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UPDATE: What next for the 2 million people in Spain who had the first dose of AstraZeneca vaccine?

Due to side-effect concerns, the Spanish government has decided that the AstraZeneca vaccine is now only going to be given to those aged 60 to 69. But hundreds of thousands of other people in Spain who have received the first dose of this vaccine now find themselves in limbo.

UPDATE: What next for the 2 million people in Spain who had the first dose of AstraZeneca vaccine?
People in the northern Spanish city of León queue to get the Covid vaccine. Photos: CESAR MANSO, GABRIEL BOUYS / AFP

On April 7th, the Spanish government announced it would reserve the AstraZeneca vaccine for those over 60, after an EU regulator said blood clots should be listed as a rare side effect of the jab.

This decision has left 23 percent of those who received at least one dose of the vaccine, in limbo. 

The circa two million people who received just their first AstraZeneca dose, before this announcement was made, mostly includes key workers such as teachers, police, firefighters, physiotherapists and chemists, the majority of them under the age of 59.

Spain’s Ministry of Health has confirmed that only 97 people received both AstraZeneca doses, which were spaced 10 weeks apart.

Those who received the first dose who are between ages 60-69 will still receive their second AstraZeneca vaccine, but what will happen to those who are younger?

Currently, there are two different scenarios that are being considered. 

READ ALSO: Spain reserves AstraZeneca vaccine for those over 60

Will the AstraZeneca vaccine be combined with another inoculation?

A clinical trial conducted by the Carlos III Health Institute is currently taking place, with 600 participants in two hospitals in Madrid, two in Barcelona and one in Bilbao to determine what should be done.

Director of the Institute Raquel Yotti announced that those taking part in the trial will be receiving a second dose of the Pfizer vaccine instead of the AstraZeneca one.

The volunteers were all given their first AstraZeneca vaccine nine weeks previously and out of these, 400 of the participants will receive their second dose of Pfizer.

“This will assess the impact of the intensification of the immune response when the second dose is the Pfizer one,” explained Jesús Antonio Frías, coordinator of the Carlos III Health Institute’s clinical research network.

If the trial is successful, this same method could be carried out on all of the roughly two million people in Spain, who have only received one dose of the AstraZeneca vaccine. 

The study, which has been named CombiVacs, has already been approved by the European Medicines Agency.

The goal was to have the results of the trial as soon as possible, but on April 30th the Health Ministry announced that would delay the fate of those who had received just one dose by an extra four weeks. 

This will take the amount of time between most people’s doses from 12 to 16 weeks. The decision will give extra time for the results of the clinical trial. 

However, the announcement has caused opposition from the Community of Madrid, as well as authorities in Castilla-La Mancha and Aragón.

Even experts from the Spanish Vaccine Commission have proposed that it would be safe to administer the second dose of Astrazeneca to those over the age of 40.

Will those who have been vaccinated with AstraZeneca receive only one dose? 

The second option being considered is that those left in limbo won’t receive a second dose at all. 

It is believed that even a single dose of AstraZeneca provides 70-75 percent protection against Covid-19, according to the news site OK Diario.

Will Spanish regions change their vaccine strategy?

The current government vaccine strategy in principle is to vaccinate those between 60-69 with AstraZeneca and those 70 and above with either Pfizer, Moderna or Janssen.

However, the government recently announced that it will give each autonomous community free reign on which vaccine it will use for the over 60s, depending on its availability.

The Health Ministry said: “Regions can vaccinate with all available vaccines” given that “there will be more than enough”.

AstraZeneca will not be used on a voluntary basis

The government however has categorically rejected the proposals of some regions, including Madrid and Catalonia, to allow those under 60 to be vaccinated with AstraZeneca on a voluntary basis.

It said that it does not seem appropriate to offer the vaccine to those under the age of 60, who wish to be vaccinated with AstraZeneca. 

“Once again, we must remember that which vaccine people receive cannot be based on individual choice, but must be based on efficacy and different population groups,” the Health Ministry wrote. 

