The Covid-19 vaccination campaign got going on Sunday in Spain, in a senior home in Guadalajara, in the region of Castilla-La Mancha. There, Araceli Hidalgo, 96, became the first person in the country to receive the first of the millions of injections that are due to be administered in the coming months. But what happens now? Here are some of the main unknowns – some of which have responses, and others that don’t.
When does the vaccine begin to take effect?
The Pfizer vaccine, which was the one that was symbolically administered on Sunday in all of Spain’s regions, needs two doses, separated by 21 days. Total immunity – at a level of around 95%, according to clinical trials – is reached around a week after the second dose. After that, the immune system begins to activate and it is less likely that the recipient will develop the illness than those people who haven’t been given it, but the drug has yet to achieve its maximum potential.
How long does the immunity last?
This is not known, and is something that happens with all new vaccines: it is unknown how long the immunity lasts until the moment that the vaccine is no longer effective. Laboratories and healthcare services will be monitoring when this takes place. For now, it has not been ruled out that a booster shot will be necessary a year or two after it is first administered, as is the case with other vaccines. In fact, the vaccine could be needed on a yearly basis. But this will only become clear with time.
When and how will Spain’s healthcare centers start to offer appointments for vaccinations?
Sunday saw the start of the first phase of the vaccination plan, which covers residents of senior homes and their carers, and will continue with healthcare workers and adults with major dependencies. This first phase, which will see approximately 2.5 million people given the vaccine, will last around three months. Once it is over, it will be the turn of the next group, although the Spanish government is yet to confirm who this will include. The most likely approach will be the over-64s and the chronically ill. While the plans for this phase are yet to be confirmed, it is expected that these people will be given appointments via their primary healthcare centers. “Citizens will be given a citation, according to the risk group to which they belong, to attend their healthcare center,” explained Health Minister Salvador Illa on Sunday. “It is voluntary and free. It is an act that will benefit both the person who receives the vaccine and the collective.”
Who is considered to be a dependent?
According to the Health Ministry’s vaccination strategy, this group includes people considered major dependents (grade III) according to the Dependency Law of 2006, those who have requested recognition as such and those who are yet to do so but are accredited medically to have an illness that requires intense support measures during their day-to-day lives, whether or not they are institutionalized. “The vaccination will take place as soon as possible, taking into account the characteristics of storage and usage of the available vaccines,” the ministry strategy adds. “Personnel who professionally care for these people with a major dependency will be able to get vaccinated during the same visit.”
What happens for those people with private health insurance?
The vaccination will be free and will be administered by the National Health System in the order that the Health Ministry establishes.
What measures must be followed when the vaccine is received?
In principle, the same as those being observed until now, until there is a sufficient amount of the population vaccinated so that herd immunity is reached. This is estimated to be about 70% of the population. While it is known that the vaccine is highly effective at avoiding the development of Covid-19, it is not yet so clear up to which point it avoids the spread of the virus. This means that it is possible that a person who has been vaccinated could still spread the virus while asymptomatic and thus become a vector for transmission.
When will enough people in Spain be vaccinated in order to achieve herd immunity?
As time passes, more vaccines will arrive – not just from Pfizer, but also, most likely, from other manufacturers too. While the initial rhythm is expected to be around 350,000 injections a week, as more and more pharmaceutical firms get approval for their vaccines this number is likely to rise. The Health Ministry calculates that between May and June around 20 million people will be vaccinated and that by the end of the summer a sufficient percentage of the population will be immunized in order to reach herd immunity.
How will people who have been vaccinated be monitored?
All citizens who receive the vaccine will get a vaccination card that will include the kind of immunization that has been administered as well as the batch number, the date the first dose was delivered and the planned date for the second injection. The card will also contain contact details should there be a suspected adverse reaction as well as a phone number to call should there be any side effects not included in the prospectus. This is the start of what is known as Phase 4 of the clinical trial. In the previous stage the frequent side effects – such as fatigue, tiredness, fever the next day – were found to affect at most one in every 30,000 people. But to detect rarer effects, those that manifest in one case per 100,000 or 1,000,000, the vaccine will be monitored as it is administered in the population. Also, more precise data will be collected on population groups that was not possible during the first trials. This will be done via the primary healthcare system using a centralized database in each region, and will be connected to a national and European system.
First image of omicron coronavirus variant shows many more mutations in area that interacts with human cells
independent– Researchers have revealed the first image of omicron, the new coronavirus variant first detected in South Africa and Botswana, which shows that it has more mutations than the currently predominant Delta variant.
