“To continue wearing the mask or not?” and “to relax social distancing measures or not?” Those are some of the questions that have arisen in the different nations that have already started their mass vaccination process. At least, until now there is consensus that the use of the mask and the distance will continue to be the norm, since the risk of infection will not fall to zero, even considering vaccines.
In this scenario, yesterday President Sebastián Piñera, in the meeting that takes place in the mornings in La Moneda, asked to analyze whether those who have already received two doses of the vaccine could be left out of the preventive isolation that a person must comply with when they are in close contact of a patient confirmed by Covid-19.
This is reaffirmed by the Minister of Health, Enrique Paris. “The President instructed today to prepare a document, based on medical evidence and scientific publications, to have a protocol in this regard. It will be in charge of the Undersecretariat of Public Health with the collaboration of experts: Advisory Council on Vaccines and Immunizations (Cavei), National Immunization Program (PNI) and by the Department of Health Technology Assessment (Etesa) ”, he says.
Those who know the backroom of the petition, the President’s doubt originates from the recommendations not to force isolation conducted by the United States Centers for Disease Control and Prevention (CDC) for people immunized with Pfizer BioNTech or the Modern Laboratory Vaccine– Both highly effective messenger RNA-based injections, exceeding 90% effectiveness, based on their phase 3 studies.
The information was also exposed a few days ago by the former Minister of Health Jaime Mañalich, on Twitter. Qwho has also pointed out -in an interview with La Tercera- It is necessary to study how many doses of vaccine a person who has already had the disease needs.
CDC notes that people who have already completed 15 days since their second dose of vaccine are not required to quarantine if they have close contact with a COVID case.
– Jaime Mañalich (@jmanalich) February 13, 2021
Thus, the CDC points out that those who have received the immunization and are exposed to an eventual contagion, will not be obliged to isolate themselves when they are fully vaccinated, that is, two weeks or more from the full schedule, one or two doses. To these categories are added those who have remained asymptomatic since exposure to the Covid-19 index case.
For now, these guidelines only apply to those who have been inoculated with some of the vaccines from these laboratories. In Chile, 57,447 have received the injection from Pfizer and, of that total, 54,818 have already completed the two doses of the scheme, according to the report updated yesterday at 6:23 pm.
Mostly, those inoculated with Pfizer correspond to health personnel. This last point is relevant, because if the CDC’s recommendation is approved in the country, it would avoid the loss of officials due to close contact. However, the President would have asked to analyze the measure also for Sinovac, the vaccine that will receive the bulk of the population at risk between now and the end of March.
The president of the Cavei, the infectologist of the University of Chile Jeannette Dabanch, emphasizes that for CoronaVac it is still risky to propose a measure of this style, since the investigations have not yet evaluated this point. “Studies at least with the inactivated CoronaVac vaccine have not studied asymptomatic infection, therefore It is risky to state without objective data that once vaccinated there is no longer a post-contact quarantine. In addition, the publication of the phase 3 study of CoronaVac is still missing, as we had access to initial data from the study of Brazil in health personnel ”, he comments.
However, the epidemiologist from the same university, Gabriel Cavada, opens up to the possibility of analyzing it in the country through tests for antibodies against Covid-19.
“It will depend on when the last dose was received. The vaccine is known to be highly effective in terms of preventing the disease from developing seriously, but not necessarily contagion. If the person has been vaccinated for at least a month, an antibody test could be done to see if they are contagious. Then, based on that result, determine whether isolation is necessary or not. If they have immunity, it would not be necessary to isolate them, but if they have not generated the antibodies, that person should be confined ”, he says.
The vice president of the Chilean Society of Infectious Diseases (Sochinf), Claudia Cortés, meanwhile, points out that “we need more studies, there is no evidence based on science to give an accurate answer. We know that the vaccine protects against serious disease, avoiding the need to be hospitalized and to use a mechanical respirator, but vaccines are not fully effective in preventing infection. Being vaccinated, there is also a theoretical risk of contagion, so it is necessary to wait for further studies to discuss the issue “.
Who makes the distinction is the epidemiologist from the Universidad del Desarrollo Manuel Nájera, who confirms that “This appears to be the case, based on data from the Pfizer and Moderna vaccines. Indeed, a vaccinated person is not going to make others as badly ill as a person who is not vaccinated. With that, a discussion could be started on the need to quarantine or not ”.
However, he warns that “there are two points that are not being considered for the situation in Chile: first, that it is not the same vaccine, so we need more robust evidence on Sinovac, with which the majority of the population in the country will be inoculated, in order to make such decisions ”.