April will represent a before and after for Covid-19 vaccinations in Spain. While a large number of doses are still arriving in the country, around a million a week, all of the pharmaceutical companies are planning to increase their deliveries next month. And that is when another vaccine is likely to be added to the three already being used by the Spanish authorities: the one made by Janssen, which is due to be approved for use by the European Medicines Agency (EMA) on March 11.
The vaccine made by Janssen, a company that belongs to pharmaceutical giant Johnson & Johnson, only requires a single dose to offer its full protection against Covid-19. This means that double the population can be inoculated with the same number of jabs of the Oxford-AstraZeneca, Moderna and Pfizer-BioNTech vaccines that have been used in the Spanish campaign up to now. Speaking on Monday on the Cadena SER radio network, Health Minister Carolina Darias said that 4.8 million doses from Janssen are due to arrive in Spain in April.
Spain is due to receive 30 million doses between April and June, which is 2.3 million doses a week – more than sufficient to meet the objectives
Assuming that there are no unforeseen events, the Spanish government’s target of vaccinating 70% of the adult population during the summer would appear to be possible – at least in terms of the number of doses that will be available. It is yet to be seen whether the country’s regional health systems – which are in charge of the vaccination process as well as the overall control of the pandemic in their territories – are capable of administering them in a timely fashion. Given that the pharmaceutical companies and governments themselves are only releasing information on the plan bit by bit, it’s difficult to establish dates, but it is possible to make an approximate forecast of what is to come.
Including this one, there are 28 weeks left to go until the end of the summer. The objective is to vaccinate a minimum of 33 million people (70% of the adult population), for which it will be necessary to have 66 million doses (in the case of the vaccines that require two jabs). This means that after subtracting the vaccines that have already been administered, a maximum of 2.2 million injections will be needed on a weekly basis between this week and September 21. In practice, fewer will be needed given that the Janssen medication requires just a single jab. But it is difficult to establish by an exact number, given that it is not known how many vials of the drug will be arriving in the second quarter – only that Spain is due to receive 21 million doses between now and the end of the year.
The European Commission revealed on Monday that between April and June, it is hoping to distribute 300 million doses, which is 20% fewer than planned. Even so, Spain is due to receive 30 million doses, which is 2.3 million doses a week – more than sufficient to meet the objectives. Until now, Brussels was expecting to receive 300 million doses from the three pharmaceutical companies whose vaccines have been authorized (Oxford-AstraZeneca, Moderna and Pfizer-BioNTech), with the total rising to 380 million with the likely incorporation of the fourth (Janssen).
So far, Spain has administered more than 4.6 million doses, which is 83.4% of those it has received. The best time to check this percentage is on Tuesday afternoons, given that by that point a week has passed since the regions have taken delivery of fresh vaccines and have had the time to administer them.
With the large majority of care home residents and frontline healthcare workers vaccinated, the regions are now concentrating on administering the AstraZeneca vaccine to essential workers under the age of 55 and the others vaccines to the 80-and-over population. This process began around two weeks ago, although the exact date varies from region to region.
While most regional governments are not supplying data by groups, those that do are providing an idea of the rate: Catalonia has administered the first dose to 11% of the 80-and-over population, Galicia to 20%, Extremadura to 25% and Andalusia nearly half. Even in the best-case scenario, there is still a majority left to inject.
The order of this group also varies from region to region. Galicia is going by alphabetical order, starting with the letter H. Other regions, such as the Balearic Islands and Navarre, are focussing on the oldest citizens first. Madrid and Aragón are going by age, but each healthcare center is in charge of its own organization – depending on the area, there are some younger over-80s who have been vaccinated than in other places. Others have not communicated any specific order.
In most regions, this group is being mixed with another that was part of phase 1 of the campaign: adults with disabilities who do not live in care homes. Some overlap was expected in order to ensure that the process was agile. But in Madrid and Andalusia, the regions started with this segment after the over-80s, thus ignoring the national vaccination protocol. Sources from the unions and some regions explain that it has been very difficult to get to the homes of the disabled, and as such these injections have been delayed in order to move along with the process as quickly as possible. Madrid already did something similar when it opted to vaccinate most healthcare workers ahead of care home residents, given that the former process is much quicker than any other.
Once the over-60s are vaccinated with the Pfizer and Moderna vaccines, the campaign will move onto vulnerable people under the age of 60. The Health Ministry is yet to define exactly who will fall into this category of “vulnerable.” The Platform of Patient Organizations (POP) believes that “they have to take advantage of the vaccination strategy in order to include the groups of most vulnerable clinically ill.” The platform’s spokesperson, María Gálvez, admits that the current system of ages is comfortable and easy to explain, but that “there are people who spend the day in hospital and who are dying.”
