Public health officials urge people missing 2nd dose of vaccine to catch up

New state data reveals that 12.2% of people who received the first dose of a covid-19 vaccine in Nevada are overdue for their second, with more than two-thirds six or more weeks overdue.

It’s a worrisome component of the state’s overall vaccination effort, which has slowed over time despite rising case numbers and the emergence of the more transmissible delta variant.

According to a Nevada Department of Health and Human Services report, as of July 18, 12.2% of people who received a first dose of the Pfizer or Moderna vaccine are considered overdue for their second dose. The DHHS report did not include the raw number of people behind on their vaccine

Of those people overdue for their second dose: 83.6% are overdue by six or more weeks, 4.3% by five weeks, 2.9% by four weeks, 2.8% by three weeks, 2.6% by two weeks, and 3.8% by one week. A four-day grace period was included in the state analysis to account for scheduling lags and reporting delays.

People must receive both doses of the Pfizer or Moderna vaccine to be considered fully vaccinated. The Centers for Disease Control recommends second doses be administered after 21 or 28 days, respectively.

A third available vaccine, Janssen (Johnnson & Johnson), requires only one dose and therefore was not included in the state analysis.

Nevada’s statewide overdue rate appears to be slightly higher than the national average, which the Washington Post and others have reported was nearly 11% as of June 16.

But rates of overdue covid vaccinations range significantly by Nevada county. Clark County has the highest rate of individuals lagging or skipping their second dose at 14.2%. The Las Vegas metropolitan area has been leading the country in new covid cases.

Only Esmeralda and Pershing counties also have overdue rates in the double digits: 13.2% and 11.1%, respectively.

On the other end, Lincoln County has the lowest overdue rate at 4.7%. However, the overall vaccination rate there is low: Only 30% of the total eligible population in the rural county is vaccinated, according to the state’s covid data tracker.

Statewide, 46.8% of the eligible population in Nevada is vaccinated; 55.8% has initiated the vaccination process.

Washoe County and Carson City, which have led the state in overall vaccination rates, have respective overdue rates of 6.8% and 5.5%.

For Washoe, that represents a significant improvement since April 28, when the county reported an overdue vaccination rate of 17.2%.

On April 28, the statewide overdue rate was 12.9%. Of those people, 31.3% were six or more weeks overdue at the time.

The rate of people who are six or more weeks overdue for their second covid vaccine dose has more than doubled since then.

Shannon Litz, a public information officer with DHHS, in an email said the state’s covid call center has made 45,000 outbound calls to people overdue for their second dose, as of mid-July.

“While making these calls some individuals are expressing concerns about the side effects from the first dose,” said Litz, “and the call center representative is able to provide information on the full protection two doses offers.”

Common side effects of the covid-19 vaccines include tiredness, headache, muscle pain and chills. The CDC website emphasizes that these are “normal signs that your body is building protection” but “they should go away in a few days.”

The site continues, “Some people have no side effects.”

Public health officials are encouraging people to get their second dose, even if they are well past the optimal three- or four-week timeframe for receiving it. Overdue people will not have to “start over.”

“It is concerning if you get only one dose,” says Johan Bester, director of bioethics at UNLV’S Kirk Kerkorian School of Medicine. “It’s better than nothing, so I’m glad they are getting it, but especially with delta variant, we know it’s much less effective than two doses.”

Vaccine hesitancy has been a focus of public health officials since the covid-19 vaccines were introduced. But most of that effort has focused on those who refuse to get the vaccine at all, which Bester notes is “a much bigger problem.”

Vaccines are safe and effective. However, a vocal and targeted misinformation campaign has waged throughout the pandemic, and the issue of the covid-19 vaccine specifically has become highly politicized.

Claims that vaccines are untested and unsafe are false, “but if you’re on Facebook and you see this obviously it makes you worry,” says Bester.

The White House has even called attention to what one watchdog organization dubbed “the disinformation dozen” — 12 people responsible for the majority of vaccine misinformation on social media. When asked by a reporter what his message to social media companies like Facebook was, President Joe Biden responded, “They’re killing people.” Though Biden later tried to soften his comments, his original response underscores just how impactful the anti-vaccine misinformation campaigns are believed to be.

Bester says researchers are still probing into the politicization of the covid vaccine and what its public health implications are.

Beyond vaccine hesitancy, people may mistakenly believe they do not need a second dose. They may not realize they received the Moderna or Pfizer shot and not the “one and done” Janssen option. Or they might simply have gotten busy and forgotten.

“Life happens,” says Bester. “Things happens. There is a significant amount of people in Vegas for who it is a big deal to get time off work to get a shot, for a variety of reasons. Those kinds of barriers might be contributing to this.”

The number of overdue people may also be inflated to some degree by reporting errors.

“Through the outbound calls to seniors we are finding that many already have a second dose appointment scheduled or have completed their second dose,” said Litz. “The Nevada State Immunization Program is reviewing this information closely to reconcile any patients who may have a duplicate record in the Nevada WebIZ system.”