Data Suggest UK's One Shot Covid Vaccine Strategy May Be World's Most Effective

The British vaccination strategy has been to make sure the maximum number of people receive at least one vaccine shot. The second shot can be delayed as much as three months. 

And contrary to concerns about efficacy, British Covid infection rates have dropped 90%, more than any other country in the world. Deaths have plummeted also. The data reveal that one shot works in halting the spread. JL

Dave Leonhardt reports in the New York Times:

The U.S. and most others make sure that anybody who gets a first vaccine shot gets the second shot within a few weeks. Britain has instead maximized the number of people who receive one “jab,” and has delayed the second jab, often for three months. The data suggest that Britain’s approach is working because even a single shot provides strong protection against the virus. In Britain, the daily number of new Covid cases has fallen by 90% since January, more than any other country. If the data changes, the lessons should change. Britain appears to have landed on the most effective vaccination strategy

One jab is doing the job

The global leaders in Covid-19 vaccination rates are Israel and the United Arab Emirates. After them come a handful of countries that have each given between 30 and 45 shots for every 100 residents, including the United States, Britain, Bahrain, Chile and Serbia.

By The New York Times | Sources: Local governments via Our World in Data

But these handful of countries have followed two different strategies. The U.S. and most others have tried to make sure that anybody who gets a first vaccine shot gets the second shot within a few weeks (except in the case of the Johnson & Johnson vaccine, which requires only one shot). Britain has instead maximized the number of people who receive one “jab,” as the British call it — and has delayed the second jab, often for about three months.

Kate Bingham, a venture capitalist who led the committee that advised the British government on vaccination, has described the strategy this way: “I think it’s the right public health response, which is to show that you try and vaccinate as many people as possible, as soon as possible. Better to protect everybody a bit rather than to vaccinate fewer people to give them an extra 10 percent protection.”

So far, the data suggest that Britain’s approach is working — because even a single shot provides strong protection against the virus.

A delay seems OK

As Dr. Robert Wachter of the University of California, San Francisco, has written, “According to most vaccine experts, delaying shot #2 by a few months is unlikely to materially diminish the ultimate effectiveness of two shots.”

In Britain, the daily number of new Covid cases has fallen by more than 90 percent since peaking in early January. The decline is larger than in virtually any other country. (In the U.S., new cases have fallen 79 percent since January.) Given that the contagious B.1.1.7 variant was first discovered in Britain and is now the country’s dominant virus form, “Britain’s free-fall in cases is all the more impressive,” Wachter told me. “Clearly their vaccination strategy has been highly effective.”

British deaths have also plummeted in recent weeks:

By The New York Times | Sources: Hospitals, health agencies and Johns Hopkins University

Britain’s approach not only brings immediate benefits, in terms of lives saved; it also reduces the chances of future outbreaks: The fewer people who have Covid, the fewer who can infect somebody else. That’s especially important when more contagious variants are circulating. Worldwide, the number of confirmed new cases has risen 21 percent over the past month.

It is probably too late for the U.S. to change policy and adopt the British approach. Doing so would create widespread confusion and frustration. Still, there are lessons from Britain:

Speeding up a vaccination program brings enormous benefits. The U.S. has recently been giving about 2.5 million shots a day, up from about 800,000 in mid-January. But the federal government will soon be receiving closer to four million shots a day from the vaccine makers. A big question is whether the Biden administration and state governments will be able to continue increasing the pace at which people are getting shots in their arms. For countries where vaccine programs have only just begun, as in much of South America, Africa and Asia, the British approach may be worth mimicking. Finally, keep in mind that one of Britain’s main vaccines has been AstraZeneca’s — the same one that some other European countries have stopped using this week, out of concern over blood clots. But there is no sign of an increase in clots in Britain. “If the choice is potentially being exposed to Covid-19, or getting the vaccine & being protected, choose the vaccine,” Devi Sridhar, a professor of public health at the University of Edinburgh, wrote yesterday.

All of this comes with the usual caveat: If the data changes, the lessons should change, too. Based on the current evidence, though, Britain appears to have landed on the most effective vaccination strategy — which is yet another sign of how powerful the vaccines are.