Darias: COVID-19 vaccines put us in an immunological safety zone

The Minister for Health, Carolina Darias, has highlighted the positive effect that the high vaccination levels in our country are having against COVID-19 and the Omicron variant; a vaccination coverage that has resulted in a lower severity of cases despite the incidence recorded recently, which places Spain "within a zone of immunological security".

This is what she stressed this Thursday during her appearance, at her own request, before the Health and Consumer Affairs Committee of the Spanish Lower House of Parliament, to give an account of the current status of the pandemic caused by COVID-19, the development of the Vaccination Strategy in Spain and other actions carried out in this regard in response to the epidemiological situation.

As the Minister for Health explained, one year after the start of the Vaccination Campaign and with nearly 91% of the population over 12 years old fully vaccinated, more than 20 million booster doses administered and almost 54% of children aged 5 to 11 years having had their first dose, hospitalisations, ICU admissions and case fatality rates have been much lower.

In addition, 90.1% of those over 60 years of age already have at least one booster dose and the 40-59 age groups have 65% and 45% coverage, respectively.

In this sense, Darias detailed that thanks to the high vaccination coverage, the probability of hospitalisation has been reduced by seven times since last year - 6.5% in 2021 compared to 0.9% in 2022; the probability of admission to ICU and death is 12 times lower than in 2021 - 0.07% compared to 0.9% for both indicators.

This is a lower severity, common to all age groups, which is also having a lower impact on healthcare capacity, although the volume of cases has increased hospital occupancy, without reaching, in comparison, the figures of previous waves and, more intensely, due to the lower severity, in primary care.

In particular, the greatest difference is observed in vulnerable people, those over 60 years old, as the incidence rate in vaccinated people in Spain is almost seven times lower than in unvaccinated people. Thus, in the 60-79 age group, there is a 9.8 times higher risk of infection in unvaccinated people, a 14.5 times higher risk of hospitalisation, a 27 times higher risk of ICU admission and a 27 times higher risk of death compared to vaccinated people.

In the age group of people over 80 years old, there is a 12 times higher risk of infection in unvaccinated people, a 10.2 times higher risk of hospitalisation, a 16 times higher risk of ICU admission, and a 20.2 times higher risk of death than in vaccinated people.

Nevertheless, Darias argued, the situation and the results of the SARS-CoV-2 Vaccination Strategy in Spain should not lead to relaxation, but should serve as a spur to continue to articulate measures in line with the evolution of the pandemic itself and to reflect on new scenarios, both present and future.

"We are determined to continue searching for new horizons, calmly, through reflection with experts, through co-governance and joint action at a European level that will allow us to move towards a new model of surveillance," explained the Minister for Health.

Vaccination Strategy

During her speech, the Minister for Health detailed some of the main data of the Vaccination Campaign, as well as the different actions undertaken through the 10 updates of the Vaccination Strategy.

Darias recalled the agreement reached a year ago today by the Interterritorial Council of the NHS, thanks to which the Strategy was agreed as the best mechanism for dealing with the vaccination process in our country. As the minister said, just one year later "we have vaccinated an entire country against COVID-19".

Thus, more than 39 million people over the age of 12 have already received a dose of the vaccine and more than 38.2 million have been fully vaccinated (90.7% of the population over the age of 12). In addition, more than 20 million booster doses have been administered and 53.8% of children aged 5-11 years have received their first dose of Pfizer's paediatric vaccine, shortly after the first month since the start of the children's campaign.

With regard to the administration of booster doses, she stressed that this is a vital issue at this point in time and to reinforce our immune system, after the passage of time since the last inoculation.

Thus, to date, 91.4% of the population over 70 years old has already received a booster dose; rates that rise to 90.3% in those over 60 years old; 82.5% in those over 50 years old; 72.3% in those over 40 years old; and 82.6% of people vaccinated with AstraZeneca.

At this point, she thanked the Ministry of Defence and the Armed Forces for their collaboration in the Vaccination Campaign, with the provision of 150 mobile vaccination teams and the military hospitals in Madrid and Zaragoza, thanks to which more than 140,000 people have already been vaccinated.

Finally, the Minister for Health recalled the new milestones set in the framework of the Vaccination Strategy, given that last year Spain met the goal of reaching 70% of the population fully vaccinated before the end of August, 80% of the population over 60 years old with a booster dose before the end of 2021 and 80% of the population over 50 years old in the week of 24 January.

On the horizon, she pointed out, are the milestones of reaching 80% of the population over 40 years old with booster doses by the first week of March and, as for paediatric vaccination, to have 70% of children aged 5 to 11 years having the first dose by the week of 7 February and 70% with the second dose by the week of 18 April.

Benchmarks in solidarity vaccination

Darias also gave an account of Spain's activity in terms of international vaccine donations, a field in which Spain continues to move forwards with its "strong commitment to vaccination in solidarity" and the WHO objective of having vaccinated 70% of the global population before the end of 2022.

