Balance of the vaccination plan against covid-19 in Spain

  • Six weeks after the first puncture, the lack of vaccines continues to weigh on the progress of the vaccination campaign against covid-19

  • In Spain only 4% of the population has already received one dose of the vaccine and only 1% already has the two necessary

  • The pharmaceutical companies blame production difficulties, while several entities ask to release the patents of the antigens

The story of the first covid-19 vaccines is a story of an unprecedented scientific, technological and economic career. The counter-chronicle of this milestone also traces a history of ups and downs, chiaroscuro and much, much uncertainty. Already six weeks that started the immunization campaign against the coronavirus in Spain and vaccines keep coming in dropper.

To date, a total of 2,218,755 doses against covid-19. Around 80% of these have been distributed as the first puncture, while the remaining 20% ​​has been used to complete the second round of immunizations. This, in practice, implies that at this time near to 4% of the Spanish population have received a dose of vaccine but only 1% already have the complete guideline. The campaign, therefore, progresses slowly. At a rate that further moves away from the goal of building 70% group immunity by summer if this continues.

The good news is that sooner rather than later the situation should change. Both Pfizer and Moderna, the main vaccine distributors during this first month of the campaign, finalize the details to increase their production capacity. AstraZeneca, for its part, is preparing to deliver the first batches of its formula; cheaper and easier to manage than its predecessors. According to the information handled by the Ministry of Health, throughout the month of February more than four million will arrive dose against covid-19. By the end of March, a total of 6.7 million injections against the coronavirus should have arrived; the equivalent to vaccinate 3.3 million inhabitants.

The most optimistic balance estimates that, if there are no more stones along the way, before Easter there should be 7% of the population vaccinated. That is, the equivalent of one tenth of the goal set to have group protection against the virus that finally manages to stop this devastating pandemic. When asked whether this scenario is feasible, or at least plausible, several experts consulted by this newspaper raise the same question. Everything will depend on the arrival of the vaccines.

Production problems

One month after the first punctures Against covid-19, the shortage of vaccines continues to hinder the progress of the immunization campaign. Pharmaceutical companies, governments and health authorities affirm that the ‘bottleneck’ What prevents putting the accelerator to the production of formulas is in the production plants. “We have underestimated complications in vaccine production”, Recognized a few days ago the president of the European Commission, Ursula von der Leyen, in reference to the logistical problems that have marked the course of these first weeks.

Industry sources consulted by this newspaper suggest that the vaccine production is stagnant by intrinsic complication of each of the formulas. Messenger RNA-based vaccines, such as those from Pfizer and Moderna, require a very complex technological platform that, today, only exists in a handful of factories around the world. Pfizer, for example, only has a couple of centers dedicated to antigen production and a couple more to finish the finish. Modern the same. “It is not as easy as opening more factories, because each machinery requires a very detailed validation process,” say sources familiar with the process. “Making vaccines is not a blow and bottle“, they insist.

The AstraZeneca and Janssen formulas, based on adenovirus, are theoretically easier to produce. Even so, any unforeseen event along the way can drastically lower expectations. “On paper you can do a lot of calculations about the manufacture of vaccines, but as soon as the machinery is started there can be a thousand unforeseen. The smallest detail can make production drop by 10% and if you transfer this percentage to large-scale orders, you see that in the blink of a dose you have lost the ability to carry out thousands and thousands of doses, “he says. Mercedes branches, QualitecFarma’s expert in drug development and clinical trials. “There is no magic formula for producing more vaccines“, Add.

Several entities claim to suspend the patent of these vaccines to accelerate the global production of antigens

Civil entities such as Doctors Without Borders and Salud por Derecho have already claimed to temporarily suspend the patent of these vaccines for other manufacturers to help speed up your production. The proposal, already in the hands of the World Trade Organization, would oblige the pharmaceutical companies responsible for antigens to ‘release your recipe’ so that other producers can emulate it. From the World Health Organization, Tedros Adhanom Ghebreyesus has supported the initiative, recalling that “this mechanism has already been used previously to expand access to treatments against HIV and hepatitis C”. Still, the big question remains to be answered. Are the world’s factories prepared to produce so many complex vaccines at unprecedented speed?

Change of plans

While pharmaceutical companies try to unblock production problems, health authorities study how to optimize the distribution of existing doses. In Spain, for example, the decision to discourage the AstraZeneca vaccine for those over 55 years of age rethinks the distribution plans drawn up a few months ago. Now that the Oxford vaccine cannot go door-to-door to immunize the elderly, it will be time to devise a strategy for getting mRNA vaccines to them. “The logistics of the Pfizer and Moderna doses are more complicated, but if it is well organized, they can reach homes directly. These antigens last for several hours at room temperature“remembers Ramas.

Everything indicates that in the coming months the European vaccine portfolio will be expanded with several more formulas. Janssen has already claimed authorization for its vaccine, the first that would require only one dose to build lasting immunity. Europe already has 100 million doses of this antigen by mid-2021. Throughout the year Novavax, Curevac and Sanofi are also expected to request authorization for their vaccines. In parallel, the European authorities study including Chinese and Russian vaccines in their immunization portfolio once they go through the scrutiny of the European Medicines Agency (EMA).

Meanwhile, waiting for more vaccines, the world fills with more and more questions. Can the formulas be mixed between one dose and another? How and how much will virus mutations affect the effectiveness of vaccines? The answer is that there is still no answer. At least for now. “Several studies are underway on the issue, so for now we can only be guided by what the theory says. Of course, we already know that Reality is much more complex than the calculations you can do on paper “, highlights Ramas.

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The global count estimates that the first 120 million doses against covid-19 have already been supplied by the world. In the last week they have administered an average four and a half million doses per day. If this continues, estimates the team of analysts of Bloomberg, it will take at least seven years to vaccinate 75% of the world’s population. In Spain, if it continues as before, it would take at least two and a half years to vaccinate the bulk of the population over 16 years of age. If the accelerator is not put on vaccines, then both the race for immunity and the pandemic will last forever.

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