Health has just updated the vaccination strategy against COVID-19 that is expected to begin in Spain next sunday 27. Although it was already known that the first population groups would be users and workers of residences, "first-line" health personnel, the rest of health workers and large dependents, the ministry has made public the details of who will be in each group. It does so on the same day that the European Medicines Agency (EMA) is expected to approve the Pfizer / BioNTech vaccine, which will then have to be authorized by the European Commission and it is expected that Spain will begin to receive between the 26 and 27, perhaps at dawn.
It is still unknown how many exact doses will arrive in the first shipment, which will be received by all the communities at the same time, but they will be used for groups 1 and 2, as specified in the document, and then "as there is more availability" vaccinate groups 3 and 4.
Shield nursing homes: all staff and residents
The first group includes "highly dependent people who are institutionalized", that is, who live in nursing homes and dependents. Also vulnerable or highly dependent people who go to day centers "as long as these centers are linked" to a residence, that is, they share activities or staff. Ideally, you should start with residences in which there are a greater number of inmates, less capacity to implement control measures or that have not had cases of coronavirus.
The specific update for this first group two specific situations: for people who are about to die, it indicates that it will be the health personnel in charge of them who will assess their vaccination. In the event that in a residence there is an active coronavirus outbreak at the time, Public Health of each autonomous community will decide. The first doses of the vaccine will also be administered to all the people who work in the center, whether they are health workers, administrative personnel, cleaning personnel, kitchen ... and to the workers of the day centers linked to the residences.
First health line: emergencies, COVID circuits, Primary Care ...
Health personnel are the second group through which the vaccination strategy will begin. And in this case, they are divided into two: "front line" and the rest. In the first of them, that is, in group 2, people who have a greater risk of exposure to the virus are included by directly treating patients with coronavirus and by having a greater probability of having contact with an infected person. They are in turn nine groups, which also include personnel who perform other functions other than health, such as administrative, cleaning or students, among others.
They are those who work in the so-called COVID units, consultations or circuits, those who are at the entrance doors of acute patients (Emergencies, admission services, Primary Care, occupational risk prevention services, penitentiary institutions ...). Those who work in mobile units for direct care of COVID patients and urgent medical transport, ICU health workers, or other non-intensive care services "where procedures that can generate aerosols are performed." Also the personnel of services and units with high-risk patients (oncology, hematology, etc.). or services where samples that potentially contain viable viruses are collected and handled. Public health health personnel who work in the direct management of the pandemic and according to their risk of exposure and personnel of the vaccination teams, including those people from occupational health and preventive medicine who will participate in the administration of vaccines against COVID19.
In this group of "first-line" health workers will also be workers from other care centers for the elderly and "at different risk" from those included in group 1, without specifying further. The document specifies that people who provide "close care" to people at risk in their own homes will be vaccinated in group 4.
The rest of the health workers, but who contact COVID patients
Group 3 includes all health and social health workers not included in groups 1 and 2. However, the document does specify in this case that serum will only be inoculated to personnel who "specifically carry out activities that require contact with people infected "with COVID-19. People who are not vaccinated in the first stage of vaccination will become part of the category of "essential first-line personnel" in the following cycles.
Grade III dependents with medical recognition or accreditation
Finally, group 4 refers to people considered as highly dependent or grade III, that is, "whose status is medically accredited for having diseases that require intense support measures to develop their life", both those "who have requested the recognition and those that have not yet requested it but is medically accredited. " This group will include both those who live in public institutions and those that are not institutionalized. The professionals dedicated to your care and attention will also receive the vaccine in the same visit as the people they assist.
The vaccination strategy also indicates for the first time that residents in centers for the elderly who have had the disease should be vaccinated in the same way, due to their vulnerability by not having complete evidence that they cannot be infected again. For their part, health and social care personnel who face this dilemma may delay vaccination until 90 days after being infected by SARS-CoV-2. In this way, it will be possible to prioritize professionals who have not suffered from the disease recently.
It will not be mandatory
Vaccination will be a voluntary procedure, as the spokesmen for the Ministry of Health had already been warning. The strategy explicitly confirms that this activity will not be included within the provisions of the Special Measures on Public Health and, therefore, will depend on the will of the people, although Health appeals to the duty of collaboration of citizens.
However, the cases of rejection will be noted in the Vaccination Registry to know the possible reluctance among the different population groups.
Vaccination even if they have passed the disease
The document also refers to whether or not people who have passed the coronavirus should be vaccinated. Although current evidence shows that most have antibodies, there is still "little information about some aspects" such as reinfections or the duration of immunity. This "high degree of uncertainty" together with the vulnerability of people living in residences, lead the Ministry to recommend that all users and workers be vaccinated, whether or not they have had the disease. In the case of health personnel, it explains that they can delay vaccination until 90 days after diagnosis, in order to prioritize those who have not had it recently.