Spanish health authorities approve the Janssen vaccine for use among the under-60s

The Spanish Health Ministry and the country’s regional governments on Tuesday approved the use of the Janssen single-dose Covid-19 vaccine among the under-60s. The decision was taken at a meeting of the Public Health Commission, at which the officials also decided to focus the ongoing vaccination campaign on “people who are very vulnerable, such as those with major disabilities and accessibility problems, those with autism or severe mental illness,” according to a statement from the ministry.

The first group, those aged between 50 and 59, number 7.03 million people in Spain, according to Health Ministry reports. Around 17% (1.2 million people) have already started their vaccination process given that they belong to other target groups that have been designated priority. Of these, 459,000 have received the full protection offered by the vaccines, i.e. two doses, according to the latest data from the ministry.

Healthcare personnel and carers among this age group account for some of those citizens who have already been immunized, in this case using the Pfizer-BioNTech and Moderna vaccines, which use the new messenger RNA technology to offer protection against Covid-19.

Essential workers such as teachers, police officers, soldiers and prison guards, meanwhile, have been given the Oxford-AstraZeneca vaccine, although this process has encountered a number of bumps in the road, after the detection of a tiny number of cases of rare blood clots associated with the medication.

The Health Ministry has opted to extend the time between the first AstraZeneca shot administered to this group from 12 weeks to 16 weeks, while the Carlos III Institute in Madrid carries out research to determine whether it will be safer to give this segment of the population another dose of AstraZeneca, or a shot of the Moderna or Pfizer vaccine in order to give them full protection against Covid-19.

Until now, Spain has received 272,400 doses of the Janssen vaccine, of which 71% have been administered

Meanwhile, most of Spain’s regions have already opted to start inoculating the 50-59 age group using the Pfizer vaccine, in order to move the campaign along to younger people.

The second target group for the Janssen vaccine is made up of the over-18s who are in a vulnerable situation or those for whom getting two shots would be complicated. “These are patients who can be difficult to locate because, for example, they do not have a fixed abode,” explained healthcare sources from one region. “In these cases, the fact that this vaccine is single dose facilitates the completion of the immunization process in one go.”

Up until now, Spain has received 272,400 doses of the Janssen vaccine, of which 71% have been administered. These vials so far have gone to the 70-79 group. Before June 30, another five million doses are due to arrive, which will allow for the vaccination of a large part of the 50-59 group. What’s more, until September 30, the company will give the Spanish government another 12 million doses, according to the agreements reached by the European Commission and the pharmaceutical companies that are supplying vaccines to European Union countries.

While there are only 49 days left to go before Janssen must complete its first major round of deliveries, neither the Health Ministry nor the pharmaceutical company have responded to questions from this newspaper as to the dates or quantities agreed for delivery in the coming weeks, due to confidentiality clauses signed with the sector.

The Janssen vaccine uses a viral vector to produce the spike proteins of the SARS-CoV-2 virus, which activates the body’s immune system. The process is the same as that used by the Oxford-AstraZeneca vaccine. The European Medicines Agency has obliged the manufacturers to add a warning to the prospectus of both medications pointing to the risk of very rare cases of blood clots associated with their use, although the incidence is lower with the Janssen shots than it is with AstraZeneca. In both cases, the risk is considered extremely low – one serious case per million doses – and that the benefits of vaccination against Covid-19 greatly outweigh the risks.

The Janssen vaccine has so far proved to be effective against the main variants of the coronavirus that are circulating: the British, South African and Brazilian strains. Its published effectiveness is currently at 67%. While this percentage is lower than that of other vaccines – for Pfizer, for example, the rate is 95% – experts insist that there is no use in comparing these figures, given that each one is the result of different clinical trials.

The Janssen tests, for example, were executed when variants such as that from South Africa were already circulating. This strain has been shown in some cases to reduce the effectiveness of the vaccines, leading to Covid-19 symptoms – albeit much milder ones than those seen in people who have not been immunized.

13% with full protection

According to the latest report from the Spanish Health Ministry, a total of 23,107,595 doses of Covid-19 vaccines have been delivered to the central authorities. Of these, 20,162,661 have been administered (87.3%). The number of people with one dose of the vaccine stands at 14,028,954, which is 29.6% of the population. A total of 6,327,447 people have the full protection offered by the vaccines (i.e. either the two doses needed for the Pfizer, Moderna and AstraZeneca vaccines, or the single shot of Janssen). That is 13.3% of the population.

After a slow start in the first quarter of the year, the vaccination campaign has now picked up speed in Spain. Earlier this week, Prime Minister Pedro Sánchez predicted that group immunity in the country thanks to the vaccination drive was less than 100 days away. The government is aiming to have immunized 70% of the population by the end of the summer, but believes that it may be able to exceed that target provided there are no bumps in the road such as supply issues. Spain has also met its first target of fully immunizing five million people by the start of May.

Latest figures

On Tuesday night, the central Health Ministry reported 4,941 new coronavirus cases detected, and added 205 victims to the overall death toll. In total, there have been 3,586,333 confirmed infections since the health crisis began last year in March, while 79,100 people have died after testing positive for Covid-19. The 14-day cumulative number of coronavirus cases per 100,000 inhabitants continues to fall, dropping a full eight points on Tuesday to 180.69, according to the Health Ministry report. This key data point fell 10 points on Monday, a trend that has been attributed by the experts to the ongoing vaccination campaign.

The cumulative incidence remains dangerously high in some Spanish regions, however, coming in at 279.83 in Aragón, 291.73 in Madrid, 261.19 in Navarre and 387.75 in the Basque Country.

English version by Simon Hunter.