Should America be delaying first doses for half the country to give a second dose to those who have already received one shot? A growing number of scientists, epidemiologists and doctors say no.

1. The Case for Delaying
Most Second Shots
Grows Stronger and Stronger
Elton B. Sherwin
Environmentalist and Author
Elton@EltonSherwin.com
February 2021
Rev. 11c
Prepared for California’s
Scientific Safety Review
Workgroup
Technical details and bio
at the end

2. 2
“…it has turned out, as a result of the
UK's bravery frankly, that these extended
intervals [between vaccine shots] seems
to be associated with greater protection.”
“…Thank you, thank you
British scientists.”
Dr David Nabarro,
2/7/21
World Health Organization's chief Covid expert
https://news.sky.com/story/covid-19-uk-vindicated-over-brave-decision-to-delay-second-vaccine-dose-who-
official-says-12211550

3. “Single Dose of Pfizer Vaccine Shows
Signs of Success in UK”
3
“Public Health England found that a single dose reduced
symptomatic infection by 65 per cent in younger adults and
64 per cent in the over-80s, while two jabs conferred 79 and
84 per cent protection respectively.”*
A single shot “…appeared to be triggering a good immune
response about two weeks after the jab among younger
adults…and after about three weeks in the elderly…”*
Financial Times 2/10/2021
There is not yet enough data to determine a single shot’s effect on
hospitalizations and deaths
* www.ft.com/content/eb311423-dd2f-48f8-af57-8d8f0103c313

4. California Should Adopt a
“First Shots First” Strategy
 Two shots for essential workers most at risk
 One shot first for everyone else
 Better protection against new variants as
second shots will be updated
 “Herd immunity” achieved 2-4 months sooner
 Lowers the risk of new “mutants” taking hold
 Improves availability for teachers 4

5. Every Second Dose
Is a First Dose Delayed
5

6. Second Shots Should Wait Until They
Can Protect Against “Mutants”
6
“Moderna is launching a trial of a new Covid-
19 vaccine to tackle the coronavirus strain
that has emerged in South Africa after
warning that its existing jab was less effective
at tackling the new variant.”*
* www.ft.com/content/c0c8f72c-e58e-4319-80c4-0db153ad85db

7. “Legendary Vaccinologist”*
Doctor Stanley Plotkin
“I’ve looked over the data, and it suggests that you
have pretty good immune protection starting 12
days after the first dose. Obviously, you need a
second dose to get long-term protection, but the
immune system stays primed for the second dose
for at least six months. I’m suggesting we wait
on the second dose for up to 12 weeks until
our supply improves.”*
7
* www.washingtonpost.com/nation/2021/01/27/expert-covid-vaccine

8. “With the current circumstances, I would
strongly urge that you should use as many
first doses as you possible can for risk
groups and only after you have done all of
that come back with second doses.”
8
www.standard.co.uk/news/uk/covid-vaccine-rollout-speed-up-david-salisbury-b454310.html
Former Director of Immunization, Dept. of Health in the UK
Professor David Salisbury

9. First “Jabs” First
9
“...will protect the greatest number of at risk
people overall in the shortest possible time
and
will have the greatest impact on reducing
mortality, severe disease and
hospitalizations”
National Health Service, UK*
* www.bmj.com/content/372/bmj.n18
www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/12/C0994-System-letter-COVID-19-
vaccination-deployment-planning-30-December-2020.pdf

10.  More people receive a vaccine sooner
 “Herd” immunity achieved 2-4 months sooner
 Time to modify 2nd doses to combat new strains
 Fewer adverse reactions in first half of 2021
 This may improve the uptake by minority communities
 Time to test if 1/2 doses suffice for the second shot
 Reducing adverse reactions and freeing up 125 million doses
 Decreases the likelihood Americans will need a 3rd shot
 This would free up an additional 125-250 million doses
10
Advantages of
First Shots First Strategy

11. The UK and Denmark
Both Britain and Denmark have said “they
will stretch out the interval between the
administration of the two doses required for
Covid-19 vaccines already in use —
potentially to as long as three months.”
11
* www.statnews.com/2021/01/04/britain-takes-a-gamble-with-covid-19-vaccines-upping-the-stakes-for-the-rest-of-us/
www.reuters.com/article/health-coronavirus-vaccines-germany/update-1-germany-mulls-delaying-second-covid-19-
vaccine-shot-document-idUSL8N2JF1PQ?edition-redirect=uk
What Other States
Are Doing

12. Canada
“Vaccine panel says Canada can delay 2nd dose of
COVID-19 vaccine…for up to 6 weeks…”*
Quebec
“The [Quebec] government could wait up to 90
days to administer the second dose of the Pfizer-
BioNTech and Moderna vaccines…”**
Over 12 weeks
12
* www.cbc.ca/news/politics/vaccine-panel-ok-to-delay-second-dose-1.5871677
** https://montrealgazette.com/news/quebec-releases-details-of-its-vaccination-plan
What Other States
Are Doing

