The vaccination campaign against the coronavirus faces the second year in Spain with good general figures but with symptoms of fatigue and suspicion on the part of some population groups, a phenomenon that has tarnished records that have so far been applauded on the international scene. The most obvious is the slow progress in immunization among children between the ages of 5 and 11, which in the first eight weeks barely reached 55.6% of the target population and during the last week added less than 3,000 new vaccinated to day when this group is about to start receiving the second dose. The booster dose among the healthy adult population under 50 years of age is also not advancing at the same rate as in other European countries and, more worryingly, a remarkable bag of more than half a million people is consolidating, who despite being over 70 years of age age have not received the third puncture.
“We are seeing less adherence to vaccination and booster doses,” admits the president of the Spanish Association of Vaccinology, Amós García. Experts warn that the large number of infections caused by the omicron variant – the Ministry of Health has notified almost five million since mid-December – has altered the pace of the campaign, since all these people will have to wait longer to receive the dose. “But in addition to this, it is undeniable that the citizens are bored by the pandemic, the doubts of the parents, some confusion about some measures, the contradictory messages sent by some experts and also the lower perception of risk among children and young people. ”, adds Amos Garcia.
The vaccination campaign for children from 5 to 11 years old began on December 15 and it will be on Wednesday of this week when the first ones will begin to complete the pattern once the eight weeks of separation between the two punctures have elapsed (in children it is not planned the booster dose). This group is made up of 3.3 million minors and although vaccination started at a good pace (more than 100,000 daily vaccinations), after the Christmas holidays it has slowed down a lot. Just 14,000 children were vaccinated last week, according to Health data.
The large number of registered infections among children partly explains this low coverage. Communities such as Catalonia, for example, have registered incidences of over 11,000 cases per 100,000 inhabitants within 14 days among children under 12 years of age, which means that one in nine children had the infection in the previous two weeks. A prudent estimate indicates that at least a quarter of Catalans of this age have been able to test positive in the last month and a half. Now these children will complete the regimen with a single dose, which will be administered eight weeks after infection, while those who have tested positive after receiving the first dose will receive the “second when they are fully recovered and at least eight weeks have elapsed.” from the diagnosis”, according to the Health recommendations. Children with risk factors will receive two doses in all cases.
Some specialists still do not fully see the need to vaccinate this group. José Miguel Cisneros, head of infectious diseases at the Virgen del Rocío Hospital (Seville), does not consider it a high priority. “I consider the health benefit that they are going to obtain with the vaccine to be doubtful, because they are going to have a very mild infection. This is something that also goes for the booster dose in healthy young adults. With omicron, moreover, we can no longer aspire to herd immunity, it is a chimera, and this weakens one of the arguments for extending vaccination or the third dose to these groups”, he defends.
Along these lines, countries such as Germany, Sweden and Finland have not universalized childhood vaccination in children between 5 and 11 years of age and only administer it to those with risk factors. Quique Bassat, ICREA epidemiologist and researcher at the ISGlobal institute (Barcelona), is in favor of expanding the vaccinated groups as much as possible: “I think it is beneficial to vaccinate children because, although small, the risk of serious cases is not zero and this, in a context of great circulation of the virus, will make it inevitable that they will occur. I am talking about cases of systemic multi-inflammatory syndrome due to covid and persistent symptoms. Vaccines do not prevent all infections, but they do prevent many. And the same goes for young adults, who can also develop severe cases and persistent covid.”
Bassat describes as “disappointing the rate of childhood vaccination and booster doses among young and healthy adults”, something that may have contributed, in addition to the doubts and the many current infections, “the idea that we are already near the end and that perhaps it is no longer worth getting vaccinated if it has come this far.”
Facing these groups, Cisneros focuses on the most vulnerable. “The great risk in terms of health are the elderly and people with underlying pathologies. In hospitals, we continue to treat serious cases that are almost always people who have not been vaccinated or who have not received the third dose despite having risk factors. The efforts of the vaccination campaign must focus on them because they are the people who are occupying the ICUs and dying”, affirms this specialist.
The data from the Ministry of Health offer some worrying clues. Among those over 70, the following of the first part of the campaign was massive. More than 99% of this group received the first two doses and only 50,000 were not vaccinated. This percentage has now fallen almost eight points and there are more than 550,000 people over 70 years of age who still do not have a booster dose. The rate of those who continue to receive it is also very slow: about 25,000 a week.
These percentages are somewhat higher in those in their sixties. Those who decided not to be vaccinated were almost 250,000 people (4.5% of the total), but now there are 530,000 more who, having received the first two doses, have not received the third. In this group, there are about 40,000 people a week who receive the reinforcement.
Among those between 50 and 59 years old, the almost 450,000 who were not vaccinated are now joined by 1.9 million people who have not yet received the third. In this case, the weekly rate of booster doses slightly exceeds 90,000 people.
Those who have passed the infection in recent weeks without having received the third dose, will have to wait five months to receive the puncture, according to the recommendation of Health and the communities, although they can shorten this period to four weeks if they prefer.
The good results obtained by Spain in the first year of the vaccination campaign, in which it held the leading positions at the world level together with countries such as Portugal, have been somewhat blurred. According to the Oxford University repository Our World in Data, which measures the booster doses administered per 100 inhabitants, Spain is with 47.3 in the middle of the continent and clearly below countries such as Italy, Germany, Belgium, Denmark and even France.
Part of this delay is due to the fact that “in Spain, booster doses were prioritized for the groups at greatest risk and the agendas were opened later for the rest of the population, while other countries did it for everyone at the same time”, explains Amos Garcia. This expert, however, reiterates that in this phase of the campaign other variables have gained weight, such as boredom with the pandemic and the doubts generated by certain messages and debates that have made a dent in the pace of administration of third doses.
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