The COVID Vaccination Campaign and Flu Campaign: Uncertainty in Drug Selection and Availability

The covid vaccination campaign will begin in the fall together with the flu campaign, focused on the groups most vulnerable to the disease. But it is not yet clear which drugs will be used. Spain has bought more than 100 million doses that have not been used, but these have become outdated. The international health authorities recommend waiting for the ones that the pharmaceutical companies will foreseeably have ready after the summer, …

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The covid vaccination campaign will begin in the fall together with the flu campaign, focused on the groups most vulnerable to the disease. But it is not yet clear which drugs will be used. Spain has bought more than 100 million doses that have not been used, but these have become outdated. The international health authorities recommend waiting for the ones that pharmaceutical companies will foreseeably have ready after the summer, adapted to the XBB family, the omicron variant that circulates mostly throughout the world. But it is not even clear that they will arrive on time.

The vaccination strategy, approved by the Public Health Commission in July, it will be implemented from October (or somewhat later, depending on the availability of new drugs). In it, it outlines the population groups for which a new dose is recommended, provided that at least five months have passed since the previous one (or since the last infection).

All people over 60 years of age are included, although the document places special emphasis on the relevance of puncturing those over 80, whose risk of suffering a serious disease caused by SARS-CoV-2 increases. In addition, it is recommended for all institutionalized people (in residences, disability centers, prisons…) and health and social health workers, as well as essential public services (police, firefighters…).

Among the rest of the population, the Public Health Commission indicates a new dose of the covid vaccine for pregnant women and those who suffer from some diseases that increase their risk. Among others: diabetes, morbid obesity, chronic cardiovascular, neurological, respiratory and renal diseases, coagulation disorders and chronic bleeding disorders, chronic liver disease, including chronic alcoholism, severe neuromuscular diseases. It is also recommended for people with immunosuppression cancer and blood malignancies, cerebrospinal fluid fistula, celiac disease, chronic inflammatory disease, disorders and diseases involving cognitive dysfunction such as Down syndrome and dementias.

For the rest of the population, the vaccine is not recommended, but those who want to can receive it voluntarily. In the opinion of Marcos López Hoyos, president of the Spanish Immunology Society, for them it is not necessary at all due to the immunity generated by successive infections and previous vaccinations. As time goes by, the protection is declining, especially with regard to the transmission, which also increases with the change of variants. However, deep protection against the virus remains. “People are not virgins to the virus. We are protected, ”he assures.

According to this expert, it would not even be necessary for everyone over 60, and the ideal would be to do cellular immunity tests to determine who really needs it. But as Antoni Trilla, professor of Public Health at the University of Barcelona, ​​points out, there are no rapid tests and logistics would make it very complicated. In the opinion of this epidemiologist, the vaccination plan as it is embodied is the most appropriate to keep the majority of the population protected from the virus.

However, Trilla fears that in this new campaign there are people for whom the vaccine is recommended not to get it. Already last fall, only reached 61% of those over 60, although coverage increased to 77% among octogenarians and those over this age. He believes that it is possible that this population has seen the covid pass in a mild way and they downplay it. But it strongly recommends that the entire vulnerable population receive it, precisely so that the coronavirus does not send them to the hospital if they are infected.

Regarding the type of vaccine, the professor believes that both those that are already purchased and those that are foreseeably to come would help to improve this protection. “But the ideal would be one adapted to the new XBB variants,” he underlines. This is what is recommended by both the European Medicines Agency (EMA), such as the European Center for Disease Prevention and Control (ECDC).

which vaccine to use

Right now there is no vaccine on the market with these characteristics. The main pharmaceutical companies that supply Spain (Pfizer and Moderna) are working on these new versions, although it is not clear if they will arrive in time for the vaccination season. López Hoyos is skeptical and believes that once the international health emergency is over, bureaucratic procedures will make it difficult for them to arrive on time.

Trilla, for his part, believes that everything will depend on the epidemiological situation: “If we see that there is no great rise in infections and that EG.5 [popularmente conocida como Eris, la última variante que tiene en el punto de mira la Organización Mundial de la Salud] The landscape has not changed substantially, surely we could wait for these new vaccines ”.

In the event that this is not the case, the president of the Spanish Immunology Society considers that the most convenient thing would be to put this new dose with Hipra, the Spanish vaccine that was approved last March and of which the Government bought 3.2 million for 31 million euros. “It generates a broader immunity and good duration. That would possibly be the most recommended when it comes to vaccinating the Spanish population ”, he maintains.

What is not clear is what will happen to the more than 100 million doses that are purchased and that are expected to no longer be used. Although Health has been defending that they are part of the country’s drug reserve in case of emergency and that their expiration date can be reviewed, the truth is that they have fewer and fewer signs of being injected.

The contracts do not allow knowing the exact price of each dose, but most of those that were purchased in 2022, when more than a billion euros were budgeted, have not been spent. In addition, international agreements establish that these drugs cannot be given away or sold once they have been received.

2023-08-23 03:30:00
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