are hospitals doing to encourage people to get the second shot?
These hospitals — and other vaccination sites — automatically schedule appointments for the second dose when patients are seen for their first shot. UH and Clinic patients receive emails, texts or phone calls as reminders about the second appointment.
Western Reserve keeps the patient’s COVID-19 vaccine card until the patient returns for the second dose. At the first dose appointment, patients receive a reminder card containing information concerning the second appointment date, D’Abate said.
Are people who skip the second shot fully protected?
The first shot is a good start, but people are not fully protected until two weeks after the second dose, MetroHealth Systems chief quality officer Dr. Brook Watts said.
Presently, studies published by the U.S. Centers for Disease Control and Prevention point to approximately 70-80% immunity following the first dose, said Thomas Bauer, pharmacy director at Western Reserve Hospital.
UH’s Strosaker is seeing a dramatic decrease in hospitalizations for those who are fully vaccinated. However, people who had only one dose of the vaccine are being hospitalized for COVID-19.
“You have a higher risk of hospitalization and severe illness if you only receive one dose,” whether or not you’ve previously had COVID-19, Strosaker said.
What about people who have recovered from COVID-19?
People who have had COVID-19 still need two shots, UH’s Strosaker said.
“There is some concern that the antibody protection you have after a COVID-19 infection may not be as protective against the variants as the vaccine,” she said. “So for that reason we are still recommending the vaccine in both doses of the vaccine, even if you have had a COVID infection.”
Why do young people need to be fully vaccinated?
Patients currently hospitalized are markedly younger, which suggests that young, healthy people also need to be immunized, Strosaker said.
“Young people are at risk as well, and they tend to remain at risk for passing COVID on to those who may be less healthy,” she said. “We are continuing to stress the need for all those 16 and above to come back for their second shot.”
If a sizeable percentage of Ohioans skip the second shot, how will that affect herd immunity?
The state won’t reach herd immunity if it doesn’t completely immunize 70% or more of the population, MetroHealth’s Watts said.
“All of our calculations on herd immunity, are based on the vaccine efficacy of getting two doses,” Strosaker said. “If people choose to get only one dose, it’s going to decrease our vaccine efficacy, which means that even a higher percentage of the population would need to be vaccinated for herd immunity.”
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