Publication: Friday, April 30, 2021 10:37
The Ministry of Health is running out of time to make a decision on the second dose of AstraZeneca. In fact, this is the mission of the public health commission this Friday: Darias meets with health technicians and the autonomous communities to give an answer to the vaccination of people under 60 years old.
And the deadline is tight. According to the government file, the first doses of Anglo-Swedish society landed in Spain on February 6. However, these were not inoculated until two days later, on day 8. Thus, if the pharmacist’s recommendation is followed (which sets a limit of 12 weeks to inoculate the second vial), this Monday the first vaccinated should complete your guide. But the strategy that will be followed is not yet known.
Three options on the table: the first, keep everything as is
On April 7, Santé decided to modify the vaccination campaign. AstraZeneca injection, which was given primarily to essential workers (such as state security forces and bodies, second-line health workers or teachers), could only be given to people over 60 years old. Although before it had already undergone changes, because at first it was only applied to under 55s, then it was decided to extend the range to 65.
Since that announcement, nearly two million people have been left in limbo. The vast majority of essential professionals are under the age of 60 and, according to health recommendations, they should receive the second dose.
The point is that several weeks after this shutdown, the options remain exactly the same as those already offered by Health. The first is to follow the vaccine package insert; that is, vaccinate all these people with the second dose before the end of the quarter (this could be done from this weekend, also counting Monday, with the activity of the CCAA).
This first option is the one defended by the European Medicines Agency, because it considers that “there was not enough exposure or follow-up” to determine whether the risk of thrombus after the second dose differs from the risk after the first one. Thus, there is not enough data to change the strategy. A decision to which Italy has adhered, which, despite vaccinating people aged 60 to 80 with this bottle, completes the directive regardless of age.
Second possibility: mix the vaccines
This is one of the options that Carolina Darias had the most impact on: ending the vaccination with a different dose than AstraZeneca, predictably with Pfizer, which is why a trial is currently underway at the Carlos III Institute in five Spanish hospitals.
For example, the “CombiVacs” study works with 600 patients from different age groups and regions of Spain who have received a single dose of AstraZeneca. However, the results of this study are late, as a conclusion is not expected until mid-May.
However, as the Minister of Health indicated on Wednesday, at the end of the meeting of the Interterritorial Health Council, this is one of the strongest possibilities: “My opinion as minister is d ‘wait for the results of the clinical trial,’ he said. But as she herself mentions, it is one opinion among others that has been expressed, also taking into account the fact that this decision will depend not only on health technicians, but also on those of the autonomous communities. For now, there are several countries that have jumped on this train, such as France, Finland, Germany or Sweden, where there are still no conclusive results.
Third option: delay the second dose
This last possibility is one of those that seems more complicated, because, as we have explained, Darias believes that in the meantime it is better to do this until the ISCIII test has a conclusion. However, also this Wednesday, Health recalled that the first dose of AstraZeneca already offers 76% effectiveness against serious infections, “there are therefore reasons to be able to lengthen the interval of the second dose”.
This is what Ireland did, where it waited 16 weeks while awaiting the arrival of scientific evidence. In addition, depending on the vaccination strategy, people who have passed COVID and received a dose will not receive a second at least 6 months later. So, everything is done to the detriment of what Public Health decides, but the dates maintain their urgency: these two million people affected are waiting for a response this weekend.