EL PAÍS has consulted the regions about how the campaign is progressing, and here are their responses along with data from the central Health Ministry.
The Andalusia region is nearing a million people with the first dose of the vaccine: 934,708 which is 7% of its 8.4 million residents. Meanwhile, 255,876 people (2.95%) have had the two doses needed for the full protection offered by the Covid-19 vaccines being used. After the process was completed in the region’s 655 care homes, the regional government is now finishing the process of vaccinating healthcare professionals, with 83% having received both doses. The 400,000 in the 80-and-over population are now in the process of receiving the Pfizer and Moderna vaccines. Half have received the first dose, and 6% both doses, according to data from March 5. The regional government is also vaccinating the disabled in their homes as well as grade-three disabled people who cannot travel to vaccination sites.
Meanwhile, teachers, police officers and Civil Guard officers under the age of 55 are receiving the AstraZeneca vaccine, a process that began last week. The regional government is keeping back a reserve of 20% of and 40% of the Pfizer and Moderna drugs, respectively, but is using all of its AstraZeneca doses. Just 0.63% of the population has opted not to be inoculated so far, but the regional government has not specified the reasons given for refusal.
Aragón is expecting to vaccinate 30,090 people this week with the Pfizer vaccine (17,790 doses), Moderna (2,200) and AstraZeneca (10,100). Target groups that are already getting their shots will continue to do so: public and private medical personnel (12,900), residents and workers at care homes (537), people with severe disabilities who are not in care facilities as well as people 80 and over (10,860) and other healthcare professionals (5,793). According to Health Ministry data, 98.3% of people living in care facilities have had their first shot, and 91.7% have had both. Frontline healthcare workers and those in primary care have also been almost completely immunized.
As for people 80 and older, Aragón is prioritizing the oldest among them, although local healthcare centers are being allowed to make their own decisions due to the dynamics of population dispersal and geographical differences in the region. Last week, teachers and other school workers began getting their shots. Other essential workers such as firefighters, law enforcement officers and healthcare professionals not in the front lines are being asked to make their own appointments for a jab at one of the region’s vaccination sites. Health Ministry data to March 6 shows that Aragón has administered 153,194 doses, or 87.3% of all available doses.
Asturias has administered 128,435 doses of the Pfizer vaccine, 12,700 doses of Moderna and 25,200 doses of AstraZeneca, representing 80% out of a total available stock of 166,335 doses. There are 44,596 people who have received both shots. In Asturias, older people are being prioritized and vaccinated at health centers in the eight healthcare areas that the northern region is divided into. Vaccination teams are also visiting the homes of people with severe disabilities that prevent them from going to their local health center. There are also a few mass vaccination sites such as the sports center Palacio de Deportes in Gijón.
The region has administered 83.2% of available doses. All workers and residents of care facilities have now been immunized, as have 80% of frontline healthcare workers at hospitals. Another 20,400 healthcare professionals have received their shots, and members of the next priority group within the category are now getting vaccinated, including podiatrists, veterinarians and dentists.
Around 3,500 people with severe disabilities who are not in care homes have been vaccinated, representing 70% of the total, as well as 1,400 caregivers. Around 2,600 people 95 and over have had their first shot, and those between 90 and 94 started their inoculations this past weekend. Teachers and local police officers began receiving appointments on February 27. Since Monday of this week, they have been joined by Civil Guard and National Police officers, emergency service workers, firefighters, civil protection workers and members of the armed forces.
People 80 and older are generally being vaccinated at healthcare centers except when their medical condition prevents them from doing so, in which case teams are dispatched to homes. Other groups are being called to so-called Covid Express sites, which will immunize an estimated 80,000 people a week on the islands.
The Basque healthcare system has managed to administer 70.6% of the vaccines received until now. This week the plan is to inject 45,263 doses (34,929 from AstraZeneca, 6,037 from Moderna and 4,297 from Pfizer). The Basque Country has opted to change its strategy to speed up the process and will only reserve 10% of the vials it is receiving, compared to 50% at the start. A total of 124,365 first doses have been injected, while 55,000 people have been given the two needed for full protection. These are mostly residents and carers in senior homes (98.9%). What’s more, 84% of doctors and nurses from the public health system (of a total of 42,000) have been given the first jab while four in 10 have received both.
From the private healthcare system, 81.8% of staff have also got their first jab. As for essential workers, 87.6% of the regional police (a total of 4,700 officers) have received the first dose. The health chief, Gotzone Sagardui, is due to report on the vaccination plan for the week later on Tuesday.