READ ALSO: Region by region: What foreigners in Spain should do to register for the Covid-19 vaccine

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COVID-19

Spain rules out EU’s advice on compulsory Covid-19 vaccination 

Spain’s Health Ministry said Thursday there will be no mandatory vaccination in the country following the European Commission’s advice to Member States to “think about it” and Germany’s announcement that it will make vaccines compulsory in February.

Spain rules out EU's advice on compulsory Covid-19 vaccination 
A Spanish man being vaccinated poses with a custom-made T-shirt showing Spain's chief epidimiologist Fernando Simón striking a 'Dirty Harry/Clint Eastwood' pose over the words "What part of keep a two-metre distance don't you understand?' Photo: José Jordan

Spain’s Health Minister Carolina Darias on Thursday told journalists Covid-19 vaccines will continue to be voluntary in Spain given the “very high awareness of the population” with regard to the benefits of vaccination.

This follows the words of European Commission chief Ursula von der Leyen on Thursday, urging Member States to “think about mandatory vaccination” as more cases of the Omicron variant are detected across Europe. 

READ ALSO: Is Spain proving facts rather than force can convince the unvaccinated?

“I can understand that countries with low vaccine coverage are contemplating this and that Von der Leyen is considering opening up a debate, but in our country the situation is absolutely different,” Darias said at the press conference following her meeting with Spain’s Interterritorial Health Council.

According to the national health minister,  this was also “the general belief” of regional health leaders of each of Spain’s 17 autonomous communities she had just been in discussion with over Christmas Covid measures. 

READ MORE: Spain rules out new restrictions against Omicron variant

Almost 80 percent of Spain’s total population is fully vaccinated against Covid-19, a figure which is around 10 percent higher if looking at those who are eligible for the vaccine (over 12s). 

It has the highest vaccination rate among Europe’s most populous countries.

Germany announced tough new restrictions on Thursday in a bid to contain its fourth wave of Covid-19 aimed largely at the country’s unvaccinated people, with outgoing Chancellor Angela Merkel speaking in favour of compulsory vaccinations, which the German parliament is due to vote on soon.

Austria has also already said it will make Covid-19 vaccines compulsory next February, Belgium is also considering it and Greece on Tuesday said it will make vaccination obligatory for those over 60.

But for Spain, strict Covid-19 vaccination rules have never been on the table, having said from the start that getting the Covid-19 jabs was voluntary. 

There’s also a huge legal implication to imposing such a rule which Spanish courts are unlikely to look on favourably. 

Stricter Covid restrictions and the country’s two states of alarm, the first resulting in a full national lockdown from March to May 2020, have both been deemed unconstitutional by Spain’s Constitutional Court. 

READ ALSO: Could Spain lock down its unvaccinated or make Covid vaccines compulsory?

The Covid-19 health pass to access indoor public spaces was also until recently consistently rejected by regional high courts for breaching fundamental rights, although judges have changed their stance favouring this Covid certificate over old Covid-19 restrictions that affect the whole population.

MAP: Which regions in Spain now require a Covid health pass for daily affairs?

“In Spain what we have to do is to continue vaccinating as we have done until now” Darias added. 

“Spaniards understand that vaccines are not only a right, they are an obligation because we protect others with them”.

What Spanish health authorities are still considering is whether to vaccinate their 5 to 11 year olds after the go-ahead from the European Medicines Agency, with regions such as Madrid claiming they will start vaccinating their young children in December despite there being no official confirmation from Spain’s Vaccine Committee yet.

READ MORE: Will Spain soon vaccinate its children under 12?

Spain’s infection rate continues to rise day by day, jumping 17 points up to 234 cases per 100,000 people on Thursday. There are now also five confirmed cases of the Omicron variant in the country, one through community transmission.

Hospital bed occupancy with Covid patients has also risen slightly nationwide to 3.3 percent, as has ICU Covid occupancy which now stands at 8.4 percent, but the Spanish government insists these figures are “almost three times lower” than during previous waves of the coronavirus pandemic.

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