The Ministry of Health and the autonomous communities are studying extending the administration of the third dose to the 65 to 69 age group and, if this is done, the vaccine that the 60-year-olds will receive will not be that of AstraZeneca, with which they have completed the the vast majority of them, but one of messenger RNA (Pfizer-BioNTech or Moderna, preferably the first), as confirmed by sources familiar with the meeting of the Public Health Commission (CSP) held this Tuesday.
This was one of the issues discussed at the meeting, which also decided that everyone over 70 can receive the reinforcement puncture from the end of October. Finally, according to the same sources, it was agreed to leave the agreement for later. Some voices have proposed lowering the minimum age to receive the third puncture to 60 years, but the majority position is for now to set the limit at 65. According to these sources, and in line with what is stated by most experts in the In recent days, “with the available evidence it is not necessary to administer the third dose to healthy people younger than 65 or, taking the case to the extreme, 60 years.”
One reason for delaying the decision on those in their sixties is that with giving the third dose to those over 70 years (more than 6.5 million people) there is already enough work for several weeks. But another reason, according to these sources, is that the argument must be well prepared before taking a step that, given the antecedents, will not be free from certain controversy. Health already tried in the spring to get 1.5 million essential workers under 60 who had received a first dose of AstraZeneca to complete the schedule with a second dose of Pfizer-BioNTech, but most refused and chose not to change their serum.
Spain, like the rest of the countries of the European Union, has opted for messenger RNA vaccines as a pillar of its vaccination strategy for months. He did so as soon as he had enough doses of this type of serum and was leaving behind, except for special cases with Janssen, the rest. In the case of AstraZeneca, in addition, the rare but serious cases of thrombi detected and, above all, the crisis experienced between the European Commission and the pharmaceutical company accelerated the practical disappearance of this vaccine in the vaccination strategy. The result is that now there will be no dose if the third puncture is approved for those over 65 (or 60) – the United Kingdom, for example, has approved it – so people in this age group who they want it, they must receive the so-called heterologous pattern.
The vaccination strategy, collected in a document that has already been updated eight times, has followed the basic principle of administering the available vaccines as they reach Spain to the groups considered to be at higher risk. This has caused that, over time, the administered patterns draw a mosaic with different tiles according to the age group and the time of the punctures. Some of them even hidden some question not resolved by Health or the communities.
The following are, ordered by age, the situation of the people who have received the different vaccines:
Older than 80 years. As one of the highest risk groups, it was one of the quickest to get vaccinated, and in the second half of last May practically 100% of the 2.9 million people that make up it had already received the second dose. The vast majority have been vaccinated with Pfizer-BioNTech serum for a scheduling issue — this was the first vaccine to arrive in large quantities in the early stages of the campaign — although a portion was also able to receive Moderna’s. Although the European Medicines Agency (EMA) has not yet ruled on the third dose of this last serum in non-immunosuppressed people – it has endorsed that of Pfizer-BioNTech and is expected to do so in the coming days with Moderna’s – , the announcement made by the Ministry of Health on Tuesday assumed that those over 80 will receive the same third dose of messenger RNA vaccine as the first two. It will be, also by calendar and except for the immunosuppressed, who have already begun to inject, the first group to receive the third dose, since this will be administered at least six months after the second.
From 70 to 79 years old. Made up of 3.9 million people, this group reached 97% of those vaccinated with the full schedule on June 30. For the most part, they have also been immunized with Pfizer-BioNTech, although a small part has also received Moderna and another more important – Health has not offered data by vaccines and age groups – the single-dose vaccine from Janssen. What will happen to this last group is precisely one of the biggest unknowns to be resolved. Johnson & Johnson, Janssen’s parent, has already applied to the US regulator, the FDA, for authorization for the booster dose (in this case a second dose). Their data shows that protection against a moderate or severe covid reaches 94% with the second puncture compared to just over 70% that some studies had shown.
From 65 to 69 years old. This group, made up of about 2.6 million people (approximately double if it is extended to 60 years), has been mostly vaccinated with AstraZeneca, although in some cases they have also been able to receive the Pfizer-BioNTech vaccine and that of Modern Some communities, such as Navarra, have agreed to vaccinate people who declined to be immunized with AstraZeneca’s with these last two sera. When the Public Health Commission, predictably, makes the decision to reduce the population that will receive the third dose to 65 years (or 60), it will offer messenger RNA vaccines in all cases.