A shot. A wait. Another shot: Two-dose coronavirus vaccine regimens will make it harder to inoculate America - The Washington Post

“It definitely will be an iterative process,” Howell said, as she multiplied those problems through jails, group homes and homeless shelters, wondering how not to waste precious doses if somebody doesn’t show up as expected for their second shot, leaving a precious vial in the refrigerator.

“Do you use second doses for first doses?” Howell speculated.

As the nation gears up to vaccinate tens of millions of Americans against the novel coronavirus, public health officials like her are facing novel dilemmas, driven by the urgency of the pandemic, the fact that only a small minority may have immunity from prior exposure and by the vaccine available at each site, with the differing intervals between shots depending on the manufacturer.

“Two doses more than doubles the logistical challenges of administering the vaccines,” said Jeffrey Duchin, health officer for public health in Seattle and King County, Wash.

With Ebola, Moore said, both single- and two-dose vaccines exist and experts have been figuring out how best to deploy them both in and around outbreaks, depending on the availability of supplies.

The classic schedule for vaccines that target proteins like the spike protein on the surface of this coronavirus, Moore said, is three shots — “prime, prime, boost” — with the second and third shots coming one and six months after the first injection.

“For all we know, all these two-dose vaccines may work in one dose,” Duchin said.

The Vaccine Finder is designed to help people find providers of vaccines, from flu to shingles, close to where they live.

The challenges of registering individuals and reminding them electronically about their second shots are daunting, said Sacramento County Health Director Peter Beilenson, who like Howell is concerned about the potential inefficiency of staggered staff and residents’ immunizations in long-term-care and other residential facilities.

The coronavirus vaccines may give headaches, fevers and other unpleasant symptoms — all good signs of the body’s immune system getting to work — but Talbot is concerned they may prevent people from returning for their second dose.

Moore, who has studied another painful vaccine — two-dose shingles shots — says she is heartened by the way a vast majority of people who are educated about what to expect come back for their second doses despite the discomfort.

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