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Millions of Americans are not getting the second doses of their Covid vaccines, and their ranks are growing.
More than five million people, or nearly 8% of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccine campaign.
Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, local health authorities are confronting an emerging challenge of ensuring that those who do get inoculated are doing so fully.
The reasons vary for why people are missing their second shots. In interviews, some said they feared the side effects, which can include flu-like symptoms. Others said they felt that they were sufficiently protected with a single shot.
The C.D.C. says there is limited data on the vaccine's effectiveness when shots are separated by more than six weeks, although some countries, including Britain and Canada, are giving shots with a gap of up to three or four months.It is up to each individual to decide their vaccine destiny. Shakespeare said it best: "To be or not to be."
College students pose a particular challenge. Many recently became eligible to be vaccinated and are getting their first shots, but they will have left campus by the time they are due for their second doses.
In many cases, vaccine providers had canceled second-dose appointments because of bad winter weather.
There are rare cases in which people are supposed to forgo the second shot, such as if they had an allergic reaction after their first shot.
The stakes are high because there is only one vaccine authorized in the United States that is given as a single shot. The use of that vaccine, made by Johnson & Johnson, was paused this month after it was linked to a very rare but serious side effect involving blood clotting. Federal health officials on Friday recommended restarting use of the vaccine, but the combination of the safety scare and ongoing production problems is likely to make that vaccine a viable option for fewer people.
The C.D.C.'s count of missed second doses is through April 9. It covers only people who got a first Moderna dose by March 7 or a first Pfizer dose by March 14.
In some cases, problems with shipments or scheduling may be playing a role in people missing their second doses. Some vaccine providers have had to cancel appointments because they did not receive expected vaccine deliveries. People have also reported having their second-dose appointments canceled or showing up only to find out that there were no doses available of the brand they needed.

Comment: Planning triggered the events - not the other way around. Nothing this colossal or impactful has come about by accident.