The slow administration of vaccines jeopardizes the goal of global immunity.
Those readers who regularly read these chronicles will not be surprised at how slow the administration of the vaccine is resulting in most of the countries in which it is being applied. But what is happening exceeds any pessimistic forecast. We already cited in three articles that there are three factors that would delay vaccination plans: logic, availability and the attitude of the population.
The facts.
As of January 9, the countries of the European Union have administered far fewer vaccines per 100 inhabitants than expected. The one that has administered the most vaccines is Denmark (1.98) below the United States (2.02) but above Italy (0.98) and Germany (0.64). Spain is at 0.59, below the European average (0.6). In the case of Spain, 178,000 doses have been administered in the first two weeks, which represents 0.6% of the population. But it is that Spain has already received 743,925 doses of the Pfizer-BioNTech vaccine. In other words, not 1 in 4 vaccines received has been administered. Well understood that a vaccination requires two doses, with a 21-day interval between them.
Disponibility
As the European Health Commissioner Stella Kyriakides said a few days ago: “We understand that everyone is looking at the rate of vaccination. The bottleneck at the moment is not the volume of orders, but the lack of global production capacity “, and was willing to help the production of the vaccine for Pfizer and BioNTech, the only one that has been administered so far in the European Union (EU).
What’s going on? Is the supply being too slow? Faced with an unprecedented mass vaccination operation of the world population, experts consider that the stocks accumulated by some pharmaceutical companies for these first months is of a very considerable volume but insufficient to cover demand in the short term.
On occasion, pharmaceutical companies themselves have been optimistic. The most notorious case was that of Pfizer-BioNTech, which after getting ahead of its competitors, came to announce that before the end of 2020 it would have produced 100 million doses. However, at the beginning of December, it had to admit that it would only be able to manufacture half, which it paid for with sharp falls in the stock market despite the fact that days later it would receive its first authorization, in the US. The company blamed the problem on supplying raw materials, without specifying what they were, although they were probably chemical compounds used in the production process.
Pfizer vaccines that are distributed in Europe are produced in Puurs, Belgium. In the case of Moderna’s vaccine, the Madrid-based pharmaceutical company Rovi participates in the final production process, although its work is limited to filling, inspecting and labeling the vials before distribution. The product
arrives frozen and in bulk by plane from the US and in Spain it is separated in the 10-dose format authorized by the EMA.
In theory, the vaccine developed by the University of Oxford and pharmaceutical company AstraZeneca, which is already being administered in the UK and is likely to be the next to be approved by the EMA, has a development process much more similar to the traditional one. , because it uses a chimpanzee adenovirus as a vehicle. Does this mean that the supply will be even slower? Not necessarily, because in reality those responsible for this project were the most forward-thinking (and the most risky), manufacturing millions and millions of doses long before the research process had even signs of ending. To do this, they partnered with the Serum Institute of India, the world’s largest producer of vaccines. Thus, the advance purchase agreements with the EU include 300 million doses and another 100 optional.
Logistics
The bottleneck in the administration of vaccines does not lie, therefore, in the first instance, in the manufacture, but in their application logistics. Logistically, the fact that the Pfizer vaccine requires a storage temperature of 70 degrees below zero is an added difficulty. The risk lies in wasting doses, since “when there are some left over at one point, you have to collect them quickly to be able to administer them elsewhere,” Jaime Jesús Pérez Martín, a specialist from the Spanish Association of Vaccination (AEV), tells El Confidencial. And he adds that “Deep down, it is a production problem”, because “if Spain had 10 million doses right now, it would not be necessary to prioritize, we would take the doses to health centers and we would tell everyone older than 60 years to be vaccinated ”. On the contrary, “we are adding the problem of not having all the doses we need with the requirement of directing them to a too specific audience (risk groups), so it is not so easy to make an agile and correct distribution ”.
In reality, “it is happening everywhere, initially vaccination is a little less than expected” and part of the explanation must also be sought in other circumstances typical of the pandemic. For example, the epidemiological situation implies giving previous appointments and avoiding groups of people. It has little to do, for example, with the regular and well-planned annual flu vaccination campaign.
