Spain’s 2 million people vaccinated with AstraZeneca will get second dose of Pfizer

The 2 million people in Spain who have been kept in limbo for several weeks over whether they would receive a second dose of the AstraZeneca vaccine now have an answer from the Spanish Health Ministry: they’ll be administered the Pfizer vaccine instead.

Spain's 2 million people vaccinated with AstraZeneca will get second dose of Pfizer
Photo: GABRIEL BOUYS, Ronny Hartmann / AFP

The wait is over for the two million people and essential workers under the age of 60 who were given the first AstraZeneca jab, only to be later told by Spanish health authorities that they weren’t sure whether they would get the second dose of the Oxford-Swedish inoculation.

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

The options on the table for Spanish health authorities were not administering a second dose of the AstraZeneca vaccine or combining it with another inoculation. 

Finally, after weeks of discussions and trials, Spain’s Public Health Commission and the country’s Health Ministry have decided that the hundreds of thousands of teachers, police officers , soldiers, firefighters, health workers and other key workers who got the AstraZeneca vaccine can have the Pfizer vaccine as their second dose. 

Health representatives from the national government and the regions agreed – with the exception of Madrid and Andalusia – that the controversial ‘vaccine cocktail’ was the most suitable option for completing the immunisation of this group.

The Public Health Commission will look into the possibility that in exceptional cases the second dose be the AstraZeneca vaccine for people who categorically refuse to mix vaccines.

This contradicts an earlier message by Spain’s Health Ministry, which stated “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 news comes after the health department headed by Carolina Darias published its own study – the European Medicines Agency-approved Combivacs study – in which it concluded that mixing vaccines of absolutely different technologies of adenoviruses and messenger RNA does not entail more risk and actually triggers the body’s protection against the virus more effectively.

Those responsible for the study especially emphasized that the side effects – which in all cases disappeared after three days – were not serious enough to call the findings into question.

The side effects in test patients were: pain at the place of injection in 88 percent of cases, 44 percent reported headaches , 41 percent complained about general malaise, 35 percent about induration (hardening of the area), 31 percent erythema (temporary spots), 25 percent chills and 10 percent  nausea.

A total of 600 volunteers who had received the first dose of AstraZeneca took part in the Combivacs study, 400 of whom received the Pfizer vaccine at least eight weeks after, and 200 who didn’t receive another vaccine at all. 

Critics have said that there hasn’t been enough testing on people to detect rarer side effects, as it can’t be concluded that giving Pfizer as a second dose is more effective than giving a second dose of AstraZeneca, because this study has not looked at it. 

It has given Spain’s Health Ministry the right to say that vaccinating with Pfizer elicits a stronger immune response than not giving a second dose at all (seven times stronger according to their results), but it doesn’t necessarily answer the most important question: What is the best option for people who have received the first dose of AstraZeneca and are waiting for the second? 

This may well be revealed in June by the Com-Cov and Com-Cov2 studies carried out by Oxford University.

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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.