Spain’s Health Ministry to consider delaying second Covid-19 vaccine shots in order to speed up campaign

The measure would involve increasing the gap between the two doses of the Pfizer and the Moderna medications to eight weeks for the under-80s. A decision is still pending on whether the under-60s should get their second injection of AstraZeneca

A mass-vaccination site in Valencia on Monday.
A mass-vaccination site in Valencia on Monday.Mònica Torres

Spain’s Health Ministry and regional governments are considering whether to change the country’s Covid-19 vaccination strategy, and delay the administration of the second doses of the Pfizer-BioNTech and Moderna vaccines. Until now, a total of 21 and 28 days, respectively, were being left between the two shots necessary for the full protection offered by the vaccine, in line with the manufacturers’ recommendations.

Some of the country’s regions, including Catalonia, Madrid and Andalusia, had already suggested such a change to the process, and now the ministry is likely to debate the move today during a meeting of the Public Health Commission. The proposal will focus on leaving eight weeks between shots for the under-80s, in a bid to speed up the rate of vaccination. Among the over-80s, 98% of whom have had their first dose and 58% of whom have had two, the second injection will be given following the regular time frames.

Spacing out the vaccination allows us to gain time to immunize more people
Catalan health chief, Alba Vergés

All three of the vaccines currently being used in Spain – Pfizer, Moderna and Oxford-AstraZeneca – require two doses, although the first injection does offer high levels of protection. According to a study by the Center for Disease Control in the United States, one dose of Pfizer or Moderna offers 80% protection, while the figure is 76% for AstraZeneca.

The regions are calling for a change in approach given the problems that have been encountered with AstraZeneca, whose use was suspended by a number of European countries – including Spain – due to cases of rare blood clots after its administration. The Janssen one-dose Covid-19 vaccine has also been suspended after similar incidents were detected. Madrid and Catalonia have called for the time between doses to be increased to 42 days in a bid to speed up the process and give as many people as possible some level of protection. “Spacing out the vaccination allows us to gain time to immunize more people,” said last week the Catalan health chief, Alba Vergés.

Covid-19 vaccines are administered in Seville University on April 5.
Covid-19 vaccines are administered in Seville University on April 5.PACO PUENTES

If the idea is approved, the proposal would mean a radical shift in Spain’s vaccination strategy, in line with, for example, that of the United Kingdom, which opted to do the same with the AstraZeneca vaccine (the second dose is administered after 12 weeks). The debate centers around whether the technical prospectus of the vaccines should be followed to the letter in order to provide the greatest protection possible to the most vulnerable groups of society or whether to give a single dose to as many people as possible. France and Italy, for example, have also given the green light to leaving 42 days between doses.

As well as being debated in the Public Health Commission, the proposal will also have to be approved by the Inter-Territorial Council of the National Health System (CISNS), which brings together the country’s regional healthcare chiefs and the central Health Ministry.

“Not the ideal approach”

“The second dose can be delayed up to 42 days,” explains Amós García, the president of the Spanish Vaccinology Association. “There is a possibility of a delay. A first dose provides more than sufficient protection, in particular for the most serious forms [of Covid-19], against which [recipients] would be clearly protected.” The expert believes that the measure “could be a good strategy within a context of a vaccine deficit.” But he has a clarification: “It’s not the ideal approach,” he says. “The ideal thing is to comply with the data sheet. And it appears that a quite significant number of Pfizer vaccines are due to arrive and that will also have to be taken into account and evaluated before a decision is taken.”

The Health Ministry is also yet to decide what to do with the under-60s in Spain who were given a first dose of the AstraZeneca vaccine. After the health authorities confirmed an association with a tiny number of very rare blood clots, the Spanish Health Ministry and the regions agreed to limit the use of the medication to the 60-to-69 age group. But people under that age – in particular essential workers such as teachers and members of the emergency services – have already received their first dose of AstraZeneca. The options on the table include a second dose of another vaccine, or administer a second shot of AstraZeneca.

With reporting by Silvia Ayuso and Daniel Verdú.

English version by Simon Hunter.

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