Doubts and answers about vaccines

Why are there municipalities that have managed to vaccinate more people over 80 years of age than others?

According to the head of the Epidemiology and Prevention section of the General Directorate of Public Health of the Government of the Canary Islands and president of the Spanish Association of Vaccination (AEV), Amós García Rojas, the inequality in the progress of the vaccination campaign is due to, firstly, because certain municipalities have fewer people who are in this age group, which allows them to follow a faster pace. In addition, the imbalance may also be associated with the agendas of the Primary Care teams and the profile of the pathologies they treat. "What is clear is that it is not due to a lack of interest or will of the professionals," says the expert.

Why can inoculation reach a 65-year-old person earlier than the older population?

Based on the words of García Rojas, this fact goes hand in hand with the availability of vaccines. “Until now, the vaccine that was administered to people up to 65 years of age was that of AstraZeneca and we had many more doses of this product than the one developed by Pfizer or Moderna, which were indicated for older people. This allowed the campaign to advance further in this group ”, clarifies the epidemiologist.

Is there a balance in the distribution of doses between the countries of Europe and the Spanish communities?

Regarding the distribution of the different products, the president of the AEV maintains that it is being adjusted to the population levels of each European country and of the Spanish regions themselves. “The Canarian population is younger than that of other autonomous communities and, logically, those with an older population will receive more doses of Pfizer and Moderna vaccines. Therefore, I believe that the distribution is tight and we should not assume that there is a desire on the part of the European Union or our own country to prioritize some communities over others ”, he asserts.

What happens to the leftover product that expires and cannot return to the cold chain?

“The planning process for multidose containers cannot contemplate the possibility of any vaccine, so it is a scenario that we cannot consider. For this reason, it is necessary to know in advance how many people are going to be inoculated and even have an alternative list of patients in case someone does not attend the appointment, ”explains García Rojas. To later highlight that it is a "very complex" campaign, which aims to vaccinate a large number of people "in a very short period of time."

What criteria are applied to inoculate people who have already suffered from SARS-CoV-2 infection?

The inoculation of people who have contracted Covid-19 is governed by the criteria established by the Vaccination Strategy itself and which establishes that at least three months must elapse before receiving the compound, in the case of those over 55 years of age, and six months for those below this age. "A single dose is being applied to these groups of patients," says the doctor.

Should citizens contact the health centers to find out when they will receive the compound?

"You have to be patient and wait for the call from the health centers," says the epidemiologist. And it is that the agendas of the Primary Care services are "overloaded", so it must be the system that contacts the target population.

In which cases can you call 012?

According to the nurse and member of the coordination of the Vaccination Strategy against Covid-19 in the Canary Islands, Begoña Reyero, people should only call 012 to confirm appointments, when they have already received a message indicating the place to which they should go, or, to resolve doubts related to the access to these spaces. “You can also contact this phone to change the date, but it can only be done on the date and time, never at the place of appointment. If they receive an SMS and call when the appointment has passed, they will have to wait for a new SMS to be sent to them, ”the utility explains.

Who can access the drug at home?

The Canary Islands Health Service only inoculates in homes those who have objective difficulties in being able to travel to the assigned centers. An example is given by patients with severe mobility problems.

Should I take any medications before receiving the injection?

It should be noted that it is the health professionals who must evaluate whether it is advisable to take any medication before receiving the serums. “In the case of AstraZeneca, the consumption of paracetamol of one gram has been recommended on the eve of the vaccination and on the day of receiving the injection, in order to minimize the appearance of possible side effects. This was indicated because, fundamentally, it was applied to young people and they have a more developed immune system and respond more to the antigenic stimulus produced by vaccines ”, underlines the head of the Epidemiology and Prevention Section.

How long must elapse between the first and second doses?

The nurse notes that in the case of the Pfizer vaccine, it takes between 21 and 28 days for the second dose to be administered. Moderna, on the other hand, allows the separation time to be extended between 28 and 42 days, while AstraZeneca between 10 and 12 weeks, "being able to lengthen this interval without suffering problems at the level of immune response."

How will groups that had already received a dose of the AstraZeneca vaccine be able to complete the schedule, before the change in plan occurred?

The change in criteria on the use of the AstraZeneca vaccine, which can now only be administered to people between 60 and 69 years old, has generated uncertainty among the groups that had already received a dose of this compound, since they do not know how they will be able to complete the guideline and, therefore, develop immunity against the coronavirus. “Taking into account that there are already evaluation studies on the interchangeability between this vaccine and those of messenger RNA, and that they will be published shortly, the most reasonable thing would be to complete the guideline with Pfizer or Moderna. However, we must wait until there is scientific evidence and not rush as France or Germany has done ”, defends García Rojas.

Is the Anglo-Swedish product really safe?

The president of the AEV does not hesitate to endorse the safety of the AstraZeneca vaccine. "There should be no mistrust," he adds. For her part, Begoña Reyero calls for calm and encourages the population to access the compound. "People must be very calm and have to know that it is essential that they go to appointments because it is the only way we have to get out of this situation," he emphasizes.

What happens to people who have suffered thrombotic episodes and enter the age bracket to receive the AstraZeneca serum?

García Rojas recalls that the European Medicines Agency has not indicated any personal predisposition in relation to the processes of thromboembolism with the vaccine. "What has been detected is that they occur fundamentally below 55 years of age and, now, when administered above 60, the possibility of these effects appearing must be completely minimized," he adds.

How long is the immunity conferred by vaccines?

How often the vaccination schedule should be repeated to maintain immunity is still an enigma. “We still don't know how long the protective response that vaccines confer lasts. Therefore, it will be necessary to wait to be able to evaluate the impact of protection that the products have ”, emphasizes the doctor.

Why have there been problems vaccinating Muface or other mutual insurance policyholders?

Reyero explains that the conflict has been rooted in the "obsolescence" of some of the databases that have passed to the Canary Islands Health Service, both Muface and other mutuals. “If the data is not up-to-date, we cannot access the mutuals. Work is being done to solve the problem and it is expected that by next Wednesday 80% of the people will have been called to be vaccinated ”, says the professional.