/cloudfront-us-east-1.images.arcpublishing.com/eluniverso/WOGU6FEHIFC2XO7P3OCVHOENVQ.jpg "Cristina Aldaz, manager of the vaccination plan: ‘The efficacy of vaccination was demonstrated when we had the last wave, which was due to the omicron variant’ | Ecuador | News")
Cristina Aldaz is institutional manager of the management of the national vaccination plan of the Ministry of Public Health (MSP). She is a doctor and specialist in family medicine. She has been in office since June 2021.
tackle with this Newspaper the achievements and difficulties in the implementation of the immunization process against COVID-19, that began in the government of Lenín Moreno and has continued in the administration of Guillermo Lasso.
What evaluation would you make about the vaccination process against COVID-19 in Ecuador?
It was a very successful process and has fulfilled all the objectives for which it was designed; which, in the particular case of the virus that causes COVID disease, was to prevent severe disease and mortality. And obviously everything to achieve social and economic reactivation in the country, [cuya merma] It was a product of the pandemic.
The efficacy of vaccination was demonstrated in many ways when we had the last wave, which was due to the omicron variant. In this case, we had an incidence of cases, that is, a significant number of new cases that never occurred in the entire period of the pandemic, a very large increase; however, hospitalization, ICU (intensive care unit) bed occupancy, and mortality were not like what happened in previous waves.
What has been the biggest difficulty?
In the process of executing the vaccination we have had several barriers, (…) [como] They are the conceptions that people have about the disease and also about the vaccine: a lot of erroneous or false information that circulated in general and continues to circulate regarding the vaccine, its safety, its efficacy, etc.
Yes, it has been a critical knot in places, specifically where they live, for example, peoples and nationalities (indigenous), [cuyas] perceptions, conceptions and practices in health have allowed a good percentage of the population not to be reached. And we have particular cases, for example, the province of Morona Santiago, which still has very low vaccination coverage.
You tell me that the plan has been successful; but, if the plan started in January 2021, we have been there for more than a year. Why has 100% coverage of first doses not been achieved so far?
That percentage was recently changed, as we included the 3- and 4-year-old population.
During the vaccination process, with the 9/100 plan, we managed to cover the largest number of people in a short time, and this was done thanks to the support of many institutions; even in one day we managed to vaccinate more than 400,000 people.
These results of mass vaccination are seen when the curve of cases, and especially the curve of mortality and excess deaths, fell just after [colocamos] the second dose in September.
The INEC (National Institute of Statistics and Censuses) has had the opportunity to ask questions about why people do not get vaccinated, and the main factor is that they do not believe in the vaccine. Last year we managed to reach all corners, but we continue to be rejected due to the lack of knowledge about vaccination.
At this time, the age groups that have had the least access to vaccination: obviously, the 3 and 4-year-olds, who are the ones that have just started; and those between 5 and 11 years of age, who are, of all age groups, the ones who have had the least access to vaccination. Of those over 25 years of age, we have already managed to have more than, even, 90% coverage.
At the international level, a goal has been set to reach 70% coverage of the vulnerable population by August of this year, and we surpassed that a long time ago.
The application of the second reinforcement began, will it be extended to the entire population later?
At this time, the greatest concern that we have is the placement of the first booster in the most vulnerable population, which in this case continues to be the elderly, those over 50 years of age or people who have some comorbidity or in situations of immunosuppression.
92% of deaths in the period of January and February of this year [corresponde a personas] older than 50 years. We have more than a million people over the age of 50 who have not yet accessed their booster dose. We are trying to make communication strategies aimed at this group in particular.
The second booster dose is fundamentally focused on protecting the most vulnerable population and, obviously, all our strategic personnel, health workers who remain on the front line.
Then, if virus evolution occurs as with an endemic virus, protection should be [en función] of the epidemiological behavior; and it is most likely that later a vaccine will come out that is seasonal or that it will have to be changed from year to year, more or less as happens with influenza.
Would everyone have to be vaccinated?
This is evaluated depending on the risks that exist. If it is necessary to place the entire population, we will continue planning and executing it.
Do they have all the vaccines to cover those who have not yet received the first dose, or the second or third injection?
Yeah we got enough stock to fill that need.
Which is the stock of vaccines?
at the national bank [de vacunas] and already in territorial banks [de vacunas] we have more than four million doses. We have the arrival of the two and a half million donation from Sinovac, which was secured in the last visit they made to the Government of China, and we also have other arrivals, which are planned by the Covax mechanism.
Have you thought about perhaps bringing other vaccines, other brands?
The advantage is that for this year we ensure in our planning the resources for the need to acquire new vaccines. Obviously, in this case, the best decisions are already made at the time of acquisition, especially regarding accessibility, efficiency, safety and also costs. So, all those analyzes are done. (I)
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