Why are two doses needed for the Pfizer and Moderna COVID-19 vaccines?

Nurse prepares a COVID vaccine dose.

Important note:

On Saturday, Feb. 27, 2021, the Food & Drug Administration (FDA) issued emergency-use authorization for a third COVID-19 vaccine, produced by Janssen, the Pharmaceutical Companies of Johnson & Johnson. It is referred to by several names, including the Janssen, Johnson & Johnson or J & J vaccine. This new vaccine requires only one dose. The article below refers only to the Pfizer and Moderna vaccines, which require two doses.

Keep an eye on Roswell Park's COVID vaccine website and social media posts for more information about the J & J vaccine, including guidance for our patients from Roswell Park experts.

After you get a COVID-19 vaccine, the nurse will give you a card that tells you which vaccine you received, either Pfizer-BioNTEch or Moderna.

On the back of the card, the nurse will write down the date you received the vaccine and the date of the appointment for your second dose.

But why do we need two doses of these vaccines? Isn’t one enough? Wouldn’t we be able to get more people vaccinated — and faster — if we all took just one dose?

That might sound reasonable, but full protection comes from receiving both doses.

The FDA is advising against any change in the dosing schedule or the number of doses, says Brahm Segal, MD, Chair Of Internal Medicine and Chief of Infectious Diseases at Roswell Park Comprehensive Cancer Center.

In the Pfizer-BioNTech vaccine trial, 98% of participants received their doses three weeks apart; 92% of participants in the Moderna trial received both doses within the recommended four-week interval. In both studies, two doses of the vaccine resulted in more than 90% protection from COVID-19. Although one dose of the vaccine will provide some protection against the virus, we don’t have enough information to judge how effective it will be or how long protection will last compared to the standard two doses, Dr. Segal said.

Further research might suggest a change in this practice, but right now it would be considered a risky move to modify the dosing guidelines established by the FDA and the vaccine manufacturers.

More Information

The COVID-19 situation is evolving rapidly. To read the latest information on Roswell Park’s response and find additional resources, visit our Coronavirus (COVID-19) web page.

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Timing of second dose key to making vaccine effective

It's important to receive your second dose on time: The second dose of the Pfizer-BioNTech vaccine should be administered three weeks (21 days) after the first, while the second dose of the Moderna vaccine should be administered four weeks (28 days) after the first. The FDA and CDC recently added that second doses can be administered within a grace period of four days earlier than the recommended date. Although the second dose should be administered as close to the recommended interval as possible, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be given up to six weeks (42 days) after the first dose.

You should still wear a mask and practice social distancing even after receiving both doses of the vaccine, Dr. Segal adds. Experts believe we will need to continue these protective measures until 70% of the population receives both doses of the vaccine.

Roswell Park's vaccine supply is extremely limited. Roswell Park patients will be notified by email, phone, or text when they become eligible for vaccination at Roswell Park. Due to this limited supply, you are encouraged to schedule an appointment at a community vaccination site outside of Roswell Park if you have the opportunity to do so. The most important thing is that you get vaccinated and protected from COVID-19 — do not wait for an appointment at Roswell Park if you have an earlier opportunity to get the vaccine.