Spain’s Covid-19 vaccination drive moves on to people in their seventies and high-risk patients

As Spain’s coronavirus infection figures begin to climb again, authorities are racing to step up the vaccination effort despite this week’s news of a pause in the rollout of Johnson & Johnson’s Janssen vaccine due to blood clotting concerns.

Practically all of the 80-and-over population (95.6%) has received the first dose of one of the two Covid-19 vaccines being administered to this age group, Pfizer-BioNTech and Moderna. While they await their second shot, healthcare centers have begun calling in people in their seventies, representing over 3.9 million individuals. Of these, 21.4% have already had at least one injection.

Simultaneously, this week most of Spain’s regions are starting to immunize 355,000 people with medical conditions that make them particularly vulnerable to Covid-19, including individuals who have undergone certain types of transplants, those on dialysis, some cancer patients and those with depressed immune systems.

So far, the 70-to-79 age group has been receiving the Pfizer and Moderna vaccines, although there were plans to add Janssen to the list starting on Wednesday. On Tuesday, however, the pharmaceutical company announced a halt on its European rollout after US federal health authorities recommended pausing its use over sporadic cases of blood clots among recipients in that country. A similar decision recently affected another vaccine that is being used in Spain and elsewhere in the European Union, made by AstraZeneca and Oxford University.

The Janssen vaccine only requires one shot, and 300,000 doses were expected to arrive in Spain during the month of April. By comparison, 2.7 million doses of the Pfizer vaccine are due to arrive over the same period.

The good news is that immunization of the 70-to-79 group is moving along much faster than the 80-and-over group, which required two months. Early estimates place completion of first injections by early May.

In the meantime, people between 60 and 69 years of age are being immunized with the AstraZeneca vaccine. The Health Ministry is still deciding what to do with essential workers under that age who already received their first dose of this treatment, but who are no longer eligible for the second following a recent change in the government’s vaccination criteria. Despite some reports of citizen rejection of AstraZeneca following widespread media coverage of rare blood clotting cases, most regions said that a majority of people are going to their appointments.

Andalusia

Immunization of the 70-to-79 age group is being conducted at the usual vaccination sites, which include local healthcare centers and large facilities. The Andalusian health department is contacting eligible individuals through SMS messages on their cellphones. Progress is uneven across the different provinces. Virgen del Rocio Hospital in Seville has also begun to immunize patients with medical conditions that make them especially vulnerable to the disease.

Aragón

People who are turning 73, 74 and 75 this year can make an appointment for a shot of the Pfizer or Moderna vaccine. Those between 60 and 62 years of age will be called in for a dose of AstraZeneca.

Asturias

Around 97% of the 80-and-over population has had their first dose, and 53.2% has had both. A third of residents in their seventies have received their first injection.

Balearic Islands

The regional health department wants to start immunizing the 70-to-79 age group as well as patients with medical conditions that make them very vulnerable to the disease. The islands will receive 18,000 fewer vaccines this week, a substantial decrease due to a production drop at AstraZeneca. These doses will go to people in their sixties and essential workers. Authorities have reported isolated cases of people rejecting this vaccine.

Basque Country

The Basque Country has finished administering the first shot of the Covid-19 vaccine to the 80-and-over population and has begun to vaccinate those aged between 70 and 79, starting with the oldest people in this bracket. According to the regional health chief, Gotzone Sagardui, the vaccines are being administered as fast as they are being received. The region received 70,207 doses of the Pfizer vaccine on Monday and 6,400 of the AstraZeneca vaccine on Tuesday. The regional health department has been making vaccine appointments for people with chronic conditions and serious illnesses, such as transplant recipients and cancer patients, since last week.

The region is continuing to wait for a decision to be made about what to do with people under 60 who have received the first dose of the AstraZeneca vaccine, given this medication is now restricted to the 60-to-69 age group. The Basque government has not ruled out any of the three possible options – administering a second dose of AstraZeneca, using another vaccine or not administering the second injection at all, as the first one is considered to be 70% effective against Covid-19. Basque authorities have, however, indicated that this is a decision that should be made nationally.

Canary Islands

Regional healthcare sources said that vaccination has not been halted on any island and that there has been no significant rejection of the AstraZeneca vaccine.

Castilla-La Mancha

This region has begun immunizing people in their seventies and patients with high-risk conditions, said a government spokesperson. The 60-to-69 group is also being called in for AstraZeneca shots. Overall, 16,386 citizens under the age of 80 have received a dose.

Castilla y León

Regional premier Francisco Igea said on Monday that he expects 70% of the population to be vaccinated 30 to 50 days from now. So far, 22.1% of residents have received at least one dose.

