(WXYZ) — Andrew Cox, the head of Macomb County's Health Department, was pleasantly surprised this week when he went to check the return rate for those getting their first and second shot with the department. Less than 2 percent bailed.
"I was really surprised to see that we had 98.8 percent of people coming back for their second doses," said Cox, who said he had expected a stat closer to 4 percent for second-shot no-shows.
"I thought that number might be a little bit higher," he continued.
Cox's expectation was based largely on the national data. This month the CDC reported five million people — close to 8 percent — who got a first shot of the Pfizer or Moderna vaccines and missed their second doses.
"Overall, this increase in missed second doses was expected as eligibility expands to more people," a spokesperson for the CDC wrote in an email to WXYZ, noting that while prior eligible groups — such as health care providers and the elderly — were often vaccinated at work or their homes which likely made getting the second shot easier, the reasons for the missed second doses should still be analyzed.
"Public health officials and providers are encouraged to work to better understand whether missed doses or delays are due to access (e.g., supply, vaccine availability, health inequity) or vaccine hesitancy," the spokesperson continued.
While the CDC has not released data by state, Macomb’s numbers track closely with previous low Michigan figures. In March, a CDC report found that only 1.2 percent of those vaccinated in the state missed their second dose. At the time the national figure for ‘vax-dodgers’ was just over 3 percent.
It is likely the number has risen in Michigan as it has nationally, but health experts believe it likely still falls below the national average.
"There are those that aren’t appearing for the second shot, but those numbers are pretty low," said Dr. Mustafa Bohra, an infectious disease specialist at Beaumont Health System.
Similar to Macomb’s Health Department, Beaumont Health System says only 1.5 percent of patients vaccinated at their hospitals failed to return for their second dose, but this statistic even comes with a caveat: "We would not have record of their second shot if they went someplace else for the second dose," a spokesperson for the hospital said, noting that the skip-rate could be even lower.
While the state's success in individuals following thru for a second shot is being celebrated, local health officials are aware of the CDC's concerns that this could change as eligibility has widened.
"I had the same concern that we might get into a group or a phase where we won’t see as many people coming back," said Cox of Macomb County. "It could be what we see are people who are more diligent about coming to get vaccinated so we will see if that trend changes for us in the future."
This shift in demographic — and future follow-thru — is something Dr. Leonard Johnson, the Program Director of the Infectious Disease fellowship at St. John Hospital and Medical Center, is paying attention to as well.
"The first three months it was a lot of highly motivated people going out," he said. "Patients like that, in general, are going to be very motivated to be compliant with the doses, what we’re maybe seeing is younger people, slightly less vulnerable to complications not always following thru on that second dose."
But the difference between coverage from one dose and two is massive one, according to Johnson.
"In terms of ramifications, it’s actually a good time to ask that question," he said, pointing to a CDC study released this week looking at the effectiveness of the vaccines.
According to the report, two weeks after the second shot — in a two-shot series — a person 65+ is 94 percent less likely to be hospitalized with COVID. The stat drops to 64 percent for those who are partially vaccinated.
"That’s real-world data and very recently, from the CDC, that shows it’s really important to get that second dose," said Johnson, adding: "If you’re going to go thru the bother of getting one vaccine, would you rather be 64 percent or 94 percent that’s a really big difference."
And this discrepancy has played out in the real world. While Bohra said the number of people skipping their second dose at Beaumont is low, the hospital is still admitting individuals who are in the midst of the vaccination timeline.
"I see patients who are unfortunate to get infected between the first and second shot," said Bohra.
Johnson acknowledged there are a few patients who have gotten COVID after getting both shots, but said this is a very small minority — the six percent the CDC study notes.
"The vast majority of people we’re seeing are people who are unvaccinated or have only received one dose," he said, noting that beyond personal protections, sticking to the vaccine timeline is critical for ending the pandemic.
Michigan was already hit hard by the UK variant, and health officials say messing with recommendations could have dire consequences.
"The more we don’t follow the proper cycles of these vaccines there’s going to be increased pressure on these variants to develop potential resistance to these vaccines as well," said Johnson.
As of Friday, 37 percent of the state's 16+ population is fully vaccinated.