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Lessons From Vaccination Learned In UK And The US

Key Gallwey, an 84-year-old painter, was among the first to go on December 8, on a cold and foggy morning, to the Royal Free London Hospital to receive the initial injection of the vaccine from Pfizer and BioNTech.

“What if I regret it? Please, not at all! I feel much safer now, and I have begun to meet in small bubbles with other people who have also put it on, or who have had the disease and have antibodies, ”she tells EL PAÍS. You have already been scheduled on January 5 for the second dose. A little later than the 21 days the manufacturer recommends, but not too long.

The British Government announced on December 24 that more than 600,000 citizens had already received the vaccine. They are all people in their 80s, many of them in residences, as well as the health personnel who are on the front lines of the battle against the virus.

It took more than a week to start distributing it to the residences, even though they were the top priority. The complicated logistics required to transport a drug that needed to be kept at minus 70 degrees and which, in the first distribution, contained 975 doses per cooler box, forced the authorities to design and approve a way to safely divide the doses.

Most residences (some 2,900, in England alone) barely have 40 or 50 beds, and there was a risk of wasting many doses.

There are around 500 vaccination points across the UK, with the majority (414) in England. Large makeshift facilities have been erected in stadiums and convention buildings, but most of the distribution takes place in hospitals and health centers. The main problem resides in the latter, because the vaccine has not yet arrived in many cases.

In hospitals, only 42% (57) of the 135 prepared for the campaign have received the planned doses. “We need millions of doses to arrive now, urgently. It is the number one priority of many GPs, their patients and the whole country, especially after the appearance of the new strain of the virus ”, demanded this week Richard Vautrey, the president of the commission of family doctors of the British Medical Association.

The Executive assured at first that five million doses of the vaccine would reach the United Kingdom before the end of the year. It is transported from Pfizer’s facilities in Puur (Belgium).

Faced with the collapse caused in the Eurotunnel, after France ordered its closure for 24 hours to prevent the entry into the continent of the new variant of the virus, Downing Street assured that it had military aircraft ready so that the transport operation was not interrupted. The truth is that the Government no longer indicates how many doses have arrived – and will arrive – in 2020.

In recent days, former Prime Minister Tony Blair has created some controversy by suggesting that health authorities should not withhold half of the available doses to provide patients with the second injection prescribed by Pfizer.

“It requires two doses, but the first already provides remarkable immunity (…) We should consider using all available doses in January,” wrote Blair in The Independent newspaper ,in defense of an acceleration of the campaign.

The scientific community, however, has responded with skepticism, although some, such as David Salisbury, former director of Immunizations at the Health Ministry, have supported the politician’s proposal.

But other experts have pointed out that Pfizer’s trials were conducted on a double-shot basis, and the efficacy (some put as high as 80%) of a single injection is less clear.

In addition, the main problem, at the rate that the campaign unfolds, is not so much a shortage (the vaccine developed by Oxford-Astrazeneca will probably be available soon) as a distribution logistics that must continue to be adjusted so that it reaches all planned points.

More than a million people in the United States had received their first dose on December 23. The data, although it may be somewhat short due to delays in the notification of the states, indicates that it will be very difficult to meet the goal announced by the federal government of administering 20 million doses before 2021.

It would be necessary to put every day until December 31 more than double the number of injections given in total in the first nine days.

The United States began administering the Pfizer and BioNTech vaccine on December 14 and, a week later, the Moderna vaccine began to be injected. First-line health workers and nursing home residents have priority in receiving them.

In a vast country of almost 329 million people, divided into 50 states with competencies in health, which is going through a devastating wave of a pandemic that has left more than 330,000 deaths, vaccination poses a colossal challenge.

The federal government, which centralizes purchases and distributes, claimed to have distributed 9.4 million doses to the states before Christmas Day. The distribution is made proportional to the population. But numerous states complain that they have not received the promised doses.

Pfizer said on December 18 that it had millions of doses prepared, ready to distribute, but that no one in the federal Administration had given them instructions on where to send them.

Receiving the vaccine is only part of the challenge. Hospitals are required to stock up on syringes and other supplies, and to have, in the case of the Pfizer and BioNTech vaccine, chambers for ultra-low temperatures.

In some states, such as Georgia, frontline workers have had to travel up to 40 minutes by car to receive their doses at hospitals with such equipment.

But perhaps the main challenge is the reluctance of the population. Nearly four in 10 Americans say they won’t get the vaccine, according to a November Pew Research poll, jeopardizing the goal of herd immunization.

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