Spain begins its Covid vaccination program under the shadow of a possible third wave

After nearly 10 months of pandemic in Spain, the first doses of the Covid-19 vaccine developed by the Pfizer and BioNTech laboratories have begun to be administered to the sector of the population most at risk: seniors who live in homes and their carers.

An injection on Sunday morning in the arm of Araceli Hidalgo, 96, started the process at Los Olmos residence in Guadalajara. Then came Josefa in L’Hospitalet de Llobregat, Antonio in Granada, Nieves in Santiago and thousands more.

The first batch of vaccines, some 9,750 doses, arrived on Sunday in all of Spain’s regions, and over the coming 12 weeks a total of 4.6 million doses will be delivered, serving to immunize nearly 2.3 million people.

But the light at the end of the tunnel is, for now, still a faraway glimmer, and on Sunday Spain’s Health Minister Salvador Illa called on Spaniards not to “let down their guard.” The coronavirus is continuing to spread through the population and a third wave threatens to marr the celebrations over the arrival of a vaccine. “We are looking at the beginning of the end, but there are months still ahead of us and they won’t be simple,” Illa warned yesterday.

The government will be distributing 350,000 doses a week among the country’s regions, which are in charge of their own healthcare systems. The Pfizer vaccine, which is reported to be 95% effective, requires a second dose 21 days after the first, and the recipient will not be immunized until 28 days after the first injection. The immunization program is free and voluntary.

The government’s medium-term plan is for a number of different vaccines to be used at the same time. As well as the Pfizer and BioNTech injections, the European Medicines Agency (EMA) is due to give approval or otherwise to the Moderna coronavirus vaccine on January 6 – all evidence points to it passing their requirements.

Illa pointed out on Sunday that there are other vaccines – including the Astrazeneca-Oxford and the Janssen vaccine – that are being reviewed by the EMA. Apart from residents and employees at senior residences, health workers and adult dependents, who will be vaccinated in the first phase, the government is yet to confirm the order in which the immunization will continue, nor the logistical process to do so. The executive has so far merely confirmed that between May and June it will have vaccinated between 15 and 20 million Spaniards.

It will take time, however, to reach the objective set out by the government of vaccinating the entire population. This is partly because the vaccines will be arriving in small quantities, in particular to start with, and the situation will be complicated in the meantime given that the pandemic is not letting up and new infections are spiking once more.

In Spain, the 14-day cumulative number of coronavirus cases per 100,000 inhabitants has once again risen above the 250-mark considered to be extreme risk by the Health Ministry, and is now at 266.

What’s more, the pressure on Spain’s hospitals remains high, with 10,744 Covid-19 patients, and more than 1,900 people in the country’s intensive care units (ICUs). This is keeping up the stress on a system that is already exhausted. “The data is worrying,” said Illa on Sunday. “There is a change in trend that was seen last week. We have had five weeks of falls and then this interruption due to the relaxation of measures at the start of December,” he explained, in reference to the coronavirus measures that have been toughened and relaxed in recent months depending on the epidemiological situation.

Experts are already counting on another, more aggressive, spike in infections after Christmas due to the increase in social interaction. “The trend in cases is not uncontrollably rising, but it isn’t falling,” explained Toni Trilla, head of Preventive Medicine at the Clínic Hospital in Barcelona. “If it rises very quickly and gets out of control, it will be tough.” A spike, in fact, could have an effect on the vaccination campaign. “We are used to vaccinating in the middle of an expansive wave, as we do with the flu. But the campaign will be complicated because anyone who is suffering from the illness will have to wait to be vaccinated.”

Health authorities and experts are pointing out that protection measures such as the use of face masks and social distancing must remain in place for some time. The much-sought herd immunity, which would protect the population by making the circulation of the virus difficult, is still far off. “Right now we would have to reach immunity among 70 or 80% of the people, between those who have been vaccinated and those who have overcome the disease, before we have group immunity,” Trilla explained. “The message is clear: not even with a vaccine are we going to be 100% protected and we have to continue to be prudent. The protection measures cannot be lifted until the circulation of the virus has been greatly limited.” And that is yet to happen.

In fact, on the basis of the rise in cases, the Balearic Islands will be ramping up social restrictions in Mallorca, which has a cumulative incidence of 607 cases per 100,000 inhabitants. Catalonia is currently in a similar situation, and will be deciding today whether to further restrict mobility in the region.

With reporting by S. R. Pontevedra, P. Gorospe, E. Saiz, F. Bono and L. Bohórquez.

English version by Simon Hunter.