Health suggests that those over 65 vaccinated with AstraZeneca receive a third dose of Pfizer or Moderna

Vacunación con la tercera dosis en una residencia de mayores andaluza, a finales de septiembre.
Vaccination with the third dose in an Andalusian residence for the elderly, at the end of September. JUNTA DE ANDALUCÍA (JUNTA DE ANDALUCÍA)

The Ministry of Health and the autonomous communities are studying extending the age group of 60 to 69 years the administration of the third dose and, if it is done, the vaccine that the 60-year-olds will receive will not be that of AstraZeneca, with which the vast majority of them have completed the regimen, but one of messenger RNA (Pfizer-BioNTech or Moderna, preferably the former), as confirmed by sources familiar with the meeting of the Public Health Commission (CSP) held this Tuesday.

This was one of the issues discussed at the meeting, which also decided that all those older than 70 years can receive the reinforcement puncture from late oct udder. Finally, according to sources familiar with the meeting, it was agreed to leave the agreement for later. Some voices have raised lowering the minimum age to receive the third puncture to 60 years, but the majority position is for now to put the limit in 65. According to the same sources, and in line with what has been stated by most of the experts in recent days, “with the available evidence it is not necessary to administer the third dose to healthy people younger than 65 or, taking the case to the extreme, 60 years. ”

One reason for delaying the decision on the sixties is that, by administering the third doses to those older than 70 years (more than 6.5 million people) there is already enough work for several weeks. But another reason, according to these sources, is that the argument must be well prepared before taking a step that, given the antecedents, will not be free from certain controversy. Health already tried in spring that 1.5 million essential workers under 60 years who had received a first AstraZeneca doses will complete the regimen with a second Pfizer-BioNTech, but the majority refused and chose not to change their serum.

Spain, like the rest of the countries of the European Union, has opted for messenger RNA vaccines as a pillar of its vaccination strategy for months. He did it as soon as he had enough doses of this type of serum and was leaving behind, except for special cases with Janssen, the rest. In the case of AstraZeneca, in addition, the rare but serious cases of thrombi detected and, above all, the crisis experienced between the European Commission and the pharmaceutical company accelerated the practical disappearance of this vaccine in the vaccination strategy. The result is that now there will be no dose if the third puncture is approved for those older than 65 years (or 60) – the United Kingdom, for example, has approved it – so people from this age group who want to receive it must receive the so-called heterologous regimen.

The vaccination strategy, collected in a document that already It has been updated on eight occasions, it has followed the basic principle of administering the vaccines available as they arrive in Spain to the groups considered to be at higher risk. This has caused that, over time, the administered patterns draw a mosaic with different tiles according to the age group and the time of the punctures. Some of them even hides some unknown not resolved by Health or the communities.

The following are, ordered by age, the situation of the people who have received the different vaccines:

Older than 80 years. As one of the highest risk groups, it was one of the fastest to get vaccinated, and in the second half of May practically the 100% of the 2.9 million people who form it had already received the second dose. The vast majority have been vaccinated with the Pfizer-BioNTech serum for a calendar issue – this was the first vaccine to arrive in large quantities in the early stages of the campaign – although a part was also able to receive Moderna. Although the European Medicines Agency (EMA) has not yet ruled on the third dose of this last serum in non-immunosuppressed people – it has endorsed that of Pfizer-BioNTech and is expected to do so in the next few days with Moderna – , the announcement made by the Ministry of Health on Tuesday assumed that those older than 80 years will receive the same third dose of vaccine Messenger RNA than the first two. It will be, also by calendar and except for the immunosuppressed, who have already begun to receive it, the first group to receive the third dose, since this will be administered at least six months after the second.

From 70 to 79 years. Made up of 3.9 million people, this group reached 97% of vaccinated with the complete regimen the 30 of June. For the most part, they have also been immunized with Pfizer-BioNTech, although a small part has also received Moderna and another more important – Health has not offered data by vaccines and age groups – the single-dose vaccine from Janssen. What will happen to this last group is precisely one of the biggest unknowns to be resolved. Johnson & Johnson, Janssen’s parent, has already applied to the US regulator, the FDA, for authorization for the booster dose (in this case a second dose). Their data shows that protection against moderate or severe COVID reaches 94% with the second puncture compared to just over 70% that some studies had shown.

From 65 to 69 years. This group , made up of about 2.6 million people (approximately double if extended to 60 years ), has been mostly vaccinated with AstraZeneca, although in some cases they have also been able to receive the Pfizer-BioNTech and Moderna vaccines. Some communities, such as Navarra, have agreed to vaccinate people who declined to be immunized with AstraZeneca’s with these last two sera. When the Public Health Commission, as is foreseeable, takes the decision to reduce to 65 years (or 60) the population that will receive the third dose will offer messenger RNA vaccines in all cases.

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