This is how vaccination progresses in Spain: almost 40% of the population has received at least one prick against the covid | Society

Vaccination in Spain is heading for a new milestone: reach 10 million people with the full guideline by the end of the week. Still missing – there are 9.2 million – but the goal is possible. Especially, taking into account that this week the arrival of the largest shipment of vaccines to date is expected: 4.6 million. The mass immunization campaign has reached cruising speed and almost 40% of the Spanish population has received at least one puncture, but loose fringes remain that disturb the climate of optimism among experts. On the one hand, the administration of second doses to essential personnel under 60 years of age immunized with AstraZeneca: the Ministry of Health recommended completing the regimen with Pfizer, but the population is opting mostly to repeat with the Anglo-Swedish preparation, a decision that, on the one hand, puts into question the credibility of Health and, on the other, threatens the supply of vaccines from AstraZeneca to cover the population that has begun to be pricked with it. Janssen, on the other hand, had also announced five million doses before June 30, but only 576,000 have arrived and, in the midst of this delay, the Public Health Commission will decide this Tuesday whether to inject this drug, limited to those over 50, to the group of 40 to 49 years.

After the first months of dropper deliveries and with the vaccination circuit already rolled, Spain is approaching summer with a large part of its most vulnerable population immunized: 95% of those over 60 have received at least one dose (the elderly in nursing homes, those over 80 and the group from 70 to 79 have already completed the vaccination regimen). The communities are now immersed in the second punctures of the group from 60 to 69 and those of the group from 50 to 59 accelerate. “We have made progress in the vaccination rate, but we cannot afford the slightest pause or show too many signs of complacency,” he says. Daniel López-Acuña, former Director of Emergencies at the World Health Organization.

Some communities, in fact, have stepped on the accelerator and are advancing with the age group of 40 to 49. The Canary Islands and Castilla-La Mancha, for example, have already begun to vaccinate this group, the Balearic Islands start this week with those born between 1971 and 1976, Navarra will begin the next one and the Valencian Community, on June 17. In Ceuta, half of the group between 40 and 49 years old has already received the first dose. The drugs intended for this age group are those of messenger RNA (Pfizer or Moderna).

The autonomies combine the punctures by age groups with the vaccination of other socially vulnerable groups. For example, the homeless, migrants in an irregular situation or seasonal fruit. For them, groups that are difficult to locate and vaccinate, the Ministry of Health has authorized the Janssen single-dose regardless of their age. Galicia has already used this drug with sailors and large dependents and Catalonia will also summon homeless people in Barcelona this week to vaccinate them with Janssen’s drug. Andalusia has used this vaccine to immunize longshoremen and is prodding with it seafarers, homeless people and those who live in settlements. The Board has also reported that it will administer this preparation to Andalusian aid workers who travel to high-risk countries.

In Spain, 18 million people (38% of the population) have received at least one dose of the covid vaccine. And with the complete guideline there are 9.2 million (19.4% of the Spanish). Just over two million vaccines are administered each week – 2.3 in the last seven days – so the objective raised last April by the President of the Government, Pedro Sánchez, to close the first week of June with 10 million people with the full schedule, it is feasible. “Now there does not seem to be a bottleneck with respect to the first doses, but the authorities have to organize themselves well because of the vaccinations available and the population pending immunization,” says López-Acuña.

After stopping the use of the AstraZeneca vaccine – contrary to the criteria of the European Medicines Agency – in people under 60 years of age due to the (rare) cases of clots, Health recommended using Pfizer’s to cover the second doses of this group, although it also allowed the completion of the regimen with the same drug after signing an informed consent. For now, in the communities where the vaccination of this group has been resumed (in total, there are 1.5 million people), the option of repeating with AstraZeneca is the majority: Andalusia, 96% have chosen the company’s preparation Anglo-Swedish; in the Balearic Islands, 86%; in Catalonia, 87%; and in Galicia, 90%. “There is no rejection of the second dose with AstraZeneca, there is rejection of the heterologous regimen”, resolves a spokesperson for the Castilla y León Ministry of Health. Only the Basque Country has reported that the nearly 6,000 people in that group vaccinated so far have all opted for Pfizer.

López-Acuña maintains that opting for the majority of AstraZeneca’s “was expected and logical” after the endorsement by the European Medicines Agency and a large part of the scientific community for the AstraZeneca drug. “Whoever does not see it that way has a problem of political myopia. The main responsible for pushing the population towards AstraZeneca are the ministry and the Interterritorial Council with their ambivalence. These are highly rare side effects. The recommendation is that they are safe and effective. Let’s not look for three feet to the cat ”, maintains the epidemiologist. Fernando Moraga-Llop, vice president of the Spanish Association of Vaccination, agrees: “We have a population that is very intelligent and has paid attention to the scientific authorities, not the political authorities.” For his part, the coordinator of the Center for Health Alerts and Emergencies, Fernando Simón, claimed yesterday that the decision to recommend Pfizer as a second dose was “technical.” “It is not a government decision, the mixed vaccination proposal is technical. I think it has been used by the media, political parties or lobbies with different interests, which does not help the population to make an aseptic decision, “he said.

However, the decision – for now, the majority – to opt for AstraZeneca may threaten the supply of these vaccines if the announced items are not met. The Anglo-Swedish company had approved 12.2 million doses for the third quarter, but has not confirmed this amount and, for now, only about six million have arrived (900,000 of which have not yet been injected). Health assured last week that it does not foresee supply problems and, if the agreed vials arrive, it will be like that, but the pharmaceutical company has already been delayed on other occasions. For now, it remains to immunize with this preparation more than 500,000 people between 60 and 69 years old who have not yet received the first dose – 90% already have the first puncture -, administer to all this group (5.3 million of people) the second injection and also complete the vaccination regimen for those under 60 who choose to repeat doses. “All of this has hampered the vaccination strategy. If the AstraZeneca vaccines really don’t arrive, it will be a problem. But faced with this dilemma, Pfizer will have to get involved because this is better than nothing ”, Moraga-Llop ditch.

The conservative and extremely prudent position of Health regarding the use of the AstraZeneca drug may also determine the indication of the Janssen vaccine, another drug investigated after detecting rare cases of thrombi, although it also has the endorsement of the EMA. The Public Health Commission is studying expanding its use in the group from 40 to 49, but Moraga-Llop warns: “At no time was there an age limitation on the part of the EMA, neither with AstraZeneca nor with Janssen. But as Health has limited its use in AstraZeneca, they will have to justify a lot to allow one yes and another no when the risk figures for thrombi are very similar ”. López-Acuña maintains, however, that the threats to the supply or the limitations of the use of AstraZeneca and Janssen, will be offset by the massive arrival of Pfizer vaccines and will not affect the cruising speed that the vaccine campaign has acquired.

Next, the progress of immunization by autonomies:

Andalusia

Aragon

Asturias

Baleares

Canary Islands

Cantabria

Castilla la Mancha

Castile and Leon

Catalonia

Valencian Community

Estremadura

Galicia

Madrid

Murcia

Navarra

Basque Country

The Rioja

Ceuta

Melilla

With information from Ferran Bono, Lucia Bohórquez, Jesus A. Cañas, Pedro Gorospe, Juan Navarro, Guillermo Vega, Sonia Vizoso, Eva saiz, Bernat Coll e Isabel Valdes.

–