July 28, 2021


Damascus Center for Theoretical and Civil Rights Studies

Second doses of COVID-19 vaccines hard to come by in L.A. County

Most of Los Angeles County’s supply of COVID-19 vaccine will be needed for second doses into next week, as even stepped-up shipments will be insufficient to break the bottleneck of people needing to complete their inoculation regimen, officials said.

County Public Health Director Barbara Ferrer said Monday that about 55% of the doses expected this week will be needed for second shots — which are required a few weeks after people initially roll up their sleeves.

County officials have already said they will be limited to administering second doses for the rest of the week starting Tuesday at a handful of their major vaccination sites: the Fairplex in Pomona, the Forum in Inglewood, county Office of Education in Downey, Cal State Northridge, El Sereno, Six Flags Magic Mountain in Valencia and Balboa Sports Complex in Encino.

While the county is committed to providing second doses as close to the recommend interval as possible — three weeks for Pfizer-BioNTech and four weeks for Moderna — Ferrer acknowledged that “it is hard to manage a vaccination program with so much variability in the weekly allocations.”

The nation’s most-populous county has seen its vaccine shipments seesaw wildly over the past month, making it difficult for officials to accurately peg the supplies they’ll have to work with. About 193,950 doses arrived the week of Jan. 11, but 168,575 were delivered the following week and only 137,725 arrived the week after that.

Most recently, the county received 184,625 doses — a number expected to climb further this week, to more than 218,000.

“We’re encouraged that this week there’s an increase in our shipment, and we hope that this trend will continue,” Ferrer said during a briefing.

L.A. is far from alone in singing the vaccine blues. Officials throughout California have lamented the limited and variable vaccine shipments they’ve received, saying they have the capacity and capability to provide significantly more shots.

“We can’t move fast enough,” Gov. Gavin Newsom said Monday. “We are sober and mindful of the scarcity that is the number of available vaccines.”

With the shortage, there has been considerable public discussion about whether officials should shift their focus to giving first doses to as many people as possible, rather than earmarking precious supplies to ensure on-time administration of a second dose.

The thinking goes that even one shot provides some level of protection against COVID-19. Officials have said if it’s not feasible to adhere to the recommended schedule, then in extremely rare circumstances, administering the second dose within six weeks of the first dose may be done.

But federal officials are in agreement that the second dose should be delivered as close to the recommended timing as possible.

Dr. Anthony Fauci, the U.S. government’s top infectious diseases expert, said Monday that the two-dose regimen unlocks the full benefits of the vaccine. While first dose provides “some degree of protection,” the second dose multiplies the level of protection by a factor of 10.

That’s important not only “because of the height of the response and the potency of the response, but as you get to that level of antibody you get a greater breadth of response,” he said during a White House COVID-19 Response Team briefing. “And by breadth of response, we mean it covers not only the … currently circulating virus, but also the variants that we see circulating.”

Delaying the second dose for too long on a widespread scale, he said, could invite the spread of more problematic viral mutants — including the more-infectious strain first identified in Britain, which has now been found in a handful of California counties, including L.A., Orange, San Diego, San Bernardino, Alameda, San Mateo and Yolo.

“We feel the optimum approach would be to continue with getting as many people on their first dose as possible, but also making sure that people, on time, get their second dose,” Fauci said.

Officials have said they expect vaccine shortages to ease in the coming months, with the arrival of additional Pfizer and Moderna shipments and the likely introduction of a third vaccine manufactured by Johnson & Johnson, which requires only a single dose.

At any rate, additional study would be needed to figure out the full ramifications of a delayed dose approach, and Fauci said doing so “would take several months to get a meaningful answer.”

“At that time, the amount of vaccine that would be available would almost be making that question somewhat of a moot point,” he said.