A million Spaniards due second AstraZeneca shot will have to wait another month

On Tuesday, May 4, it will have been 84 days since the first doses of Oxford-AstraZeneca Covid-19 vaccine were administered in Spain. That’s 12 weeks – the maximum time that the technical sheet for the Covid-19 vaccine recommends between the two injections necessary to offer full protection. The Public Health Commission, which is made up of the central Health Ministry and the country’s regions, met today to decide what course of action to take for the more than a million under-60s who have received their first dose and have been left in limbo ever since the Spanish health authorities opted to use the medication exclusively for the 60-69 age group given concerns over the tiny risk of blood clots associated with AstraZeneca. In the end the health authorities have opted to delay the decision for another four weeks.

The only way to move forward with such uncertainty is to follow the indications from the professionals, and do what the doctors say

Isabel Solís, 36-year-old teacher in Seville

The group affected is made up of essential workers who began receiving the vaccine from February 9 onward. Around a million of them had got their first shot when the Health Ministry took the first decision to suspend the use of the vaccine on March 15. When the process restarted, the vaccine was being given to the same group as well as among the general population up to the age of 65.

But on April 7, when 2.1 million people had been given the shot, its use was halted once more leaving the under-60s in limbo (the ministry has not supplied information on exactly how many people are affected). The ministry decided to only use AstraZeneca on the 60- to 69-year-old group, given that the blood clot cases that had been registered were mostly among younger people.

This left the remaining essential workers without their first shot, and those who had been vaccinated with the first dose in the dark about what would happen next. The ministry stated that it would study the situation to decide whether to administer another AstraZeneca shot, use a different vaccine or simply skip the second injection altogether.

Germany and France have opted to use the Pfizer-BioNTech vaccine in these cases, while in the United Kingdom and Italy they are sticking with a second shot of AstraZeneca. Spain had let time pass without making a decision, despite the recommendation from the European Medicines Agency (EMA) for the second dose of AstraZeneca to be used, given that, in its opinion, the benefits greatly outweigh the risks.

On April 19 the Carlos III Institute began a study to examine the effectiveness and safety of combining two different vaccines so that a decision could be taken based on that evidence. But earlier this week, Fernando Simón, the director of the Health Ministry’s Coordination Center for Health Alerts (CCAES), admitted that the volunteers needed for the research had still not been recruited.

Germany and France have opted to use the Pfizer-BioNTech vaccine as the second shot, while in the United Kingdom and Italy they are sticking with AstraZeneca

In the end, the Public Health Commission decided on Friday to wait for the results of this study, which will show the effectiveness and safety of using a second dose of the Pfizer-BioNTech vaccine after a first dose of AstraZeneca, before making a decision. Essentially, this means that some people will now not get their second dose of vaccine until 16 weeks after the first.

The Commission pointed out on Friday that the first dose of AstraZeneca has an 80% level of effectiveness. The Health Ministry justified its decision with the following statement: “Spain, like Ireland, and following the principle of caution, is opting to wait until it has more information from the studies that are underway and the experience of other countries.” It added: “The under-60s have a lower risk of serious illness [from Covid-19] and the priority right now is to vaccinate the over-60s as fast as possible to avoid hospitalizations and deaths in an epidemiological situation of rising cumulative incidence.”

Meanwhile, the people affected by the delay are still without news about their future. They are police officers, members of the military, teachers, prison workers and front-line healthcare workers, many of whom have complained about the “uncertainty” that surrounds them right now.

“I am pro-vaccines but the whole thing is happening in such a way…,” said Isabel Solís, a 36-year-old teacher in Seville, Andalusia. She was given her first dose of AstraZeneca on March 2 and says that she has felt that sense of uncertainty ever since the second dose was suspended. “The only way to move forward with such uncertainty is to follow the indications from the professionals, and do what the doctors say,” she added. The Andalusian regional government wants the under-60s to be vaccinated with the second dose of AstraZeneca, albeit on a voluntary basis. “I would take it,” said Solís.

English version by Simon Hunter.