Slow rollout of Covid-19 vaccines in Spain raises fears of missing campaign targets

The Covid-19 vaccination program has got off to a slow start in the Madrid region, despite the expectations created by the regional premier, Isabel Díaz Ayuso of the conservative Popular Party (PP). The Madrid government had, by the weekend, administered the first dose of the immunization to 3,090 people since the Europe-wide campaign got going last Sunday. This is a very slow rate, and accounts for just 6% of the 48,750 doses that the region will receive from the central government on a weekly basis until the end of March.

The slow administration rate is in contrast to the haste with which Ayuso wanted to begin the program, voicing complaints that the Health Ministry had not allocated enough doses to the region. For much of the pandemic, Ayuso has been a highly vocal critic of the central administration – run by a coalition of the Socialist Party (PSOE) and junior partner Unidas Podemos – for its handling of the health crisis.

“Vaccination is a national problem. The strategy is a national problem and the government of Spain should be at the helm, as should our fleeing minister, so that all regions receive the same number of doses, transparency and aid,” said Ayuso on Monday, alluding to the fact that Health Minister Salvador Illa is going to step down so he can run for office in the Catalan elections of February 14 with the Catalan Socialist Party (PSC).

The slow rollout of the vaccination program, which has been seen in other areas such as Catalonia, has raised doubts among experts over whether the government’s objective of vaccinating 70% of the Spanish population before the end of the summer will be possible.

Vaccination is a national problem. The strategy is a national problem and the government of Spain should be at the helm

Madrid regional premier Isabel Díaz Ayuso

Madrid’s deputy health chief, Antonio Zapatero, explained during a press conference on Saturday that there had been a number of obstacles in the way, ranging from a one-day delay of the vaccines’ arrival early last week due to a logistical problem with manufacturer Pfizer, to the difficulty of administering the shots in senior homes, given that many residents had opted to spend the Christmas holiday with relatives.

Last week was practically a lost week for the program, since no vaccinations were administered between December 31 and January 3, given the weekend and the New Year holidays. The regional health department has not reorganized the timetables of medical workers so that they can be on hand to administer the vaccine on weekends.

“It wasn’t the best week,” said Zapatero on Saturday, adding that this week around 15,000 people would be vaccinated and arguing that the regional health department is prepared to ramp up the rate at which vaccines are administered. “Sermas [the Madrid Health Service] has the capacity to vaccinate more people, but fundamentally we are limited by the number of vaccines we receive each week,” he said.

The region has trained 46 pairs of nursing staff, who are administering the vaccines to seniors in residences – the first group that has been chosen to be immunized, given their vulnerability to the coronavirus. Each nurse has been given an objective of 25 doses a day, which will rise to 50 in the coming weeks according to the staff themselves.

But there have been other problems, according to health workers consulted by EL PAÍS. They report having to work with a registration system where the clinical history of the patient does not appear, meaning they lack information such as allergies, and that they were also given syringes initially that did not allow them to regulate the dose to the required 0.3 milliliters. They also report lacking protective equipment against accidental needle jabs, and also cite the fragile health of the seniors receiving the vaccine. “One man fainted after receiving the vaccine and we had to treat him,” one nurse, who requested to remain anonymous, reported. “If they want to speed up the rhythm of vaccination there will be no other option but to increase the number of nurses.”

On Monday, the Madrid regional health chief, Enrique Ruiz Escudero, argued that the process had been slower given that senior homes requested that the campaign begin after December 31 to avoid coinciding with a time when many residents were staying with relatives.

Ruiz Escudero also opened the door to the campaign being placed in the hands of private companies. Given the situation, he said, “all resources necessary” will be used, “whether they are public or private ones as needed.”

Catalan plans

The process has also gotten off to a slow start in Catalonia, which will receive 60,000 doses a week. By Sunday, the region had administered the vaccine to 7,774 people, barely 13% of the number who should have got it during the first week of the campaign, according to forecasts. The Catalan health department announced on Sunday that from now on it will be administering vaccines every day of the week (including holidays) in order to speed up the process. “We were, perhaps, too optimistic,” said Carmen Cabezas, in charge of the vaccination process in the region, adding that there were problems in recruiting nursing staff for the program.

The central Health Ministry wants this first phase, which is due to run until the end of March, to see all seniors and their carers in the country’s residences vaccinated, along with front-line medical staff. The objective of vaccinating 70% of the population by the end of summer appears to be too optimistic. In other developed countries the immunization process has also begun slower than expected.

Some epidemiologists consulted by this newspaper said that they thought the vaccination data from the first week was disappointing, but they understand that the process would be difficult. “It’s not unusual for there to be a certain sluggishness at the start until the machine is well oiled,” said Fernando García, spokesperson for the Madrid Public Health association. “It will have to speed up to reach the planned rhythm and also to compensate for the delays in these first weeks.”

Madrid has been particularly hard hit by the coronavirus pandemic, and has confirmed nearly 400,000 cases of the coronavirus according to the latest Health Ministry report, released on December 31. This is the highest figure for all of Spain’s territories, followed by Catalonia with 356,724. The number of confirmed Covid-related deaths currently stands at 11,828 in Madrid, and 8,723 in Catalonia.

English version by Simon Hunter.