The new injections, adapted to the variants that now predominate, will begin to be inoculated in the last week of September.
In the covid vaccination campaign, which will begin along with the flu campaign in the last week of September, new formulas adapted to the coronavirus variants of the XBB family, now predominant in the world, will be injected. This was decided this week by the Public Health Commission, which discards more than 100 million stored doses that Spain has purchased in recent years and that have become obsolete.
The exact disbursement for these outdated drugs is not known, due to the opacity of the trade agreements, but the Ministry of Health budgeted in 2021 and 2022 more than 2.2 billion euros for vaccines, which were added to the initial 1.4 billion of the first pandemic year.
Almost 64 million doses were acquired in October 2022, when 79 million had already been stored without injection and 81% of the population over 40 years of age had the two initial injections plus another as a reminder (for the general population under 60 years of age, no no other has been recommended). Since that purchase (of which not all reached Spain, a part was donated or sold) until June 30, 2023, the last date with published figures, 10 million doses were administered. Meanwhile, the Government has purchased 3.2 million additional doses from the Spanish pharmaceutical company Hipra for 31 million euros this year. These are not adapted to the new variants either.
International agreements prevent the sale or donation of these surplus vaccines that are already on Spanish soil, so they will most likely expire little by little without being used. At the end of last year, the last data made public, 14 million of a surplus of about 115 million received and not injected had already been wasted, according to the latest report from the Ministry of Health. In addition to all of these, 105 million have been inoculated and more than 60 million have been donated, giving a total of more than 282 million doses purchased so far, not including those that will arrive for the fall-winter campaign.
The Ministry of Health defends that these acquisitions are part of a centralized purchase by the European Union and in trade agreements that were signed at a time of uncertainty in which it was not known for sure how many doses were going to be necessary. These contracts committed purchases until 2025 of formulas that were adapted to the new variants. “It is necessary to have a sufficient stock of different vaccines against Covid-19 as part of the strategic reserve to be able to face potential changes in the epidemiological situation and face this fall’s vaccination with guarantees. “Vaccines are kept in storage until their maximum validity period is reached,” explains a spokesperson.
Belén Tarrafeta, a pharmacist expert in access to medicines, believes that there was an “irrational purchase” that she describes as “waste.” “That in 2020, in the midst of the crisis, when we did not know which vaccines would be successful and which would not, it was purchased assuming a lot of risk, I understand it. But these vaccines were agreed upon as of May 2021. That has no justification. Buying too much has a price to which must be added the costs of storing more than necessary, transporting and destroying. In the midst of the health system crisis, an economic crisis and an energy crisis,” she maintains.
It is a dilemma faced by all rich countries, which have purchased doses far in excess of their needs. The European Commissioner for Health, Stella Kyriakides, recognized last March that this is a problem and explained that the Commission was working with Member States and the industry to find “a solution to the imbalance between demand and supply” of vaccines. which consisted of delaying deliveries so as not to accumulate more doses without inoculating.
Jaime Manzano, researcher and political advocacy technician at the NGO Salud por Derecho, considers that this enormous surplus of doses is due to a “vaccine nationalism”, which was imposed when these medications began to see the light of day, at the end of 2020: “The global North bought a number of doses that it did not need. Meanwhile, the majority of unvaccinated people live in low-income countries in the South.” He believes that the “monopoly” position exercised by pharmaceutical companies led to signing agreements “without transparency” and with “abusive clauses.”
Manzano assures that a system based on donations or the goodwill of countries does not work: “Distribution mechanisms like Covax [un convenio internacional de donación de vacunas que ha repartido más de mil millones de dosis] They haven’t been able to solve anything. Trying to work in isolated blocks, as if we were not part of an interconnected reality, is absurd.” The researcher believes that knowledge and technology transfer mechanisms should have been enabled so that each country could have manufactured the doses it needed, which in his opinion would have led to a fairer distribution and less waste.
The new vaccines, more effective
The use of the new vaccines, instead of those already purchased, was an expected decision, since they are more effective for the new variants that are now circulating. They replace those that may remain unexpired from the first purchases, formulated for the original virus and new acquisitions that were made in 2022 to adapt them to the variants that were thriving at that time, the BA.4 and BA.5 lineages of Omicron.
Already in the first draft of the vaccination strategy for this autumn-winter, published on July 12, those adapted to Health (WHO), the European Center for Disease Control and the European Medicines Agency (EMA). But, at that time, there were still no approved ones that were adapted to the new variants, and there was some uncertainty as to whether they would be ready.
The doubt is now cleared. On September 1, the European Commission gave its approval to Pfizer, which has demonstrated greater protection against the variants that are now circulating. And the EMA has done the same with Moderna this Thursday. Both will begin to arrive in the country in the coming weeks and the vaccination schedule will be adapted to their delivery, in case they are not received on time.
In addition to these, which have been the most used in Spain, it is foreseeable that the EU will soon approve the adapted version of Novavax, which, unlike the previous two, is not based on messenger RNA. This would allow them to be inoculated to patients who are contraindicated with this technology, as recommended by the vaccination plan.
Unlike in the early stages of covid, injections are no longer recommended for the entire population, but only for the citizens most vulnerable to the disease. The Public Health Commission considers as such all those over 60 years of age, those who live in residences, pregnant women and those who suffer from certain diseases (kidney, heart, respiratory, obesity, diabetes and any period of immunosuppression, among others). In addition, they are also indicated for health workers and essential public service workers, such as police, firefighters or military.
If this entire population followed the recommendations and was vaccinated, around 14 million new doses would be needed. But the experience of last fall’s vaccination campaign says that these figures will not be reached: only 61% of those over 60 years of age received it. The objective set by Health is to reach or exceed Covid and flu vaccination coverage of 75% in the elderly and in health and socio-health personnel, as well as exceed 60% in pregnant women and people with risk conditions. Pablo Linde (EP)
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