Patients struggle with two-dose vaccines

January 29, 2021
Todd Shryock

Todd Shryock, contributing author

Reminders for the second dose needed in most cases, and patients don't like the message to come through patient portals.

Two-dose COVID-19 vaccines are rolling out across the country, but a survey of 1,000 American consumers by health technology company DrFirst reveals that patients often miss the critical second booster shot for other multi-dose vaccines.

The reason? Sixty percent of patients said they just forgot.

If the same pattern holds true for the COVID vaccines, these gaps could diminish their effectiveness in protecting people and curtailing the pandemic, according to the vaccine manufacturers and public health experts.

“It’s critical that people get all required doses of multi-dose vaccines, or they won’t work at full effectiveness. I can’t overstate how important this is right now to help bring an end to the devastating COVID-19 pandemic,” said Colin Banas, M.D., chief medical officer for DrFirst, in a statement. “We already know this can be an issue with the two-dose shingles vaccine because only 75% of people come back for the second shot. Healthcare providers need to understand how easy it is for people to miss these follow-up shots and what kind of reminders work best for patients, especially since so many patients say patient portals aren’t the answer.”

Nearly half of survey respondents (43%) reported that they had received a vaccine requiring multiple doses, including for COVID, HPV, shingles, and childhood illnesses. Yet 13% said that they did not get the second dose or aren’t sure if they did so.

Differences among age groups are evident. The youngest adults aged 18-24 were most likely to say they did not receive all required doses (18%). The oldest adults aged 65 and over were least likely to say they missed the second dose (4%) but most likely to be unsure if they did (8%).

While respondents stated numerous reasons for missing the second vaccine dose, well over half of them (60%) gave reasons that could fit within an overall “forgetfulness” category:

● Just plain forgot (21%)

● Did not receive a reminder from their provider (18%)

● Didn’t realize they needed additional vaccine doses (14%)

● Missed the appointment (10%)

Other reasons included:

● Told by family, friends or social media that a follow-up dose wasn’t needed (8%)

● Decided to only get the first dose (10%)

● Bothersome side effects (5%)

● Other unspecified reasons (18%)

The survey also looked at how patients would like to be reminded about a second dose—something physicians should keep in mind when trying to make sure their patients get fully vaccinated. According to the survey, text message reminders would make it most likely for people to get their vaccines (40%), whether it’s a single- or multi-dose regimen. For second doses, patients preferred both phone calls (32%) and text messages (24%) to remind them to get the subsequent dose. Fewer than 8% preferred receiving notifications through a patient portal.