Pretend it didn't happen – expert advice on how to behave after receiving a single dose of any of the Covid-19 vaccines.

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Fri, 2021-01-15 16:02 — mike kraft

How effective is a single vaccine dose against Covid-19? Pretend it didn't happen – expert advice on how to behave after receiving a single dose of any of the Covid-19 vaccines. Zaria Gorvett BBC_Future

... Most vaccines require booster doses to work.

Take the MMR – measles, mumps and rubella – vaccine, which is given to babies around the world to prevent these deadly childhood infections. Around 40% of people who have received just one dose are not protected from all three viruses, compared to 4% of those who have had their second. People in the former group are four times more likely to catch measles than those in the latter – and there have been outbreaks in places where a high proportion of people have not completed the full MMR vaccination schedule.

"The reason that people are so keen on boosters and consider them so vital is that they kind of send you into this whole other kind of fine-tuning mode of your immune response," says Danny Altmann, professor of immunology at Imperial College London.

How booster vaccines work

When the immune system first encounters a vaccine, it activates two important types of white blood cell. First up are the plasma B cells, which primarily focus on making antibodies. Unfortunately, this cell type is short-lived, so although your body might be swimming in antibodies within just a few weeks, without the second shot this is often followed by a rapid decline.

Then there are the T cells, each of which is specifically tailored to identify a particular pathogen and kill it. Some of these, memory T cells, are able to linger in the body for decades until they stumble upon their target – meaning immunity from vaccines or infections can sometimes last a lifetime. But crucially, you usually won't have many of this cell type until the second meeting.

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So how effective is a single dose of each of the Covid-19 vaccines? At a time when the answer is more urgent than ever – especially as the British government has decided to delay the second dose of all currently approved Covid-19 vaccines from 3-4 weeks to 12, and Russia is trialling a single-dose regimen of its Sputnik V vaccine named "Sputnik-Light" – it's also surprisingly complicated. Here's what we know so far.

According to Pfizer data published in December 2020, the Pfizer-BioNTech vaccine is roughly 52% effective after the first dose. Out of 36,523 participants in the phase three trial – the final stage of testing where people either received two full doses, 21 days apart, or a placebo – who had no evidence of existing infection, 82 people in the placebo group and 39 in the vaccine group developed Covid-19 symptoms. ..

For the Oxford-AstraZeneca vaccine, things are a bit different. In a paper published in January, the authors explain that the vaccine offers protection of 64.1% after at least one standard dose. This compares to 70.4% if you've had two full doses, or – oddly – 90% in people who have had one half dose followed by one full dose. ..

According to a document the company submitted to the FDA, the Moderna vaccine can provide 80.2% protection after one dose, compared to 95.6% after the second (in people aged 18 to 65 – it's 86.4% in those over 65). As with the Pfizer vaccine, all participants in the phase three trial received two doses of the vaccine or a placebo within a single set time period – in this case, 28 days – so it's not yet known whether the immunity from a single vaccine would continue, or drop off after this stage. ...

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