Catalonia

In Catalonia, 85% of the 80-and-over group have had their first shot, and people in their seventies are being called in this week for an injection. Immunization is also proceeding for people in their sixties and for individuals with high-risk medical conditions. On Tuesday, the regional government said that rejection of the AstraZeneca vaccine was in the range of 10%, but that these individuals will be called later in the year for a new appointment.

Galicia

Galicia began to vaccinate people between 70 and 79 years of age this week in the main cities of the region. Appointments are made via text message and confirmed by phone. A total of 50,000 doses of the Pfizer vaccine will be administered to this age group this week. People with serious health conditions began to receive their first shot on Monday. Some 35,500 doses of the Moderna vaccine have been earmarked for this priority group. The region is also set to receive 7,500 doses of the AstraZeneca vaccine, which will be used in a new mass vaccination campaign next weekend which is aimed at the 15,000 residents between 60 and 65 years of age.

La Rioja

La Rioja began to vaccinate people in the 70-to-79 age bracket on Monday. According to sources from the regional health department, this group will receive their first dose at the vaccination site set up in the exposition center Riojaforum and in mobile units that will travel to each basic health zone, beginning with those in Haro, Nájera, Santo Domingo de la Calzada and Murillo. Around 2,000 people from this age group are scheduled to get a shot every day. Sources from the health department consider the speed of the vaccination drive to be “satisfactory.” La Rioja also began on Monday to administer the vaccine to people with pre-existing medical conditions or diseases that make them vulnerable to the virus. This is being done in San Pedro Hospital, where the Moderna vaccine is being used, and in Fundación Calahorra Hospital, which is using the Pfizer vaccine. With respect to the delays in the arrival of the AstraZeneca vaccine, sources from the health department say the vaccination plan “is being adjusted according to what is delivered” and will continue to vaccinate the 60-to-65 age group with the doses that have been so far received.

Madrid

Madrid regional officials want to let citizens voluntarily get immunized with AstraZeneca doses and they are asking for the elimination of current guidelines on target groups, given the new delays expected by the halt on Johnson & Johnson’s Janssen vaccine rollout and by concern over blood clotting reports among Janssen and AstraZeneca recipients. “If there are citizens who don’t want to [receive these vaccines], there are many more who do,” said Madrid premier Isabel Díaz Ayuso of the Popular Party (PP) on the regional public broadcaster Telemadrid.

Regional authorities also want to extend the waiting period between the first and second doses for AstraZeneca, Pfizer and Moderna. Madrid officials are expected to make their case for these changes at a Wednesday meeting of central and regional health authorities. Spanish Prime Minister Pedro Sánchez of the Socialist Party (PSOE) has criticized Madrid’s position.

This week, the Madrid region will administer “nearly 150,000 doses” of the Pfizer vaccine to the over-75s in primary healthcare centers, according to a press release from the regional government. People in the 70-to-74 age bracket will also receive this vaccine, which will be administered in the hospitals of 12 de Octubre, Gregorio Marañón, La Paz and Fundación Jiménez Díaz.

With respect to people with serious medical conditions, the vaccination drive begins this week in 15 public hospitals. “These people will be contacted directly by the hospitals that usually treat them for their illness to set an appointment and will receive the Moderna vaccine,” the press release said.

According to a spokesperson from the regional health department, “only 20,000” doses of the AstraZeneca vaccine are estimated to arrive this week. Due to this “shortage,” Puerta de Hierro Hospital in Majadahonda and six hospitals in the south of the region will not be able to continue administering the vaccine until a new shipment arrives.

Murcia

Murcia began to vaccinate the 70-to-79 population last week and this week will begin to immunize people with medical conditions and illnesses that make them especially vulnerable to Covid-19. According to a spokesperson from the regional health department, 70% of those scheduled to receive the AstraZeneca vaccine are going to the appointment, compared to nearly 85% for the Pfizer vaccine.

Navarre

The vaccination of the 70-to-79 age group began last week. This week, the region has begun immunizing people “at very high risk” of developing a serious case of Covid-19, such as transplant recipients, cancer patients and the over-40s with Down syndrome. Generally, this group is vaccinated in a hospital.

With respect to the AstraZeneca vaccine, the Navarre government says that only an “insignificant” number has refused the medication at a vaccination site while a little more than 4% have refused when called in for an appointment, a slight rise from when the age criteria changed.

Valencia region

The Mediterranean region is expecting to administer 213,000 doses this week despite a smaller shipment than expected. Authorities said that they will do a follow-up of vaccinated people for a month after inoculation to enquire about potential adverse effects, the regional daily Información reported.

English version by Melissa Kitson and Susana Urra.