While the
dengue epidemic
is going through its worst moment and the lack of repellents adds to the debate over the immunization strategy against this virus,
problems appeared with another vaccine
. That of
Covid
, an old acquaintance but not forgotten, which is preparing to re-
enter the field
in the season of respiratory infections.
The phrase that is heard again is one that brings back memories of the pandemic, of those times when vaccines were a scarce commodity:
there is a lack of vaccines
. And those that are missing are specifically those that babies and younger children should receive, a population in which coverage rates against SARS-CoV-2 have always been low.
According to
Clarín
, there have been shortages of pediatric doses for several days and in important jurisdictions. Without giving details of the provinces, it was confirmed by Florencia Cahn, president of the Argentine Society of Vaccinology and Epidemiology (SAVE). “
Yes, there are shortages
. The available doses were all applied or expired. The ministry did not order the purchase of a new batch,” explained the infectious disease specialist.
In the City of Buenos Aires they admitted that they are currently
out of stock
. “The national government informed us that it was completing the tender to replace vaccines. We still do not have an exact delivery date,” they said in the Buenos Aires Ministry of Health. In the Province, the stock varies according to each municipality, but from the Buenos Aires health portfolio they agreed:
they did not receive more pediatric doses
and they do not have information from the Nation about when they will arrive.
When asked by this newspaper, the national Ministry of Health assured that “acquisitions and distribution
are progressing normally
. Both the vaccines included in the national calendar and those for Covid are in the jurisdictions, and they are being replenished as orders are received.” And when asked about the shortages reported by the jurisdictions, they responded that “we are within the
usual circuit
, where the provinces update the orders.”
What vaccine do children between 6 months and 5 years receive?
The only vaccine authorized between six months and five years by the National Administration of Food, Drugs and Medical Technology (ANMAT) is Moderna
,
which is applied in two doses. For those over five years of age, Pfizer's is also authorized.
The formulation of the Moderna pediatric vaccine is the same as for adults, but is applied in a smaller amount. For the adults today there are no shortages, but there are for the children since of the available ones they can only receive the one from that laboratory.
The doses of the Covid vaccines that did not arrive are part of the original purchase of 20 million doses from the US laboratory managed by the Alberto Fernández administration, and which was later expanded to a total of 25 million, most of which were already prepaid.
What remains to be received is a last remainder of around 1.2 million doses
. When the purchasing processes are activated, delivery takes place within a maximum period of two weeks.
But time, on the calendar, is of the essence. With the focus 100% on dengue,
today few remember the feared and dangerous Covid
. But the respiratory disease season is just around the corner, and in fact the flu vaccination campaign is already underway for next winter. Children under two years of age are part of the group that must also receive the vaccine to prevent influenza.
The thing is that these two respiratory viruses are
more complicated at the extremes of life
. That's why it's important to get vaccinated. “Vaccines are essential and when winter begins is when the Covid virus circulates the most,” recalled Eduardo López, infectious disease specialist at the Ricardo Gutiérrez Children's Hospital. Cahn agreed: “Today the perception of risk is very low, but
the virus continues to circulate
.”
For this reason, infectious disease specialists emphasize the need for vaccines to be available and to increase vaccination rates in children against SARS-CoV-2, which according to Cahn at the beginning of the year was in the second dose in 18.5% of the total country. . The reasons for the
low coverage in the pediatric population
must be sought, explains the doctor, first in the contradictions and controversies with which the campaign began back in 2021 with Sinopharm, which caused even many pediatricians to not be emphatic about the indication. .
Added to this, he points out, is the post-pandemic fatigue of people and the lack of information, as explained in the latest vaccine perception survey by the Bunge and Born Foundation in which 4 out of 10 people believed that it was false that it is due apply an annual reinforcement.
Bivalent vaccines vs. monovalent
The Covid vaccine is not included in the national vaccination calendar, because it was authorized in the health emergency, and it is one of the issues that the
National Immunization Commission (CoNaIn)
must soon resolve , which has been in the news in recent weeks for having recommended the dengue vaccine, although the Milei Government rejected its incorporation into the national strategy for now.
Returning to Covid, it is believed that it will end up included as influenza is today (for risk groups). Inclusion in the calendar implies that the vaccine is free and mandatory, and that
there is support in doses
. Many of the vaccine purchases by states are made through the Pan American Health Organization to achieve more competitive prices.
But the issue of the delayed purchase of pediatric vaccines brings another issue into focus:
updating the formula that is being applied
.
The vaccines that are currently available in Argentina are bivalent, those that are based on the original Wuhan strain and were modified to also respond to Omicron. In the northern hemisphere we have now returned to monovalent vaccines because the original strain, which has already stopped circulating, was discarded. From Health of the Nation they stated that “progress is being made in the incorporation of monovalent vaccination” also in vaccination in Argentina.
According to Cahn, the bivalent vaccine provides cross-protection and its coverage is effective: “The vaccine is not the last, but it still protects against severe forms, which is the main objective.”
Lopez disagreed. “When Omicron has been predominant for two years,
continuing to use Wuhan would seem like an old vaccine
,” he pointed out.
According to the Gutiérrez infectologist, with the bivalent there was cross immunity with the BA.4 and BA.5 subvariants, but not with JN.1 and EG.5, which already represent
more than 60% of the cases analyzed
. “There is protection, but it is less because there are already other sublineages,” said López, who in any case conceded that “the best vaccine is the one that is applied to the arm.”
“The ideal is to have vaccines that are as similar as possible to the type of virus that is circulating, but we must not lose the opportunity for vaccination, especially now that we are in the flu campaign,” added Cahn, who also recalled that he has already Included in the calendar is the vaccine against respiratory syncytial virus (RSV), which pregnant women must apply to reduce the risk of bronchiolitis in infants, the other disease that hits hard every winter.