Almost two million people, to date, have received the bivalent vaccine against Covid-19 that the Ministry of Health began distributing since October 2022. Current data from the Ministry of Health Statistics and Information Department (DEIS) indicate that a total of 1,986,995 people nationwide have been inoculated. However, this number corresponds to only 23.87% of the target population, estimated at 8,325,856 people, which includes healthy people aged 50 and over, people with chronic diseases, immunocompromised individuals, health personnel, among others.
This implies, therefore, that currently there are 6,338,861 stragglers in the vaccination plan. According to DEIS figures, the groups that are most in debt are people between 50 and 59 years of age (14.05% vaccination), and those with chronic diseases under 50 years of age (12.51%). While the population that has a higher percentage of immunization is that of 70 years and above, with 49.4%. Regarding health personnel under 50 years of age, vaccination reaches 46.51%, while 32.47% of the population between 60 and 69 years of age register with their daily dose.
In territorial terms, none of the regions exceeds 30% of its target population vaccinated. The one with the best figure is the Metropolitan Region (27.11%), followed by O’Higgins (26.85) and Maule (25.28%). While those that concentrate the least number of inoculations are Atacama (17.39%), Aysén (15.25%) and in last place, Los Lagos (13.92%).
On the other hand, currently the numbers of both new cases, deaths and critical beds remain low, in a scenario of “low health impact”, as described yesterday by María Paz Bertoglia, head of the National Immunization Program of the Minsal (PNI). The latest Covid report from the Minsal -communicated yesterday- estimated at 1,741 new infectionswhich implied a decrease of 4.6% in the last week, 8.76% positivity, and counted 84 ICU patients, of which 72 are on mechanical ventilation throughout the country.
With these numbers, the country faces its third year of vaccination against Covid-19, which began on December 24, 2021 with the application of doses from the US laboratory Pfizer for health personnel and, later, from the Chinese laboratory Sinovac for the general population.
By 2023, Salud seeks to reinvigorate its vaccination campaign, which -according to Radio ADN in January, the Undersecretary of Health, Cristóbal Cuadrado- aims to “reach 80% of high-risk people, vaccinated before the next winter wave”.
The authority affirms to La Tercera that “from the first week of March, when we officially started the Winter Campaign, we will begin joint vaccination to protect risk groups of the population against Covid-19 and influenza. Vaccines will be free for all target groups.”
Cuadrado adds that for this “We will have a new communication campaign, increase in vaccination points and available resources for this, in addition to strengthening our work with various actors to facilitate the population’s access to vaccines”.
This boost raises doubts in the former undersecretary of Public Health and executive director of the Center for Public Policies and Innovation in Health (CIPS) of the Universidad del Desarrollo, Paula Daza. “We have not seen vaccination campaigns, we have not seen strategies, and the numbers support it: we are far from reaching a desirable vaccination with the bivalent one”, he affirms.
Daza gives him urgency and asks for answers: “The pandemic continues, winter is coming and we are far from reaching desirable coverage. They wanted to reach 80% in May, but we are ending February and we should know what the ministry’s strategies are to reach that coverage.”.
This is how the application of the bivalent vaccine will be maintained, which, as its name indicates, protects against the Wuhan (original) and omicron strains.
As corresponds to a booster dose, it can only be received by people who have completed a primary scheme, that is, the two initial doses of the Covid-19 vaccine or the single dose of the Cansino vaccine.
Is it then a fifth dose? The Undersecretary of Public Health explains that “it is not appropriate to speak of a fifth or sixth dose”, because “the bivalent vaccine is different from the vaccine used in the primary scheme and booster doses.” By virtue of this, he assures that “it is not necessary to have four doses to receive the bivalent vaccine”, since there may be “people who for different reasons did not have their four doses or because they started their primary schedule later, since we started vaccination bivalent receive this annual vaccine directly and not the previous boosters.
