85% of Spaniards already have at least one vaccine

It was nine o’clock in the morning on Sunday, December 27, 2020 when Araceli Hidalgo placeholder image, 96, became the first Spanish vaccinated against covid-19. Right afterwards, Mónica Tapias, a nursing assistant care technician at the Los Olmos Residence in Guadalajara, followed. That was the start of a vaccination campaign, which marks one year this Monday and which has already immunized almost 40 million citizens, avoiding thousands of deaths.

The pandemic is not over yet, but if its end is in sight, it is due to vaccines developed in just a few months. But that triumphalist history of science has a dark reverse, the enormous inequality in access to medicines. Rich countries have very high vaccination coverage (their main problem is not access, but the rejection of part of its population), while the poorest have barely been able to vaccinate their citizens. And that is not only an injustice in itself, but it threatens to lengthen the health crisis due to the appearance of new variants of the virus, as has happened with omicron.

Spain is in the group of privileged countries. It belongs to the European Union, which centralized the purchase of doses and has allowed all member states to have enough vaccines to vaccinate their entire population. But that only explains part of the success of the campaign. The other is the strategy agreed by the Government and the autonomous communities and, above all, the predisposition of the population to be vaccinated, higher than that of many countries.

One year later, almost 85% of the Spanish population has received at least one dose of the vaccine, almost 80% have the complete vaccination schedule and more than 25% already have the additional dose. By age group, the highest coverage is among the oldest groups: almost all people over 60 years old have had the complete guideline. The least vaccinated bands are those of 20-29 and 30-39 years: there, one in five people has not completed the vaccination schedule.

As in many other places, vaccination in Spain has followed a staggered process in which priority has been given to the most vulnerable and essential groups, that is: older people, those with more health problems and health professionals. Those were the first to get vaccinated in winter and early spring, when the vaccine supply wasn’t working as well as it is now.

Of the four brands that Spain has had access to (Pfizer-BioNTech, Moderna, AstraZeneca and Janssen), only the first, and to a lesser extent the second, have met expectations. Much of the hopes of the vaccination campaign were placed on the other two (one for the price and the other for being single-dose), but for various reasons they have not worked. Doubts about side effects sapped confidence in AstraZeneca and forced a change in strategy.

What’s more, the Anglo-Swedish company also failed to meet its supply commitments. Most of the doses purchased by Spain have been donated. Later, the evolution of the pandemic certified that a single dose of Janssen was not enough to maintain immunity, so the almost two million Spaniards who used it are receiving a second from Pfizer-BioNTech or Moderna.

Starting in April, with the progressive expansion of the target population, the vaccination rate accelerated. He did it continuously until the beginning of July, when more than four million doses were given in a week, almost 10% of the entire population. The main objective, set before the start of the campaign, was to reach 70%, but it soon became clear that this percentage did not have to be a goal, but an intermediate step towards more ambitious objectives. Although with quite a bit of confusion, originated in part from the government itself, Spain met the goal of ending August with 70% of the population vaccinated: on August 31, 70.3% were vaccinated.

By then, the vaccination rate had been declining for weeks and continued to do so during the following months, until nearly 80% of the total population, 90% of the target population, stagnated. Between the end of May and the end of August, vaccination coverage went from 20% to 70% of the population. And between that date and the end of November, the increase did not reach ten points.

It has only recently been sped up again with the initiation of vaccination in children between 5 and 11 years of age, the last age group to receive the covid-19 vaccine. That, together with the administration of the additional dose (third for those who already had two or second for those who had received only one, such as those vaccinated with Janssen), has increased the pace in vaccination centers.

The next milestone set by the Government was that at least 16 million people had the booster dose before the holidayss, or failing that before the end of the year. The first date has not been reached on time and the second will be difficult to do. By April, almost all children between the ages of 5 and 11 are expected to have the full guideline. And by then it is also quite likely that the booster dose will take time for the rest of the vaccinable population.

Meanwhile, Israel, a country that has been leading the way for the rest of the world since the beginning of vaccination, already raises a fourth dose of the vaccine for its most vulnerable population. So it is likely to become mainstream, at least among the richest countries. The poorest still hope to give the first dose to the majority of the population. And as long as that happens, the threat of new variants will not go away.

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