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After Prime Minister Ingrida Šimonyte announced the possibility of extending the interval until the administration of the second dose of Pzifer in order to increase the number of people who received at least the first dose of the vaccine, Health Minister Arūnas Dulkys announced that a working group had been formed to solve this problem.
The head of government said that France and other countries have already made such a decision on the delay in vaccination, and that the deferral period under consideration would be up to 8 weeks. However, this ambition to extend the interval between the first and second doses of the vaccine has led to mixed evaluations.
Could be extended to 12 weeks
Seimas spokesperson Viktorija Čmilytė-Nielsen expressed support for such a goal: “I think it is a good idea, because the goal is to vaccinate as many people as possible with the first vaccination. From the health experts.
According to Marius Strioga, doctor of biomedical sciences at the National Cancer Institute, BNS, it is possible to delay the second dose, as shown by clinical trials, but it is necessary to choose a safe range:
“Up to six weeks, freely, maybe up to eight weeks, but longer would be up for debate. I think it’s safe enough to do that by extending it to eight weeks.”
According to Professor Aurelija Žvirblienė, an immunologist at the Vilnius University Life Sciences Center, the second dose of the vaccine could be given not after six or eight weeks, but after twelve weeks.
“I am the one in favor of extending the second dose because it is scientifically justified and there is no need to fear that it will affect the effectiveness of the vaccines in any way. On the contrary, it would be useful because immune memory cells take some time to form. Therefore, a longer interval could create a more sustainable immunity.
This seems like a comprehensive benefit, as it would also allow more people to be vaccinated. All the more so since many other countries have extended the timeframe specifically recommended for Pfizer vaccines. We know not only the example of the United Kingdom (UK), where the choice of a second dose after 12 weeks shows a very significant reduction in infections, but also Finland, where all vaccines have this range. Many countries have extended this interval to, for example, 30, 35, 42 days. Therefore, the countries are taking this initiative ”, commented the researcher on the tv3.lt portal.
It’s true, he added that both the US and Israel (along with the UK, the world’s leading countries in terms of vaccination coverage) are meeting the manufacturer’s requirement and adhering to a 3-week window.
The risks outweigh the potential benefits
However, the State Drug Control Agency (IARC) reacted strongly to such considerations, arguing that such use of the vaccine would not be in line with the RCP.
In turn, the infectologist prof. Vytautas Usonis said he didn’t understand how much distraction can be generated when making decisions in general.
“We are stopping AstraZeneca, we are allowing it, now we are deciding on a second dose: we want to extend the time for one vaccine and shorten the time for another. Where is the logic of all this? “, He asked himself.
According to the interlocutor, such a distraction does not do anything well both psychologically and responds to the load at the vaccination points to be able to properly control the flow and avoid such queues.
According to Usonis, it is not appropriate to extend the time of the second dose of Pfizer, as the risks outweigh the possible benefits.
“The interval between the first and the second dose is specified by the manufacturer: it is 3 to 4 weeks, we have no analogues and experience with a vaccine of this type to extend the period.” Furthermore, we cannot compare this vaccine to viral vector vaccines, which have significantly longer intervals because they work a little differently.
In the sense of the immune system, one logic is one month, the other logic is three months. It is a big problem for people to calculate the doses, but do not delve into what is behind it, what is the biological meaning, why in one case it is done in one way and in another ”, explained the doctor.
The question is whether more could be vaccinated
Furthermore, the interviewee questioned whether extending the interval between the two doses would actually vaccinate more people.
“What happens if you vaccinate twice, if the quality of that vaccine could be affected? And what will we gain? A month in time? Perhaps it is better to mobilize the use of what is in the warehouses and start vaccinating people more freely and flexibly, to talk about supplies.
It is still announced that we are receiving new shipments of vaccines, so we must see how to maximize this process so that everything is done quickly, but according to the rules, ”said V. Usonis.
Although it is argued that the fact that more and more young people with coronavirus are admitted to hospitals is forcing vaccines to be accelerated to the maximum, the professor assured that there would not be much to be gained here either.
“Yes, younger people are in resuscitation, but what we are vaccinating today, the effect will be visible in 3-4 weeks at best. That is why we will not solve today’s problems by changing vaccination schedules or vaccinating more people ”, he did not hide.
The doctor added, without mentioning the legal aspects: who will be responsible for the changes if the vaccine is not vaccinated according to an approved vaccination schedule?
“There are all the administrative and legal nuances of the so-called immunity passport: will it be valid if the vaccine is not properly vaccinated? I don’t know, maybe it will be known? But it is obvious that there are still many unanswered questions,” he said.
Although from the scientific side A. Žvirblienė stated that he sees no problems in extending the aforementioned interval, he agreed that it is necessary to pay attention to the legal aspects: “You must listen to what the IWT lawyers and the Ministry of Health say no it’s so insignificant. “
Commitment: postpone vaccination for 6 weeks?
According to Auksė Mickienė, a professor at the LSMU Infectious Diseases Clinic, the maximum time recommended by the manufacturer to postpone the booster vaccination could be 6 weeks.
“Postponing up to 42 days is what complies with our regulations, characteristics of the drugs and clinical trials, what is known, investigated and validated,” he said. COVID-19 infection and vaccination: What can we do better?
At that time, the speeches to extend this interval to 8 weeks, said the professor, are not well founded and continue to be the subject of discussion in the societies of immunologists and infectologists of several countries.
“It is as if a commitment was made here, with the aim of winning the race with universal immunization, preventing the spread of the virus. The more people we inject the first dose and postpone the second, the faster we will increase the number of people after one. dose of the vaccine, ”noted A. Mickienė.
At the same time, the professor stressed that the formation of an immune response remains a delicate matter, and said that she herself is more inclined to endure 42 days. interval to not do what we do not fully realize.
“It just came to our attention then. With other vaccines, regimens have been developed that provide the best, most sustainable, and longest-lasting response to cell stimulation for some time. 42 days would be a compromise on how best to get out of the situation. That is my personal position. “Many accredited societies of infectologists and immunologists discuss this, but do not find consensus,” explained the doctor.
I would vaccinate a critical mass of people
By removing this position doc. Dr. Vaidotas Gurskis pointed out that the period of 42, that is, 6 weeks, is also indicated by the producer himself. In arguing why those six weeks would be important for Lithuania, the rapporteur argued that this time was sufficient to vaccinate a critical mass that would already allow to stop the spread of the infection.
“We don’t need to get out of those rules and think a lot about how to break them legally. This is definitely a way out for our state, those 42 days are 6 weeks. I don’t think we need 8 or 12 weeks.” The British have done it, they have won up to now, and in long-term races it is difficult to say how it will be, “he said.
The portal tv3.lt recalls that 84 people received the first dose of the vaccine last day, the second alone, the Statistics Department announced on Monday.
In the country, 563 thousand people were vaccinated against COVID-19 with the first dose of the vaccine. 724 people, both – 209 thousand. 600.
At least one dose of the 46.5% vaccine is administered. more than 80, 59 percent. 70-79 years and 37.6 percent. Population aged 60 to 69 years.
In total, Lithuania has received 806 thousand. 525 doses of vaccine, 801 thousand. 725 of them were delivered to vaccination centers. So far, 773 thousand have been used. 324 doses.
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