A performance that, Darias recalled, has been publicly recognised by the director general of the World Health Organization, Tedros Adhanom Ghebreyesus, the WHO's regional director for Europe, Hans Kluge, the president of the European Commission, Ursula Von Der Leyen, and the UNHCR.

Thus, Spain has already surpassed the initially committed goal of donating 50 million doses of vaccine by the end of the first quarter of 2022, reaching almost 57 million vaccines donated to a total of 23 countries in Latin America, Africa and Asia.

Of these, 53.7 million have been donated through COVAX; 2.2 million to humanitarian corridors, such as those received in Iran for Afghan refugees; and the 0.8 million that have been donated to third countries bilaterally. "This is solidarity in action", she remarked.

Changes in the epidemiology of COVID-19

The Minister for Health called for reflection on the changes that are progressively taking place in the epidemiology of COVID-19, given the current situation compared to previous waves, both in terms of high vaccination coverage, the increasingly widespread presence of the Omicron variant - which now represents between 73% and 95% of the cases sequenced in Spain - and the incidences recorded during the pandemic, with 7.5 million cases reported.

Thus, she defended the need to anticipate new scenarios and, therefore, "begin to work, from a place of reflection, calm and sharing", the adaptation to a new system of surveillance and control of COVID-19, once this sixth pandemic wave has been overcome.

This is, she explained, a process of assessment of a possible modification of the current strategies that have already been initiated by the experts of the Alerts Committee of the Interterritorial Council of the NHS, and whose debate Spain is promoting, with caution, in the context of the European Union "with the aim of determining the best options for dealing with a pandemic disease that is gradually acquiring endemic characteristics, at least in our environment".

"We have been regaining normality in our social relations. And we need to continue to adapt our strategic responses to the epidemiological situation at any given time. In accordance with the evidence that is being generated, with the international response, with the lessons learned and in a joint and coordinated manner," Darias argued.

Antigen tests and masks

The Minister for Health also reported on other measures taken recently against COVID-19, such as the regulation of the maximum retail price of antigen tests for self-testing, which has been set at 2.94 euros.

This measure is in addition to the authorisation of the sale of these products in pharmacies approved last July, the purchase of 8.8 million antigen tests for professional use for distribution to the autonomous communities and cities and the express authorisation of the sale of professional tests for the general population in December, due to the exponential growth in demand recorded at the end of 2021.

Among others, Darias also highlighted the approval, last December in the Council of Ministers, of the Royal Decree-Law re-establishing the obligatory use of masks in any open-air space for public use or that is open to the public, except for doing sport or in natural spaces.

This measure stems from the agreements reached by the majority of the regional presidents at the 25th Conference of Presidents held on 22 December and which, Darias reminded the audience, is strictly temporary.

Together with this measure, this Royal Decree-Law also incorporated the hiring of retired health personnel, maintaining the compatibility of their benefits and those of their retirement, and the authorisation to hire professionals with specialist qualifications obtained in non-EU member states.

Among other actions, the Minister for Health referred to the joint meeting of the Interterritorial Council and the Sectoral Conference on Education and the General Conference on University Policy on 4 January, at which it was unanimously agreed to return to the classroom and to reinforce prevention and communication measures.

She also referred to the agreements on the limitation of capacity at sporting events of the Interterritorial Council of the NHS and the ENE- COVID Senior study, promoted by the Carlos III Health Institute, which highlights that the third dose in over-65s increases total neutralising antibodies up to 20 times, with a 17-fold increase in neutralising titres against the Delta variant and 10 times against Omicron, as well as confirming cellular immunity after the third dose.

Finally, the minister also pointed out the "utmost importance" of the agreements adopted on the elimination of the 10-day quarantine of close contacts of Omicron variant-positive people if they were fully vaccinated, with the recommendation to limit their activities to essential ones and to reduce their social interactions as much as possible.

Treatments against COVID-19

On the other hand, Darias acknowledged the work carried out by all members of the NHS in the acquisition of treatments in the fight against COVID-19. In this regard, and in addition to the purchases made by the regional governments, within the Pharmaceutical Benefits Committee for the purchase of monoclonal antibodies and antivirals, she recalled that the Ministry is immersed in the purchase of another antiviral from the company Pfizer.

In this regard, she reported that, following the European Commission's strategy, Spain, with the participation of the regional governments, has signed three joint procurement agreements with the companies Gilead, Roche and GSK.

These three medicines have already received marketing authorisation at a European level, following a positive assessment by the EMA.

She also reported on the evaluation process currently underway for two other medicines from MSD and Pfizer, which have been recommended for use by the EMA.

Of these two treatments, Pfizer's (Paxlovid) has an 89% efficacy in reducing hospitalisation and maintains its activity compared to Omicron, she recalled, which is why the Government of Spain has already signed a bilateral agreement with the company to acquire 344,000 treatments.

Non official translation