And when the age ranges for the Astrazeneca vaccine are completed ... The paradox of having doses to spare?

The vaccination campaign is assuming a real sudoku for the autonomous communities. For just over two months, when the vaccination of the most vulnerable groups was completed and the general population began, every week is a challenge for the technicians of the health departments: you have to determine the following population groups, choose the points to put the punctures, send the appointments, wait for the number of committed vials to be the one that is finally received … and, as if this were not enough, attend to the age specifications set for each vaccine.

Currently, in Spain four different doses are being administered: those developed by Pfizer, Moderna, Astrazeneca (also called Vaxzevria) and Janssen (the laboratory of the Johnson & Johnson company). The first two have the largest target population: Pfizer is marketed over 12 years (a change that was approved on Friday) and Moderna from 18. The remaining two are more limited: Astrazeneca is currently being marketed to people between 60 and 69 years old and those under 60 who received the first puncture 12 weeks or more ago now, while Janssen is inoculating those over 50 years old.

If these age ranges do not change, in not too long, it could happen that communities had doses of both vaccines, but no target population to which to administer it. This, which would be a paradox in the middle of the vaccination campaign against Covid-19 to be able to leave the pandemic behind, is already something that some autonomies, such as Madrid, are considering with the Astrazeneca drug.

changes with the astrazeneca vaccine

  • – Under 55s: it was the first population group targeted by the vaccine when it arrived in Spain in February.
    – Under 65 years: the vaccine target population was expanded in early April.
    – From 60 to 69 years: at the end of April it was decided to inoculate only people in this age group, a guideline that is maintained.

This community has vaccinated with the first dose to more than 88% of the population aged 60 to 69 years and this Monday begins to complete the guideline for those under 60 who so decide. Based on the response that is being registered in other territories, it is expected that most of the approximately 200,000 people who are awaiting this second puncture will choose to receive the same vaccine.

The regional government chaired by Isabel Díaz Ayuso, now in office, assures that with the doses that it has supplied – in part due to the stoppage of several weeks dictated by the Ministry of Health – added to those that it foresees that they will enter next Monday, it has enough drugs to give the second doses to those under 60 who request it and to complete the group from 60 to 69.

The population of this second strip should receive their second dose from the end of July and throughout the whole of August (when 12 weeks after the first puncture will be completed) and at the time these are completed, if there are no changes in the strip of age to administer Astrazeneca, there will be no population for this vaccine approved by the health authorities.

“If the age of vaccination with Astrazeneca is not extended, when the 12-week vaccination period for those over 60 years is fulfilled, we will run out of target population to which to administer this vaccine,” the Madrid Health Minister said this week , Enrique Ruiz Escudero. “In the situation we are in, it certainly doesn’t seem like the right decision to me”added.

This is not a trivial question because Europe expects to receive millions of doses from this laboratory in the coming weeks. The European Commission announced in the middle of the month that it would not renew vaccine orders beyond June with the Anglo-Swedish laboratory for the repeated breach of the contract that has been taking place in recent months. During the first half of 2021 Astrazeneca was expected to deliver 300 million doses for distribution among Member States, but by mid-May it had only distributed about 55 million.

The Commission is asking for around 200 million euros for each day of late delivery and to have 120 million doses to distribute by the end of June. If this shipment was made, Spain would have several thousand doses with which it would have to decide what to do.

Another element to take into account in the immediate future is to know how will the purchase of vaccines be, if there will continue to be centralized purchase of vaccines from Brussels, which after all does not close the door to buying more vials from Astrazeneca if necessary, or if each country will supply itself.

The Janssen strip could change in the coming days

Changes in the recommended age are closer in the Janssen vaccine. This week, within the Public Health Commission, the Ministry of Health and the autonomous communities opened the door to vaccinate with this drug to the age group between 49 and 40 years. This possibility was also discussed in the Interterritorial Council of the National Health System on Wednesday, but a firm decision was not reached. Those responsible for the vaccination strategy will explore this possibility and it is not ruled out that changes in this regard may be announced in the coming days or weeks.


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