One of the novelties that the process will bring in 2023 is the incorporation of children between six months and three years of age to the vaccination program.
The Advisory Committee on Vaccines and Immunizations of the Minsal (Cavei) is soon to release this recommendation, which will be reported next week.
This comes after the Santiago Appeals Court ordered the portfolio to incorporate this group in January, under the instructions of the Institute of Public Health, after its refusal to do so last August.
“It is possible to conclude that the respondent has committed an arbitrary and illegal omissionsince it is accredited in the records that, technically, the inclusion in the national program of vaccines against Covid-19 assists children between six months and three years of age ”, ruled the court of appeal.
The president of Cavei, Jaime Rodríguez, affirms that “There is no problem in this group in administering the vaccine together with the influenza vaccine.”. It will not be, of course, the bivalent vaccine, but “only Covid”, specifies Rodríguez.
Which specifically? From the Minsal they do not detail. The Cavei headline assures that “the ministry has not yet defined which one, but the one with the most studies is messenger RNA and the Moderna vaccine is the one with published studies in relation to that, it is probably messenger RNA.”
On the other hand, the doses administered -until now- will continue to be from the laboratories that have these vaccines developed “and with authorization for use by high-level international regulatory agencies such as the FDA and our ISP, which are Moderna and Pfizer-BioNTech ”, explains Square. “To the extent that new products are approved, these will be considered to ensure a diversified offer,” he adds.
For now, They assure the Minsal, it is not planned to incorporate Covid vaccines into the mandatory immunization program.
The 2023 campaign raises some unknowns. One of the points in doubt is whether there will be a progressive incorporation of groups into the vaccination program, such as healthy people between 40 and 49 years of age.
Rodríguez, the president of Cavei, explains that “not so far, it depends on how the disease develops, we don’t know what can happen.”
Paula Daza emphasizes that First, 80% of the population at risk must be reached, and “once that vaccination coverage is reached, of course, then one can begin to expand to others with lower risk and lower the target population to 40 years of age.”. “It could be done in parallel, but not lose priority to urgent groups,” he adds.
María Paz Bertoglia, head of the PNI, assured yesterday at a press point that “if there is a need to increase or convene more groups, this from the point of view of epidemiological evaluation, we do it constantly, therefore, it is a possibility, It is evaluated and when necessary it will be informed by the authorities”. And he added that “it is an epidemiological priority that the groups at greatest risk can attend soon to be vaccinated.”
However, if the population to be vaccinated expands, it could no longer be free. This is at least the belief of María de la Luz Endeiza, head of the Vaccination Center at the Universidad de los Andes Clinic and a member of the Cavei, who affirms that if it is introduced into the PNI and it is enabled for all, “It is very difficult for a country to sustain a permanent massive vaccine over time, it is a lot of money”. Therefore, he recommends that it be free for risk groups and that it be free for the rest “to the extent that the production of Covid vaccines increases for the whole world.”
Another point in doubt lies in the immunity of the bivalent vaccine that is currently administered in the country.
Undersecretary Cuadrado states that “there is currently no record (the duration of the vaccine’s effectiveness), but it has been observed with the monovalent vaccine (against the ancestral Wuhan strain) that antibody levels decrease between four and six months approximately. Surely the work led by Dr. Rafael Araos will continue to measure the effectiveness now with bivalent, it is a process that advances as more people are vaccinated ”.
And he adds that thebivalent delivers an effectiveness against hospitalization by Covid-19 between 74% and 80%. While the effectiveness of this vaccine against death from this disease reaches 85% ”.
For former undersecretary Daza the picture is different. “They say that the fourth dose has had a good response to vaccination, but these studies have not been published, it is important to know the studies that have been done to know how long immunity lasts.”.
From the Cavei, María Luz Endeiza assesses that “immunity is lasting more than six months, but healthy people have already been more than a year since the fourth dose”, for which she affirms that in winter “in any case we are going to need reinforcements, reinforcements will always be there, forever”.
