Great deeds are not usually repeated. The massive response to the initial two-dose vaccination schedule against covid, which led Spain to be a world example in immunization levels, will not be repeated at the same level with booster doses.
Pandemic fatigue, the perception of lower risk in those under 40, the consideration of covid as a mild disease – and even as a disease “of the elderly” – and/or the behavior of Ómicron and his “descendants”, that have caused the highest number of infections of the entire pandemic without significantly influencing hospitalizations and deaths, are some of the factors that influence the inoculation of third doses in Spain has been stagnant for months.
Weekly reports from the Ministry of Health show that very few are receiving the “third puncture” outside of the time in which they corresponded by age. The figures advance below one tenth a week.
Even so, the levels of protection that have been achieved remain high– especially among the elderly – although they are an average of 15/20 percentage points below those achieved with the initial two-dose regimen. Just over 92% of those over 60, 87.5% of those over 50 and 81.4% of those over 40 have completed the three-prick pattern. Nevertheless, one in three Spaniards between the ages of 19 and 39 has not wanted to take (yet) the booster dose.
During the last months, neither the Ministry of Health nor the autonomous communities have launched campaigns to promote the booster vaccination of those who are lagging behind. If regions such as Galicia or the Canary Islands have donethe latter through social networks with the message that, without the three doses, one is not sufficiently protected.
«We are influencing several points; on the one hand, to remember that we are in a context of high transmission of the virus in which, if you don’t have the 2+1 regimen and you get infected, you are more likely to have strong clinical symptoms. On the other hand, in that the reason that the increase in cases is not generating greater hospital pressure is vaccines,” he points out. Amos Garcia Rojas, Canarian and president of the Spanish Association of Vaccinology.
“I don’t think there is a rejection of vaccination, it’s just that people are tired, tired. As professionals, and understanding this fatigue, we must transfer the idea that, for example, children carry a lot of souvenir doses. As the disease progresses further and the virus is better known, it becomes necessary to use these additional doses to be sufficiently protected », he adds.
It is evident that the psychological perception of the pandemic has changedespecially since the end of the restrictions was decreed, but there are no certainties about how different population groups see it now. The truth is that no surveys have been done of any kind in which they have been asked, both by age and taking into account other conditions (education, socio-economic level, etc), how they currently perceive the covid; whether as a serious or minor illness; whether or not they are worried about getting sick; if more booster doses would be given, among other aspects.
“Really understanding how the infection is perceived among the population is of great importance since this will determine the success of the application of public health policies in the future”, highlights Francisco J. Roig, pulmonologist at the HM Montepríncipe University Hospital, from Madrid.
“In my opinion, a psychological protection/mental shield about their immunity is being generated, especially among the young population. There is a feeling that the fact of having received a dose of the vaccine (one, two, or all three) and, in addition, having passed the infection, catapults you to be immune and be able to lead a normal life. The information that has been transmitted from public bodies about the end of the restrictions has also contributed to this state of psychological immunity“, Add.
In this situation, the underlying question is whether the population, in general, is willing to receive new booster doses. And it is a key aspect at this time, in which the fourth dose – or second booster –, It will begin to be administered in less than a month to those over 60 years of age, as approved by the Public Health Commission last week.
There is little doubt about the reception it will have in these age groups, but it may not be so easy to mobilize those under 50 -if it ends up being generalized to the entire population- considering what happened with the first reinforcement. Nevertheless, the availability of bivariate vaccines may help.
“The possibility of having the vaccine updated to be more effective against Omicron variants may increase interest in booster doses in younger age groups,” says the virologist Stanislaus Nistal, from the San Pablo CEU University, Madrid. «We must influence the messages that they reduce the chance of getting infected –especially in the months around vaccination and when the incidence is high– and also in the possibility of developing persistent covid»highlights.
Antivirals as an alternative to vaccines
Although the end of the restrictions has been one of the reasons that has precipitated the latest wave of infections in Europe – in addition to the greater transmissibility of the new Omicron subvariants and the increase in social contacts and mobility in much of the world – society does not seem to be willing to give an inch when it comes to their freedom.
This, added to the slow progress in the inoculation of reinforcements in most of the countries around us, suggests what new options will we have to stop the transmission and the new onslaught of the virus. One of them will be treated with antivirals, such as Paxlovid, which has been shown to reduce the risk of hospitalization and death by 88%. “Taking this medicine can be as or more effective than getting vaccinated. For this reason, it is possible that there are people who prefer to treat themselves with it when they test positive, rather than inoculate themselves with new doses, ”says Roig.