Coronavirus crisis in Spain: will nursing home residents need a third Covid-19 vaccine shot?

The fifth wave of the coronavirus in Spain has shown that nursing homes are not free from risk, even if the elderly are vaccinated against Covid-19. The number of coronavirus cases in these centers has jumped eighteenfold in just a month: from 64 between June 28 and July 4 to 1,150 between July 26 and August 1, according to data from the public social services agency Imserso. Most of these cases have been mild or asymptomatic, but there continue to be hospitalizations and deaths. In that same period, the number of Covid-19 fatalities rose from three to 71. Such a high weekly number of deaths has not been recorded since February.

This rise in infections has opened a debate about whether a third dose of a Covid-19 vaccine is needed. More than seven months have passed since the first shots were administered to nursing home residents in Spain, and there are questions about whether the vaccines continue to provide the same level of protection. For now, there are no clear answers. Several investigations are trying to assess how the immune system responds to the coronavirus and its mutations, but so far, there is no evidence that backs the use of a third booster shot. People with compromised immune systems, such as cancer patients, however, are an exception, but in this case, a third dose is recommended not to increase protection, but rather because their defense systems do not respond effectively enough to the two shots.

The most urgent matter is for all the vulnerable population to receive the first dose, regardless of where they are

Federico Martinón, vaccination advisor from the WHO

For this reason, the US Food and Drug Administration (FDA) gave the green light on Friday morning for a third dose of a Covid-19 vaccine to be administered to immuno-compromised individuals – a move France took months ago. Meanwhile, in Israel, third shots are being offered to the over-60 population, of whom 60% – the equivalent of more than 700,000 people – have received it, reports Juan Carlos Sanz. France, the United Kingdom and Germany are planning to do the same in September. But Israel is even considering expanding the age range to the over-40s. “That doesn’t make sense,” says Roselyn Lemus-Martin, a researcher at Oxford University, who argues that the science only supports a third shot in immuno-compromised individuals. The World Health Organization (WHO) has called on wealthy countries to hold back from administering a third round of vaccine shots until at least 10% of the global population has received the first.

Spain, for now, is not considering administering a third vaccine dose. Health Minister Carolina Darias, however, does believe it will be necessary in the future. At the end of July, she confirmed that Spain had signed up to the European Union’s €1.8-million plan to purchase Pfizer-BioNTech and Moderna vaccines for 2022 and 2023 to be used for the third round. Following the WHO’s request, Science Minister Diana Morant clarified that “there will not be a third dose while the scientific community does not have clear evidence that it is needed.”

But nursing home associations are calling for immediate action. “Even Pfizer has recommended a third dose,” says Ignacio Fernández, the head of the Dependent Business Federation. “We are asking for preferential treatment and for them to give it to us as soon as possible.”

Federico Martinón, a vaccination advisor from the WHO, stresses that the decision should be based on science, not politics. “The most urgent matter is for all the vulnerable population to receive the first dose, regardless of where they are,” he says. “From then on, we can start thinking about the third dose.”

According to the latest figures from the Spanish Health Ministry, released Thursday evening, the incidence rate continues to fall. The 14-day cumulative number of cases per 100,000 inhabitants now stands at 483, a drop of 20 points since Wednesday. The Balearic Islands have the highest transmission rates in Spain, with 648.8 cases per 100,000. Pressure on hospitals and intensive care units (ICUs) also continues to ease, with the occupancy rate of Covid-19 patients falling to 8% and 20.7%, respectively.

One in 10 Catalans have not received second dose

According to the Catalan health department, 10% of people who received the first shot of a Covid-19 vaccine have not gone to their appointment to receive the second. According to Gemma Craywinkel, the head of the Catalan Health Service, this is due to the summer vacations, when many people are away, and the false “sense of security” provided by the first shot.

In a bid to speed up the Covid-19 immunization drive, the Catalan health department has reduced the vaccination waiting period for the under-65s who have recently had the coronavirus. Until now, the advice has been to wait six months from the date of the positive test result before getting vaccinated. In Catalonia, that interval has been reduced to two months.

With reporting by Josep Catà Figuls.

English version by Melissa Kitson.