13. France
“France’s top health authority is
recommending doubling the time between
the two required Covid-19 vaccine shots
as a way to stretch supplies and inoculate
as many people as possible amid a
resurgence in the spread of the
coronavirus.”*
13
* www.bloomberg.com/news/articles/2021-01-23/french-group-advises-delaying-second-shots-to-vaccinate-faster
What Other States
Are Doing

14.  Two Grandparents (70s)
 Two Parents (50s)
 Two “Kids” (early 20s)
In the next few months, America has enough
vaccines give every American one shot.
If this were your family of six how would you
allocate six these shots?
14
Thought Experiment
Family of Six

15. What Would You Do?
Current rules:
 Six shots go to the grandparents and one
other family member and
three family members go unvaccinated
Many families would chose otherwise
What would you do?
One shot for everyone is the better answer. 15
Thought Experiment

16. “We need to get as many one-doses… as we possibly can"
Dr. Michael Osterholm on Meet the Press
Jan 31, 2021
16
“…the longer you wait [between doses] the better you may do…”
https://youtu.be/b5QF9PFFaY8?t=162
Video is queued to the correct spot. Ad can be skipped after 4 seconds

17. 17
“The former prime minister Tony Blair and
Prof David Salisbury…
…second shots should be given only
when more stock is available.”
* www.theguardian.com/world/2020/dec/23/more-data-needed-before-second-vaccine-dose-diverted-to-first-timers-
says-covid-adviser
Professor David Salisbury
Formerly the director of immunization at the Department of
Health in the UK where he was responsible for the national
immunization program and led the introduction of many new
vaccines.

18. What Should the CDC Do?
 Adopt a “First Shots First” strategy
 Two shots for essential workers most at risk
 One shot first for everyone else
 America could achieve “herd immunity”
2-4 months sooner
 Monitor the UK, Denmark and Canada
then adjusting if they encounter problems
 If there are problems these early adopters will alert us
18

19. There are unknowns and some risks to
delaying second doses
But there is now a much greater risk in
delaying first shots
for half the population
while the other half gets second doses
19

20. Details
20

21. After the First Dose, the Moderna Vaccine…
…had 80% efficacy at preventing disease*
…greater than 80% preventing serious
symptoms or hospitalization*
Should we really be delaying first doses for
half the country to give a second dose to
those who have already received one shot?
* www.cdc.gov/vaccines/acip/recs/grade/covid-19-pfizer-biontech-vaccine.html
www.sciencenews.org/article/covid-19-coronavirus-moderna-vaccine-fda-approval
www.forbes.com/sites/roberthart/2020/11/30/moderna-submits-covid-19-vaccine-for-emergency-approval-says-it-is-100-
effective-at-preventing-severe-forms-of-disease/

22. Against the South African Variant: “Moderna…said lab
studies showed antibodies made in response to its
vaccine were six times LESS effective…”*
 Moderna is working on vaccine booster for the
new variants
 People will need likely need a third shot unless
the second shots are delayed
 Giving every American one shot of the current
vaccine and a second “booster” shot later will
likely negate the need for three shots in 2021,
reducing the need for 125-250 million shots
22
* www.reuters.com/article/us-health-coronavirus-vaccines-variant-f-idUSKBN29X1DI
www.nytimes.com/live/2021/01/25/world/covid-19-coronavirus

23. The Pfizer Vaccine
23
“If you look at the New England Journal of Medicine paper
about the Pfizer vaccine... you give one dose and you get
91 per cent protection, you give two doses and you get 95
per cent.
“So you are only gaining four percent for giving the
second dose.
“With the current circumstances, I would strongly urge that
you should use as many first doses as you possible can
for risk groups and only after you have done all of that
come back with second doses.”
Professor David Salisbury
www.standard.co.uk/news/uk/covid-vaccine-rollout-speed-up-david-salisbury-b454310.html

24.  More people receive a vaccine sooner
 “Herd” immunity achieved 2-4 months sooner
 Time to modify 2nd doses to combat new strains
 Fewer adverse reactions in first half of 2021
 This may improve the uptake by minority communities
 Time to test if 1/2 doses suffice for the second shot
 Reducing adverse reactions and freeing up 125 million doses
 Decreases the likelihood Americans will need a 3rd shot
 This would free up an additional 125-250 million doses
24
Summary of Advantages of a
First Shots First Strategy

25. 25
Disclaimer: This is not individual medical advice. You should receive your second
shot on the schedule recommended by your healthcare provider.
About the Author:
Elton Sherwin is a retired venture capitalist, a seasoned researcher, and author
of two books: "The Silicon Valley Way," and "Addicted to Energy - How to Save
our Economy and Our Climate.”
He has a BA in political science from UC Berkeley and holds eight patents in
various fields.
Elton has spent the last ten months researching what Asia and Europe have
done differently and why the US has been so ineffective confronting this virus.
He was an early advocate of masking and using technology to combat COVID-19.
This presentation can be found at: tiny.cc/FirstShotsFirst
Previous presentations can be found at:
• tiny.cc/COVIDLessons
• tiny.cc/COVIDActions
• tiny.cc/COVIDFails
Elton can be reached at: Elton@EltonSherwin.com
Conflicts:
Elton and his wife
Own 10 shares of
Moderna stock