By the end of April 2021, about eight percent of those who received the first dose of the experimental mRNA Pfizer/BioNTech or Moderna/NIAID COVID-19 vaccines being distributed under an Emergency Use Authorization (EUA) granted by the U.S. Food and Drug Administration (FDA) had not received the second dose of the vaccines. This represents more than five million people in the United States.1 The percentage of people who had missed the second COVID vaccine dose was up by 3.4 percent since March 2021.2
The Pfizer/BioNTech and Moderna/NIAID (National Institute of Allergy and Infectious Diseases) COVID-19 vaccines are supposed to be given in two doses three to four weeks apart.3
“Obviously whenever you have a two-dose vaccine, you’re going to see people who for one reason or other—convenience, forgetting, a number of other things—just don’t show up for the second vaccine,” said Anthony Fauci, MD, director of NIAID.4
Public health officials predicted that two-dose vaccination campaign for adults would be challenging. Officials say that childhood vaccines, which usually have multiple doses, are easier to administer because children are scheduled to see their pediatricians frequently for “well-child” visits.5
Why Some Americans Are Skipping the Second Dose of the COVID-19 Vaccine
A U.S. Centers for Disease Control and Prevention (CDC) spokesperson said that the reasons behind why people are missing their second dose of the COVID-19 vaccine requires further analysis. However, it is speculated that there are a number of reasons for this, including a perception that one dose is enough to provide protection and, in other cases, concern that a more serious reaction will occur after the second dose of COVID-19 vaccine if a strong reaction was experienced following the first vaccination.6
Public health officials have suggested that some people may be choosing to miss the second dose of the vaccine because they believe that one dose is effective.7 Another reason is that they may have been advised by their healthcare provider not to get the second dose if they experienced an allergic reaction after their first dose. Angela Rasmussen, PhD, a virologist at the Vaccine and Infectious Disease Organization (VIDO) in Canada said:
I think other people have been advised by their health care provider to not get a second shot, and that’s if they’ve had an allergic reaction or have a bad history with getting vaccine boosters—that’s probably a minority of cases but I think some people for medical reasons will have been advised not to get the second shot.8
The other reason why many people are reluctant to get the second dose of the vaccine is due to awareness about reports of moderate to severe adverse reactions that many people are experiencing following the second dose, reactions which are considered “normal” by health officials.9 The CDC lists fatigue, headaches, muscle pain, chills, fever and nausea as some of the common adverse affects for both Pfizer/BioNTech and Moderna/NIAID COVID-19 vaccines and advises that those symptoms may be severe enough to interfere with daily activity for several days or more, depending upon the individual.10
Opting Out of the Second Dose Due to Concerns About Adverse Affects
Aaron Milstone, MD of Williamson County Medical Center in Franklin, Tennessee said that many of his patients do not want to get the second dose of the COVID-19 vaccine because of the fear of a potentially severe adverse reaction. “I’ve had a fair number of patients come in and say I’m only going to get the one dose. I felt good with it, I didn’t have any side effects, why go ahead and tempt fate,” Dr. Milstone said.11
Danielle Lee, an occupational therapist living in Southern California expressed hesitancy in in getting a COVID-19 vaccine since she has had adverse reactions to vaccines in the past. She said she decided to get the first dose of the Pfizer/BioNTech vaccine and had a mild reaction but she is unsure whether she will get the second dose. She said, “It’s almost like, I guess, maybe an emotional decision. I think it was a combination of, you know, maybe a little bit of peer pressure as well. Like you see other people doing it.”12
When asked if she was more concerned about the risks associated with the second dose of the vaccine than contracting the COVID-19 infection, Lee said, “To be honest, I’m more worried about a bad reaction to the second dose.”13
Marlene Ceballo of North Ogden, Utah said:
I am scheduled for my second dose on Wednesday. However, I have been debating on whether to go in and getting it or just skipping it overall. I’m afraid I might get another reaction to it. My in-laws received their second does on Friday and all were sick throughout the weekend. They are better now but it scares me to think of not making it, so I might just skip it.14
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Click here to view References:
1 Pereira I. 2nd vaccine shot statistics show majority getting it, only 5 million missing it: CDC. ABC News Apr. 25, 2021.
2 Maxouris C, Andone D, Fox M. CDC data shows more Americans are missing their second dose of Covid-19 vaccines. CNN Apr. 25, 2021.
3 U.S. Centers for Disease Control and Prevention. COVID-19 Vaccines That Require 2 Shots. May. 24, 2021.
4 Maxouris C, Andone D, Fox M. CDC data shows more Americans are missing their second dose of Covid-19 vaccines. CNN Apr. 25, 2021.
5 Weise E. About 92% of Americans who got the COVID-19 vaccine returned for their second shot. That’s good, but experts say the rest should do it now. USA Today Apr. 29, 2021.
6 Waldrop T. Why so many Americans are skipping their second COVID-19 shot. CTV News May. 2, 2021.
7 Cavanagh M, Mudge R. Fact check: COVID-19 vaccines — Why are people missing their second shot? DW May. 1, 2021.
10 CDC. Different COVID-19 Vaccines. May. 13, 2021.
11 Ismail L. Doctors say some are opting out of second vaccine dose in fear of side effects. News Channel 5 Feb. 8, 2021.
12 CBS News. Millions of Americans have missed their second Pfizer or Moderna COVID-19 vaccine dose appointments. Apr. 28, 2021.
14 Alberty E. Why thousands of Utahns have missed their second COVID-19 vaccine dose and how it might affect the spread of the virus. Sltribe.com May. 11, 2021.