Cantabria has received 62,745 doses of the Pfizer vaccine, 5,900 of the Moderna and 14,300 of the AstraZeneca. Out of the total 82,945 doses, 60,014 (82%) have been administered, and 21,002 care home residents have already had their two jabs.
On the Canary Islands, 80.9% of the received doses have been administered, with a total of 54,926 people having received their two jabs – 4% of the target population. In terms of groups, 97.8% of group 1 have received their first dose (senior care residents and staff); 96.6% of group 2 (frontline healthcare workers); 97.4% of group 3 (other healthcare and care home staff); 67.1% of group 4 (people with serious disabilities who do not live in care homes); 17.9% of group 5 (people aged 80 and over); and 6.73% of group 6 (active collectives with an essential role in society). The regional healthcare department has reported that refusal of the vaccine is practically non-existent on the islands, and only accounts for 0.5% to 1% of the current groups.
The Castilla-La Mancha region has given two doses to 72,611 people, including 100% of senior home residents, 95% of frontline health staff, 70% of the disabled who are housebound, and 7% of the 80-and-over population. On Monday, the campaign moved onto the National Police and Civil Guard, while the next group will be primary and secondary teaching staff.
Of the 259,575 received doses (190,575 from Pfizer, 18,600 from Moderna and 50,400 from AstraZeneca), a total of 201,466 have been administered, which is 77.6%.
Among the 80-and-overs, the eldest citizens are being given priority. People with private health insurance, the regional government reports, are being included in the campaign. “They are being vaccinated at the same time according to the [age] group they belong to,” a spokesperson reported.
Castilla y León
The Castilla y León region has received 285,195 doses of the Pfizer vaccine, 27,300 of the Moderna and 59,000 of the AstraZenceca. That gives a total of 371,495 vials, of which 82.4% have been injected. A total of 99,651 individuals have received the full two doses.
The regional healthcare chief reports that medical professionals who are not on the front line are currently being vaccinated, as well as the disabled, people aged 80 and over and essential workers. Seniors and the disabled who cannot travel to healthcare centers will be vaccinated in their homes. People with private insurance are also being included in the campaign.
Catalonia is finalizing the vaccination of care home residents and medical staff. The health department has administered the two doses to 82.3% of the seniors living in care homes, and to 60.4% of medical staff. The process of vaccinating the disabled and those who need home care is currently underway, with 38% having received the first jab. Essential workers are also being vaccinated with the AstraZeneca vaccine – the coverage with the first dose among teachers is at 30.4%; at 64% for police and firefighters; and at 55% for pharmacists. Catalonia has administered the first dose to 11% of the population aged 80 and over, while the department has also begun to cite transplant recipients. In total, Catalonia has administered a total of 774,027 vaccines as of this Monday.
Health officials in the western region said the vaccination is taking place “at a good pace” and lamented not having more doses. “In an ideal scenario, we could administer 175,000 vaccines a week,” said the Extremadura health department chief, José María Vergeles.
On Sunday, Extremadura had vaccinated 84,413 people with 129,850 doses, and 45,437 were fully vaccinated. At care homes, the immunization rate is now 90% and no positive cases have been reported. Healthcare workers and other workers at public hospitals, private clinics and healthcare centers have also been immunized (except for those on leave, who will be vaccinated when they return to their posts). And 8,230 people with severe disabilities who are not living in care facilities have also been inoculated with the Covid-19 vaccine.
As for the 80-and-over population not living in care homes, 18,280 out of a group of 72,000 have already been immunized. Essential workers (firefighters, law enforcement officers, non-university teachers) are now being vaccinated as well as students of medicine, nursing, occupational therapy and physiotherapy who are doing internships at hospitals or other medical centers. Other healthcare professionals including pharmacists veterinarians and podiatrists are also in line for vaccination at this time.
Galicia has administered 87.7% of the received doses and has given 75,259 people of the 2.7 million residents in the region their two jabs. The Galician health system (Sergas) will this week start to immunize the nearly 250,000 Galicians aged between 50 and 55 with the AstraZeneca vaccine. Among the 80-and-over population, who began to receive their vaccines from February 22, 45,000 people have already had their first dose (just over 20% of the total in that age range). From this group, only those who can travel to their healthcare centers are receiving the jab, while in other cases, where a citizen cannot leave their home, a date has yet to be set for when nurses will be able to attend to them. In all age groups in Galicia, the injections will be administered in alphabetical order, starting with the letter H, which was picked randomly.
