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Vaccination, particularly for the most vulnerable Americans, is the surest way for us to overcome the Covid-19 crisis. As physicians, we celebrate the light at the end of the tunnel, in large part due to Operation Warp Speed. But as members of Congress, we are becoming increasingly concerned that federal bureaucracy continues to stand in the way of rapid, widespread administration of Covid-19 vaccines.

The nation has gained a tremendous amount of knowledge about Covid-19 over the past year. Similarly, over the past few weeks, the scientific community has published encouraging analyses about the vaccines that are playing a starring role in leading us out of this crisis. Mountains of real-world evidence are showing that the two mRNA vaccines authorized by the FDA — the first made by Pfizer and BioNTech, the other by Moderna, both of which are supposed to be administered as a two-dose regimen — will provide substantial protection against Covid-19 even after only one dose.

Considering that nearly every state is facing shortfalls in the supply of Covid-19 vaccines, we believe this groundbreaking development can help remedy some of the vaccine supply issues the nation is facing. This new evidence indicates that the second doses currently administered to comply with the Food and Drug Administration’s emergency use authorizations (EUA) could instead be used as initial first doses — essentially doubling the supply.

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Unfortunately, governors who would like to follow this new evidence and provide protection for more citizens have their hands tied by the emergency use authorizations. The FDA’s failure to revise it to allow single doses now — with second doses administered when they become available — may result in tens of thousands of additional deaths. According to recent data coming out of the United Kingdom, it is clear that second doses can be administered up to 12 weeks after the first dose, while maintaining efficacy.

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On March 2, President Joe Biden announced the United States will have enough doses of Covid-19 vaccines to allow every citizen to get vaccinated by May 31 under the current emergency use authorizations. Imagine if they were revised to increase the window for administering the second dose. Under this scenario, April 15 could be National Vax Day — the day when every vulnerable or essential worker has gotten at least one dose of a Covid-19 vaccine — instead of National Tax Day.

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As physicians who are also members of Congress, we are calling on the FDA to break down the bureaucracy and consider revising the EUAs. This call for revising the dosing schedule is bicameral and bipartisan, with seven members of the GOP Doctors Caucus joining two Democratic senators calling for such a change.

What is stopping this from happening? The bureaucracy’s failure to truly follow the science. The FDA claims the manufacturers themselves must apply for any change to their emergency use authorizations. But we know the FDA has been unwilling to look at real-world evidence in the past, especially if it comes from other countries.

Nonetheless, in this case the Health and Human Services (HHS) secretary has clear statutory authority to revise the EUAs using real-world experience — and not wait for a manufacturer’s request — if he or she finds the revision is “appropriate to protect the public health or safety.”

The large amount of real-world evidence collected from data analysis of the Covid-19 vaccines in Israel and Great Britain — two countries whose scientific rigor is well appreciated — clearly supports the revision we suggest.

Frustratingly, when Dr. Anthony Fauci was asked this week about changing the EUA, he noted it would be a “messaging challenge.”

With all the recent calls for patient-centered care, we should be willing to be honest with our patients and give them the choice to receive one dose now, with the knowledge that their designated “second dose” would be going to a vulnerable or essential person. They can receive a second dose later, and have nearly the same protection.

Calling it a “messaging challenge” is not following the science. Fauci also raised concerns that offering only a single dose of these Covid-19 vaccines would enable variants to spread. Yet a February report by the Center for Infectious Disease Research and Policy at the University of Minnesota reiterates our calls, and urges timely consideration of these new studies. That report actually came to the opposite conclusion of Fauci: the change needs to be made now in order to get ahead of the variants and potentially save up to 50,000 lives.

The Biden administration must cut through the red tape and ivory-tower arguments now and immediately consider revising the dosing schedule of the Pfizer and Moderna mRNA vaccines to allow for an extended second dosing interval. Any other action will cost lives that need not be lost.

U.S. Rep. Andy Harris (R-Md.) is an anesthesiologist and former head of obstetric anesthesiology at Johns Hopkins University. U.S. Rep. Greg Murphy (R-N.C.) is a urological surgeon who has practiced for more than 30 years. U.S. Rep. Mariannette Miller-Meeks (R-Iowa) is an ophthalmologist and former president of the Iowa Medical Society.

  • Supply is not the presenting issue. Delivery is the factor due to tremendous skilled/trained human resources requirements and logistics and planning scaled up. There are some medical, /legal liability and safety issues as well. Vaccinees cannot be jammed carelessly onto arms. Medicines have to be stored at certain temps to be visible. Recall the states understaffed and somewhat unqualifisd experts had first line control on deployment. Finding sites and keeping them staffed was struggle. It is part of the stark reality of public health. Public health agencies have been diminished and budgets cut for year’s. People go to private doctors not state health clinics they can. Those that cannot go to safety net hospital er. Not ideal when a public health emergency presents. Physicians/ doctors /pharmacists do not work for public health. They work in private for profit practices. USA is gapped on healthcare staff trained in this discipline. We are doing well for where as are. I commend use of fed acumen and boots on ground to build mass sites. Instead of continuing previous administrations omissions and strategies that left state and local trying to figure out delivery logistics. Dph leaders skill set does not match the mission. Some state leaders lack strategic vision or blinded by party politics to construct fair broad delivery to all. The mass scale up/ deployment skills of fed troops/corp of engineers etc trained in mass supply chain and mission oriented mindset is of value. I think is of any closed military forts for either resource stocking and staying of vaccinations be explored for helping as well. The effort be turned over completely to private interests as well. We are capitalist society after all. The trifsctor of private, public and fed/mil is the point of spear to get it done. Politically driven commentary can resume later. Not helpful.

  • I really dont think an anesthesiologist, a urologist and an opthamologist are experts on covid. This is way too important to allow non experts to mess with it.

  • A doctor title does not mean you have worked on COVID or have the research expertise to change vaccine protocols. Perhaps as members of Congress their efforts Southaven been better spent on getting their party to take this seriously over the past year. They have zero credibility

  • The vaccines all have specific protocol, why mess with it ?
    Producing enough for everyone is needed and now we also have johnson &johnson. Let’s not mess this up, leave the scientists do there job’s, please!!

  • The congressmen are absolutely spot on. Canada has become the most recent country to prioritize a first dose into everyone’s arm while delaying the second dose for up to 16 weeks. The three or four week interval for the Pfizer and Moderna second shots, respectively, are based on an accelerated timeline in the clinical trials that were simply trying to get an answer as quickly as possible. What vaccine for other diseases has a booster given that close to the first shot? None that I know of.

  • The problem I see with this approach is the variants that are partially resistant to the vaccines. It might take the full two-shot regimen to give a person reasonable immunity to variants with the E486K mutation.

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