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Strategies to Support Compliance With Multi-Dose COVID-19 Vaccinations

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The first person in the United States to receive the new Pfizer COVID-19 vaccine, a New York nurse, received the initial dose on December 14. But without the second shot required 21 days after the initial one, the first dose of Pfizer’s vaccine only offers about 52% effectiveness. To reach the holy grail of 95% efficacy, the patient must return for a second dose. So how will the nation’s public health system encourage Americans to return for the second shot? The answer to this important question lies with individual states, as they are charged with distributing the vaccine to their residents. However, the US Centers for Disease Control and Prevention (CDC)  is recommending that vaccine distributors schedule the patient’s follow-up appointment for the second shot at the time of the first dose. A national education campaign on the COVID-19 vaccinations is also in the works. Most important, systems must be developed to enable communication between the vaccine provider and patient to ensure compliance with the second dose. All education efforts need to consider the needs of marginalized groups, as well, to support compliance among traditionally hesitant populations.

The CDC recommends that frontline healthcare providers and long-term care residents receive the Pfizer COVID-19 vaccine first; however, states will create their own action plans. It may be as early as April or as late as June before the Pfizer vaccine is available at pharmacies and medical offices. The Moderna COVID-19 vaccine is expected to receive emergency use authorization within the next few days. It also requires a second dose given 28 days after the first. Both the Pfizer and Moderna vaccines are based on synthetic messenger RNA (mRNA), a new technology that helps the body’s own immune system identify and then combat the novel coronavirus by copying its surface.

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