The regional government is due this week to finish administering the first AstraZeneca dose to teachers under 55 – so far more than 25,000 have received the injection. In the field of education, the next step will be to immunize non-teaching school staff. Meanwhile, medical staff, teachers, police officers, firefighters, prison workers, social services staff and emergency workers are also getting their first AstraZeneca jab, with Civil Guard officers due to be next in line. A total of 92% of senior home residents have got their two doses, while 99% have had their first.
La Rioja has administered 82.5% of available doses. This week, people with severe disabilities will receive their second jabs, while the 80-and-over population will start getting their first. Essential workers under 55 years of age will get their first dose of the AstraZeneca vaccine. Authorities are using some sports centers and parking lots as mass vaccination sites.
In Madrid, a total of 643,424 doses have been administered as of Monday, which is 86% of those delivered. A total of 179,265 people have been given both jabs. While the health department has not supplied percentages in terms of groups, on Friday the deputy public health chief Antonio Zapatero stated that “more than 90,000 people aged 80 and over, 30,000 members of the armed forces, emergency services and civil protection, 34,000 teachers and 2,500 people with disabilities” had received the vaccine.
This week the process will begin to vaccinate the disabled who are in their homes and are unable to travel to a vaccination site, as well as those who can reach their healthcare center – “More than 23,000 people,” according to Zapatero.
What’s more, the health chief added that “98% of senior home residents have received the full vaccination,” which has led to a 96% drop in Covid-19 cases in such centers and a 73% fall in hospitalizations among this group.
The region explained that “all of these groups are underway,” and that one of the priorities, that of the over-80s, is proceeding from the eldest to the youngest at healthcare centers. This includes people with private health insurance: “They are included,” the region reports. But in an email sent by the Madrid regional government, to which EL PAÍS has had access, primary healthcare centers are advised not to make any new appointments to vaccinate people aged 80 and over. According to a spokesperson from the Madrid health department, this change is due to a “shortage of vaccines.” “The speed of the vaccination is going to slow because we have to reserve doses for the second jabs,” they said.
In the Murcia region, the process of administering the AstraZeneca vaccine to teachers and staff under 55 from preschools and special education began on Sunday. This group is made up of 10,572 people. This week, teachers and staff from primary and secondary schools are expected to join the campaign, a total of 28,240 people. A regional spokesperson stated that the 38,912 teachers aged under 55 in the region are likely to be vaccinated in the next two weeks. Meanwhile, the campaign continues for healthcare and social workers, as well as the 80-and-over population and people who need daily assistance who are not in care homes.
In Navarre, 77,694 doses have been administered out of a stock of 84,845. A total of 25,124 people have had both shots. The vaccination campaign at long-term care facilities ended on February 12 and immunized 94% of residents. The regional health department said that only four coronavirus cases have been detected at these centers since that date. Around 2,000 people with severe disabilities who do not live in care facilities have also been fully vaccinated. Immunization of healthcare workers will end this week, as well as some essential worker groups such as police officers and firefighters.
Last week, health authorities also began inoculating the 90-and-over population in cities, and the 80-and-overs in rural areas. “Navarre is vaccinating at top capacity based on the doses that we receive,” said a government spokesperson.
In the Valencia region, 54,900 new doses of the Pfizer vaccine arrived at the Manises Airport on Monday. With these vials, the vaccination of disabled people aged over 55 and who are not living in care homes will continue, as will the vaccination of the 80-and-over population. The former will be vaccinated in their homes by the nearest healthcare staff, while the second will have to attend their local healthcare centers.
What’s more, residents of senior homes where outbreaks had been detected in previous months will receive their first or second dose from this week, while public and private healthcare staff will also get their first or second jab. Professional carers are set to get their first injection from this week. This week a total of 70,000 doses are due to be administered, compared to 82,000 last week.
On Saturday, the process of administering the first dose of the AstraZeneca vaccine to the security forces, firefighters and civil protection was completed. Just 31,7000 doses of the Moderna vaccine have arrived in Valencia since its approval. Sources from the regional health department have voiced concerns over the difficulty of planning the campaign when they cannot regularly count on the expected doses. As such, it has opted to keep back a number of vials in order to ensure the second dose can be administered within the recommended time frame.
In the Valencia region, 394,021 doses have been administered. A total of 113,077 people have received both jabs. From April, 161 points in the entire region will be used for mass vaccination, a process that will depend on the arrival of the vaccines that have been promised.
With additonal reporting by Bernardo de Miguel, Bernat Coll, Juan Navarro, Sonia Vizoso, Lucía Bohórquez, Silvia Norte, Isabel Valdés, Lucía Tolosa, Ferran Bono, Elisa Tasca, Guillermo Vega, Mikel Ormazabal, Emilio de Benito and Javier Martín-Arroyo.