In Europe we are witnessing an acceleration of the times for vaccinating health workers and the population groups most exposed to Covid-19. And it is good to try to contain as much and in the shortest time possible the circulation of the viral agent. This is not only due to the serious direct consequences of the pandemic on the health of citizens and indirect consequences on the economy, production, trade, school and sports and recreational activities, but also to reduce the onset of multiple genomic variants that can turn into new strains of betacoronavirus with unpredictable and potentially more dangerous characteristics than the current one, both in terms of infectivity, pathogenicity, virulence and invasiveness, and resistance to prophylaxis and therapy.
After the rush in the testing and approval of vaccines (for now, in the US and in Europe, not ordinary, definitive, but only “emergency”, as the US Food and Drug Administration says, or “conditioned”, according to the European Medicines Agency ), has there been a rush to mass vaccination? We hope not, because in medicine, as in other delicate activities of precision and responsibility, haste and good are not combined. The doctors and nurses who work in the emergency and emergency departments and in the first aid units know this: contrary to what certain television dramas show, one of the first things taught to them is to move quickly but without falling into agitation, because the ‘self-control of the operator and safety in maneuvers during an intervention are worth as much as its effectiveness. Even those involved in public health policy and management should not forget the wisdom of what experience in the field teaches health care providers. Some news coming from the United Kingdom, under pressure for the exponential spread of the new variant B.1.1.7 of the coronavirus, does not seem to go in this direction. The UK drug agency MHRA has extended the interval between the first to twelve weeks
and the second dose of Pfizer-BioNTech vaccine, versus the three weeks that followed during the Phase 2-3 trial of the same vaccine, on the basis of which the safety and efficacy results (at three weeks) had been approved in the US and Europe. This delay – criticized both by the manufacturer and by numerous British immunologists and virologists, and by the European Medicines Agency – would have the purpose of being able to vaccinate as many people as possible in a very short time, even risking giving them uncertain or partial immunity. . Furthermore, in the vaccination manual provided by the British Health Service (NHS) to doctors and nurses in charge of prophylaxis, the possibility of the so-called mix-and-match is admitted, that is, “to those who have started the immunization cycle but for whom at the time of recall [per la seconda dose] the same type of vaccine is not available or the type of the first dose is not known, it is reasonable to offer a dose of the product [vaccino di altro produttore] available on site to complete the »vaccination course. A firm negative reaction came both from Pfizer (which validated the two-dose protocol of only the same type), and from the Centers for Disease Control and Prevention of the USA, where they explicitly exclude this possibility, as “vaccines are not interchangeable” and ‘the efficacy and safety of these alternative administration techniques have not yet been proven’. As Chancellor Ferrer asked his coachman as he drove the carriage among the tumultuous people in the squares of Milan, hurrying to free the vicar of Provvisione besieged by the crowd, “Adelante, Pedro, cum juicio” (A. Manzoni, I Promessi Sposi, chap. XIII). While making us move with due determination, the coronavirus siege that is gripping Europe and the world must not lead us to lose our judgment of prudence (or precaution) in the use of prophylactic and therapeutic means available so far.
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