Staff Photo by Matt Hamilton / First responders wait 20 minutes after getting their first dose of the Moderna COVID-19 vaccine at the Hubert Fry Center on Wednesday, Dec. 23, 2020.

While appointments in Hamilton County for the first dose of a COVID-19 vaccine continue to be filled within hours of being announced, the ongoing availability of second-dose appointments is not necessarily a sign that area residents are passing up the required second shot.

As of Monday afternoon, all first-dose appointments through Feb. 7 were filled in the county. Yet, dozens of slots for the second dose in the coming days remain unfilled.

Becky Barnes, Hamilton County Health Department administrator, said the department created more second-dose appointment slots than necessary to provide flexibility. The department has enough second doses in storage to cover anyone needing it and even provides some second shots to people who may have received their first dose through another organization, such as an employer or a residential facility, she said.

As of Jan. 23, the county had more than 6,500 doses of the Pfizer-BioNTech vaccine and nearly 3,600 doses of the Moderna vaccine assigned to either first- or second-dose appointments in the coming days, Barnes said.

The data provides a more complete picture of how the rollout is going in the county. Last week, the Times Free Press requested data about the number of doses being held for the second shot. The health department did not make the data available at the time and later clarified that it does not distinguish first and second doses in its storage of the vaccines.

The department also clarified its plans in creating new appointments. Barnes said the health department does not announce new appointments until vaccine shipments arrive from the state. This decision creates some uncertainty on when new appointment days will be announced but sidesteps issues plaguing other health departments across the country that had to cancel appointments when deliveries did not arrive on time.

Across Tennessee, more than 486,000 vaccines have been administered as of Jan. 24, according to the Tennessee Department of Health. In Hamilton County, around 7,000 people, or 1.92% of the county population, have received both doses, according to the most recent public data from the state.

Hamilton County ranks third among Tennessee's six major metropolitan counties for the highest percentage of residents with two doses. Davidson County leads the state with 2.25% of its population having both doses and Rutherford County is last with 0.83% of its population having both doses. Barnes said her organization is working to provide county-level vaccination data.

While county leaders hope everyone who receives the first dose will return for the second dose, the health department will not hold back second doses if they are not taken up by available appointments, Barnes said.

Medical experts have said a single shot of the vaccine may provide some protection but the research showing that the two available vaccines are more than 90% effective is based on trials in which participants received both shots.

For the Pfizer vaccine, a second shot is recommended 21 days after the first. For the Moderna vaccine, the second shot is recommended 28 days later. When getting the first dose of a vaccine, a person receives a card that lists which type of vaccine they received and what date they are eligible to get the second dose.

Dr. Clarence Creech, director of the Vaccine Research Program at Vanderbilt University Medical Center, told the Times Free Press last week people should not be concerned if they do not get the second shot on the exact day listed on their vaccination card. People should still get the second shot if more than a month has passed because there will be benefits, he said.

Hamilton County is experiencing a dropoff in new COVID-19 infections and hospitalizations in the past week compared to the month prior. On Monday, the county reported 181 new cases and 124 hospitalizations. In December, the county was adding twice that many cases a day and total hospitalizations were above 200 for several days as part of the post-Thanksgiving surge.

Contact Wyatt Massey at or 423-757-6249. Follow him on Twitter @news4mass.