The rise in infections among young people and the threat of the delta variant of the virus, more contagious and able to better overcome the effects of the first dose of the vaccine, are beginning to condition the immunization campaign in Spain. Communities are accelerating punctures among those in their thirties and some have even started with those in their 20s, two of the age groups where the bulk of new infections currently occur. In addition, autonomies such as Madrid, Castilla-La Mancha, Galicia, Catalonia, Murcia, Andalusia and the Valencian Community are already advancing - or plan to do so - the administration of the second dose of AstraZeneca in the group of 60 to 69: the term between punctures was three months and they are reducing it to between 8 and 11 weeks, according to the community. 58.8% of those in their sixties,one of the groups most vulnerable to the virus and at risk of developing a serious disease, have not yet received the second dose.
More information
Spain fails to meet the June vaccination goal with almost three million doses in warehouses
The rise of the delta variant puts Europe on alert
The incidence of covid in Spain has reversed its trend and is on the rise again: 100 cases per 100,000 inhabitants in the last two weeks. Infections among young people, such as the macro outbreak in Mallorca in which more than a thousand kids from eight communities have been infected, have put communities on alert. In the Canary Islands, for example, the increase in cases in recent days has precipitated that the autonomous government has begun to advance appointments in the age group between 30 and 39 and has started vaccination 24 hours a day in the Santiago Martín pavilion, in La Laguna (Tenerife). Also Madrid, the most lagging behind in terms of the number of doses administered over those received —85% compared to 92% of the Spanish average—, has begun to vaccinate this Monday uninterruptedly at the Isabel Zendal Hospital.
The islands of Menorca, Ibiza and Formentera are vaccinating young people between 16 and 29 years of age since Monday, while in Mallorca the vaccination of people between 30 and 34 years has been advanced. Galicia and Asturias have also opened the punctures this week to thirty-year-olds and Catalonia, which already started last week with those from 35 to 39, has done the same with the group from 30 to 34. In fact, the Catalan Government has started the citation of three different age groups in less than three weeks when verifying the difficulty of exceeding 80% of the protection of each group and does not rule out suddenly opening vaccination to all those under 30 years of age. The Generalitat also gives appointment to those people who will go to study or work abroad for a long period of time.
The Basque Country, for its part, also continues this week with the immunization of thirty-somethings and with the second dose of those in their sixties who received their first AstraZeneca around Easter. In addition, the regional government is studying the possibility of accelerating the vaccination of Erasmus students, after they have gathered in front of the Bilbao Palace of Justice with suitcases and posters asking to be immunized.
The communities are also rushing the second doses, especially in the group of 60 to 69 who, due to the type of vaccine received (that of AstraZeneca), which included a longer waiting time between punctures, have not yet completed the vaccination schedule. The rise of the delta variant, discovered in India at the end of last year and up to 60% more contagious, according to the European Center for Disease Control (ECDC, for its acronym in English), has precipitated that autonomies such as Madrid have advanced one week (from 12 to 11) the time between doses. The ECDC estimates that this variant will cause 90% of infections at the end of August in Europe and, according to data from the British authorities, where this lineage is already predominant,the effectiveness of the first dose of the Pfizer or AstraZeneca vaccine drops to 35% with this variant (it was 50% with the alpha, which originated in the UK).
With the complete vaccination regimen, protection is very similar between alpha and delta, but there is still a pool of people at high risk of serious disease (59% in the 60 to 69 group and 30% in the group of 50 to 59) that have not completed the puncture cycle. Alberto Infante, emeritus professor of International Health at the National School of Health of the Carlos III Health Institute, laments: “Looking at the vaccine coverage data, it gives the feeling that we have made little progress in recent weeks. And this is very striking considering that injection records have been broken in recent days [on Thursday, 733,000 doses in one day] ”. In the last two weeks, vaccination coverage with first doses in the 40-49 age group has doubled (62% already have a puncture),while the second doses for those in their sixties and those between 50 and 59 years old, have grown, but not so much: 58% and 72%, respectively.
“You have to make a call for alarm and danger. Second doses to vulnerable groups must be accelerated at full speed. Our main gap in vaccination is the group of 60 to 69. What is urgent is to avoid serious disease and the risk of entering intensive care, ”says Infante. Although data from the Ministry of Health place the presence of the delta variant in 2.7% of infections (with a very heterogeneous dispersion between communities), the experts consulted assure that its circulation in Spain is greater. In Catalonia, one of the communities where they follow the track of this lineage more closely, the Government assured last week that this variant already causes 32% of infections.
In addition to Madrid, which is now considering reducing the time between AstraZeneca doses for another week and administering the second puncture 10 weeks after the first, the Valencian Community will also advance the second doses of the drug from the Anglo-Swedish company 10 weeks after the first . Galicia has also decided to advance this second injection at 11 weeks and Castilla-La Mancha has started this week to puncture these second doses at 10 weeks after the first. Catalonia, which had already reduced the term to 10 weeks, will again cut it to 8.
Given the increase in the delta variant in Gibraltar, the conviction that a community transmission with this lineage could occur in Andalusia and due to the slow decrease in the accumulated incidence in the community, the Board also decided last week to advance the second to 10 weeks AstraZeneca vaccine doses in those over 60 years of age. Murcia is another of the autonomies that is considering an advance "given the evolution of the variants throughout the national territory," a spokeswoman has justified, and has ensured that the regional government will take the issue this Tuesday to the Public Health Commission, the Health body where the ministry and regional public health officials are represented.The latest update of the National Vaccination Strategy contemplates the administration of the second dose between 10 and 12 weeks after the first.
Experts agree that the priority of the vaccination campaign is twofold: on the one hand, completing the vaccination schedule for the most vulnerable and, on the other hand, accelerating punctures in the young population, which is where the virus is circulating the most: Although they have a low risk of suffering a serious disease, they do trigger transmission due to their social dynamics of more mobility and interaction with other people.
The President of the Government, Pedro Sánchez, announced on Friday that this week there will be a jump in the arrival of vaccines and more than six million doses will enter Spain.
The President of the Government, Pedro Sánchez.
Photo: Carles Ribas.
In video, his statements about vaccination in Spain last Friday. EFE
Ángela Domínguez, coordinator of the Working Group on Vaccination of the Spanish Epidemiology Society, maintains: “The delta variant is increasing and is more transmissible. It is very important that the population, especially the most vulnerable, get second doses. The other flank that we have is the young population, who have to advance with them. The vaccination of both groups are compatible because they are different vaccines and can be done at the same time ”. Since the beginning of the vaccination campaign, almost 40 million doses have been administered in Spain: more than half of Spaniards have received at least one. 35% of the population, that is, 16.6 million people, already has the complete guideline.
With information from
Juan Navarro, Sonia Vizoso, María Fabra, Eva Saiz, Isabel Valdés, Lucía Bohórquez, Guillermo Vega, Bernat Coll
and
Pedro Gorospe.