Spain will immediately start administering the third dose of the Covid vaccine to the ‘at risk’ and elderly in care homes. ‘At risk’ includes patients undergoing dialysis or chemotherapy, those suffering from cystic fibrosis or people over 40 with Down’s syndrome.
The Spanish autonomous communities agreed on this on Thursday. They do not want to wait until 4 October, as the Ministry of Health previously proposed, or let the third vaccination coincide with the flu campaign. Instead of early October, the administration of the third dose will start immediately. The elderly were the first to be vaccinated, together with care workers, in January a year ago. In a statement, the Ministry of Health pointed to ‘the vulnerable profile, often underlying suffering and closed environment’ common to these elderly people.
More at-risk groups
Only a week ago, Castilla-La Mancha was the first autonomous region to ask the Ministry of Health for a third dose; a request followed by six other regions. Initially, Minister Carolina Darias asked for more time so the vaccination committee could assess which groups should receive the extra dose. These were patients with underlying issues who are less protected against Covid. Subsequently, elderly people in nursing homes were also added to the list.
Group 7
In addition, a third dose will be administered to patients listed in group 7 of the vaccination strategy. These include people who have had an organ or bone marrow transplant and cancer patients treated with anti-CD-20 drugs. People undergoing haemodialysis or peritoneal dialysis – for kidney failure – and people over 40 with Down’s syndrome will also receive the third dose. Patients who are being treated for cancer in blood, bone marrow and lymph nodes, or who are receiving chemotherapy for cancer in the organs, people who are suffering from lung cancer and who are being treated with chemotherapy or immunotherapy are also vaccinated for a third time. People with HIV infection and cystic fibrosis are also included in group 7.
Debate about the third dose
The immunisation of the entire population over the age of 12 is still ongoing. Darias stressed on Wednesday that 75% of the Spanish population is fully vaccinated. She encouraged those who have not yet done so to get vaccinated. On Thursday, the health committee not only wanted to approve more groups for the third dose, but also stressed that “at this time it is of the utmost importance to vaccinate all people over 12 years old who have not yet been vaccinated”.
The administration of the third vaccination has become a global battle. Not only are high-income countries looking for ways to protect their citizens. In addition, they, middle- and low-income countries – together with the World Health Organisation (WHO), are demanding the vaccination be given earlier in countries with fewer opportunities. Pharmaceutical companies such as Moderna recommend a booster dose against the delta variant by the end of the year.
Booster dose
The Ministry’s position is there should be continuous assessment of which groups qualify for a third vaccination. This includes the booster or boost dose. This was previously considered by the European Medicines Agency (EMA) and the European Centre for Disease Prevention and Control. However, they reject re-vaccination of the general population.
Darias assured on Thursday that the proposal has now been adopted is in line with the recommendations of the EMA. She also stressed the authorities continuously evaluate all measures to be implemented; and that this is always done with scientific evidence as a basis.
