Monday, October 25

Health will value spacing doses before the outcry to unblock vaccination




The latest setback in the global vaccination process has caused 146,000 doses of the Janssen / Johnson & Johnson vaccine to sleep on Spanish soil since Wednesday and they are not being inoculated at the moment. It was the laboratory itself that asked European countries, who craved their single dose, to wait until both the European Medicines Agency (EMA) and the United States (FDA) rule on the appearance of six thrombi reported among the almost seven million of people already vaccinated with its serum in the United States.

The pause in the administration of the Johnson & Johnson vaccine together with the change in the immunization strategy with that of AstraZeneca (now aimed at people between 60 and 69 years old) has caused the autonomous communities raise the pressure on the Ministry of Health and propose your own roadmap, with the shared goal of reaching as many people as possible as soon as possible.

Thus, this Wednesday, different proposals by the councilors arrived at the Interterritorial Council of the National Health System (CISNS), such as the possibility of voluntarily offering the AstraZeneca vaccine to children under 60 years of age (Madrid and Andalusia), inoculating with it to the who have already received the first dose (Valencian Community) or to distance the 21 days between the inoculation of the Pfizer / BioNTech vaccine and the 28 of the Moderna one to reach more citizens (Catalonia and Madrid) earlier.

Like UK

The strategy of distancing both doses is reminiscent of the one applied in the United Kingdom, where all those over 50 have already received at least one puncture, reaching herd immunity in record time. At the moment, the Ministry of Health works with the Carlos III Health Institute, the Spanish Medicines Agency and the scientific community to offer answers also to those who are under the age of 60 and have already received a dose of AstraZeneca. The conclusions will be presented to the vaccine presentation and the public health commission to finally be approved within the CISNS.

In this sense, the Minister of Health, Carolina DariasHe pointed out this Wednesday at a press conference that no change is expected from the age limit that has been established for the same, older than 60 years. “We are convinced, like other neighboring countries, that from this age we maximize profit,” he defended.

Regarding the defendant change in the administration criteria of the rest of the vaccines, Health is open to analyze together with the rest of the communities the consequences of distancing the application of the two doses. “If the effectiveness achieved with one is around 50% and with two it rises to more than 80%, it will be an issue to consider when making any decision”, since “the most vulnerable groups should have the maximum protection, “said Darias. “I am of the opinion that it is important to apply the second doses to protect the most vulnerable people, the oldest, as much as possible.”

Short vaccination cycles

According to the Catalan Health Minister, Alba Vergés, the first dose of Pfizer allows acquiring a “high degree of protection” against the virus, and the administration of the second dose of the vaccine at 21 days requires “very short cycles” to end up meeting the full guideline. This week in Catalonia 40,000 injections will be inoculated, which, according to the counselor, could be destined to immunize other people who have not yet received any. Postponing 42 days both punctures could mean “Reach a lot more people in a lot less time.” The distancing would only occur among those under the age of 79.

The minister is less receptive about Madrid’s proposal to voluntarily offer both the AstraZeneca and Janssen vaccines to those under 60 years of age. “When a majority agreement is adopted, it must be respected”, Darias remarked, although he left the door open to accumulate scientific evidence to “always make the best decision.”

In a letter addressed to the minister, the Madrid Minister of Health, Enrique Ruiz Escudero, asked before the meeting to also eliminate the limitation of use of the AstraZeneca vaccine up to 69 years of age and extend it to those over that age, and that the Children under 60 who request it can receive this vaccine, and also Janssen’s when available.

According to Escudero, “there is no scientific evidence” to support the decision to limit the administration of the AstraZeneca vaccine to the age range between 60 and 69 years. In this sense, he highlights in his letter that there is no vaccine against Covid-19 contraindicated by age range, but that all can be applied from 16-18 years of age. Therefore, it qualifies as Decision not to administer AstraZeneca to children under 60 ‘incomprehensible’, to which Darias asked, for the moment, to adhere to the groups established and approved by the CISNS.

On the other hand, Madrid insisted this Wednesday, like Catalonia, that «there is scientific evidence that with the first dose of Pfizer and Moderna vaccines an immunity of between 75% and 80% is generated ». For this reason, and as Escudero explained by letter, “our technicians are committed to completing the second doses at 42 days”, respecting, like Catalonia, the Group 7 risk groups that are already established in the National Vaccination Strategy.

Keeps the forecast

Despite the delay in her administration, the minister maintains Janssen’s vaccine arrival forecasts if it is finally endorsed by the EMA: “Around 300,000 in April, 1.3 million in May and 3.9 million in June” .

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