Spain considers widening group of vulnerable people who will be offered third vaccine shot

The Spanish Health Ministry and the country’s regional authorities are considering allowing a third dose of a Covid-19 vaccine for people who are undergoing dialysis treatment, cancer patients, the over-40s with Down syndrome and seniors who live in care homes. These groups would be in addition to those who are already being offered this extra shot – i.e. people with suppressed immune systems, a collective that the health authorities believe is insufficiently protected by the two doses of the vaccines that have been given to the vast majority of the Spanish public.

The issue will be discussed today at a meeting of the Public Health Commission. The plan was given backing on Wednesday during a meeting of the Inter-Territorial Council of the National Health System (CISNS), which brings together the central Health Ministry and the regions, who are in charge of their own healthcare systems, their vaccination programs and the overall control of the pandemic in their territories.

The third dose is already being administered to those with compromised immune systems. In Spain, this group numbers around 100,000

Health Minister Carolina Darias explained on Wednesday after the meeting that the plan could go into action by October 4, once approved by the Public Health Commission today. Darias indicated that there had been no opposition to the move from any regional authority. The minister went on to explain that in the case of seniors in care homes, they may be given the third dose now, or authorities may wait to administer it at the same time as the flu shot campaign gets going – usually at some point in the autumn.

The third dose is already being administered to those with compromised immune systems. In Spain, this group numbers around 100,000, and includes transplant recipients, people with lymphoma, lupus or multiple sclerosis, among other conditions. Catalonia, for example, announced on Wednesday that it had administered 2,829 such shots between September 9 and 14. The new injection is not a booster, but rather an additional shot to complete the vaccination cycle, given that the standard two doses of a vaccine such as the Pfizer-BioNTech is not sufficient to produce an adequate immune response against Covid-19.

According to the Facme federation of medical and scientific associations in Spain, patients with suppressed immune systems are two to five times more at risk than the general population of being hospitalized, needing intensive care unit treatment or of dying if they have Covid-19.

With the inclusion of these new groups, the regions are trying to protect the most-vulnerable sections of the population – those who have the greatest risk of becoming seriously ill or dying from Covid.

Debate continues, meanwhile, among experts about the need for this third dose. The European Medicines Agency (EMA) and the European Center for Disease Prevention and Control (ECDC) presented a technical report last week that concluded that there is “no urgent need” to administer booster shots to people in the general population who are fully vaccinated. The priority, the paper continued, was to complete the full vaccination of anyone who still required it.

“Older and fragile people”

The EMA and the ECDC did, however, admit that the possibility could be considered of administering additional doses to people with suppressed immune systems, as well as “older and fragile people” as a precautionary measures – in particular those who live in closed environments, such as care homes.

The backing of the EMA and the ECDC for this move is one of the arguments that was cited by Health Minister Darias to justify the decision the Spanish government is taking, although she made clear that today’s meeting of the Public Health Commission would be the place where all of the arguments for this third dose are set out.

English version by Simon Hunter.