Sunday, December 5

The need to freeze the vaccine may determine priority groups

If the first vaccines to arrive in Spain require a deep-frozen chain (-70ºC), as is the case of BioNtech / Pfizer, the selection of priority groups for vaccination may be affected, according to experts from the Multidisciplinary Collaborative Group for Scientific Monitoring of COVID-19 (GCMSC).

Silvia de Sanjosé and Adelaida Sarukhan, scientists at the GCMSC, an initiative promoted by the Barcelona Institute for Global Health (ISGlobal) and the Barcelona Medical Association (COMB), with the collaboration of the Catalan Association of Research Entities (ACER) have made a proposal to select who has to be vaccinated first when the anticovid vaccines arrive.

After noting that the number of doses available in the first months will be limited, the scientists have published a report through ISGlobal, a center promoted by the La Caixa Foundation, on how vaccination should be carried out and point out that the first must be health personnel, first aid personnel and people over 80 years of age and institutionalized elderly.

Thus, they estimate that the priority vaccination groups in order must be:

1.-The health personnel in contact with patients, including those in nursing homes and first aid personnel.

2.-People of 80 years or more and institutionalized elderly.

3.-People of over 65 years.

4.-People with comorbilidades -type 2 diabetes, coronary heart disease, COPD, chronic kidney disease, obesity, chemotherapy, immunosuppression.

5.-The fifth group would be the people institutionalized and at risk of exclusion social – prisons, refugee centers.

6.-The sixth the essential staff in transportation, education or food.

7.-The seventh over 55 years.

8.-The eighth the rest of population.

The proposal details that the Health personnel in direct contact with patients is estimated at 513,777 people In Spain, medical personnel (149,342 people) and nurses (186,000), other health professionals (331,000) and emergency personnel (19,000), while remembering that those over 80 are approximately 2.8 million, and the elderly 64-year-olds with diabetes (2.1 million).

The GCMSC proposal suggests that “people with evidence of previous infection SARS-CoV-2 (PCR, antigen test or serology) do not have to be considered as a priority in access to vaccines “.

Despite this prioritization, the scientists warn that the logistics of vaccines that require deep-freezing in their transport and storage they may condition that the vaccination can be carried out according to the established order. “The vaccines go from the plane to a central warehouse, from where they are distributed to decentralized warehouses in autonomous communities with deep-frozen trucks. Then they have to be taken to the vaccination centers, but in Spain there are no freezers available outside of hospitals and universities,” they warn researchers.

To maintain temperature, Pfizer provides a box that holds 200 vials (5 doses per vial) and once the box is opened, the thousand doses have to be administered in 5 hours. “This vaccine will therefore be more difficult to administer in the primary care system and of course very difficult to administer in home care to those over 80 years of age who do not live in residences,” warns the GCMSC.

Sanjosé and Sarukhan recommend varying the prioritization criteria as the degree and duration of protection of the different vaccines available in specific risk groups becomes known. “For example, if a vaccine capable of reducing viral transmission is approved, even if it is less effective in protecting against the disease, it could be used as a priority to immunize the young population,” they point out.

The two experts also warn of the need to prepare “a communication plan to deal with reluctance or rejection to vaccination. “” The speed at which vaccines have been developed, as well as the new technologies they use, may raise public concern. For this reason, it is essential to clearly communicate the risks and benefits of the different vaccines that are being introduced, as well as the prioritization criteria, “they explain.

They also see a need for monitoring plan (including a national registry) to monitor coverage, effectiveness (degree and duration of protection) and safety of vaccines, and “pharmacovigilance mechanisms that guarantee a rapid reaction in the event of a serious side effect, including a government compensation program.”

On November 24, the Spanish Government presented the master lines of its COVID-19 Vaccination Strategy, in which details goals and governance of the strategy and summarizes the main candidate vaccines that could reach Spain, which are those of the pharmaceutical companies with which the EU has signed contracts.

The experts emphasize that when vaccination begins, “explicit emphasis” must be placed on the need to insist on the use of a mask and social distance until a sufficiently large percentage of the population is vaccinated and epidemiological indicators show a decrease in virus transmission.

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