The 3D image of omicron, produced and published by the Bambino Gesu hospital in Rome, reveals that the variant has many mutations concentrated in the spike (S) protein — the part of the novel coronavirus that enables it to enter human cells.
“We can clearly see that the omicron variant presents many more mutations than the delta variant, concentrated above all in one area of the protein that interacts with human cells,” the researchers said in a statement on Sunday. “This does not automatically mean that these variations are more dangerous, simply that the virus has further adapted to the human species by generating another variant.”
The scientists called for further studies to unravel if the adaptation seen in the variant is “neutral, less dangerous, or more dangerous”.
Scientists have found about 50 mutations in omicron, 30 of which are on the S protein, and half of those in the receptor-binding domain – the part that binds to the ACE2 receptor on human cells through which the virus enters tissues.
The red dots in the image, researchers said, indicate areas with “very high variability,” while the orange ones are those with “high variability”, and the yellow ones with “medium variability.” Green dots are parts of the S protein showing low difference between the two variants, while the gray area shows portions that do not vary.
“Case numbers tripled in 3 days in South Africa to 2,828, but this is perhaps partly because of intensive monitoring, although it is possible that the transmission rate is double that of delta (R=2) and the doubling time is about 4.8 days,” Peter Openshaw, professor of experimental medicine, Imperial College London, said in a statement on Saturday.
“South Africa is going into summer and rates of delta are very low, so hard to say if omicron competes over delta,” Dr Openshaw added.
On Friday, the World Health Organisation noted that there could be an increased risk of reinfection with the new B.1.1529 coronavirus variant, named omicron, compared to other variants of concern.
“The number of cases of this variant appears to be increasing in almost all provinces in South Africa,” the WHO noted in a statement on Friday. “In recent weeks, infections have increased steeply, coinciding with the detection of B.1.1.529 variant.”
While the number of people testing positive has risen in areas of South Africa affected by this variant, the WHO says further studies are underway to understand if the surge in cases is because of omicron or other factors.
The WHO’s Technical Advisory Group on Virus Evolution also highlighted that it is still unclear whether infection with omicron causes more severe disease compared to infections with other variants.
“While preliminary data suggests that there are increasing rates of hospitalisation in South Africa, this may be due to increasing overall numbers of people becoming infected, rather than a result of a specific infection with omicron,” the experts noted in a statement on Sunday.
They urged all countries to enhance surveillance and sequencing efforts to better understand circulating variants of the novel coronavirus, and submit complete genome sequences and associated metadata to a publicly available database, such as GISAID.
The WHO and several health experts across the world have called for increasing global vaccine equity to ensure that new variants of concern do not emerge.
“It is very likely that current vaccines will protect against severe disease with omicron as they do for all the previously identified virus variants. But this does highlight the need to remain vigilant – the pandemic is not over,” Lawrence Young, virologist and professor of molecular oncology at Warwick Medical School, said.
Spanish researchers pave way for fair play in global Covid testing and research
thelocal– The World Health Organisation described the accord as the first transparent, global, non-exclusive licence for a Covid-19 health tool, that should help towards correcting the “devastating global inequity” in access.
The deal brings the Spanish National Research Council CSIC together with the global Medicines Patent Pool (MPP) and the WHO’s Covid-19 Technology Access Pool (C-TAP) knowledge-sharing platform.
“The aim of the licence is to facilitate the rapid manufacture and commercialisation of CSIC’s Covid-19 serological test worldwide,” the WHO said.
The test effectively detects anti-SARS-CoV-2 antibodies developed in response to either a Covid-19 infection or a vaccine.
CSIC, one of Europe’s main public research institutions, will provide the MPP or prospective licencees with know-how and training.
WHO chief Tedros Adhanom Ghebreyesus described the licence, which will be royalty-free for low and middle-income countries, as “the kind of open and transparent licence we need to move the needle on access during and after the pandemic”.
He added: “I urge developers of Covid-19 vaccines, treatments and diagnostics to follow this example and turn the tide… on the devastating
global inequity this pandemic has spotlighted.”
C-TAP was founded in May 2020 as a platform for developers of Covid-19 tools to share knowledge and intellectual property.
Set up during the scramble for Covid vaccines and treatments, the health technology repository was first suggested by Costa Rican President Carlos Alvarado.
The information pool was intended as a voluntary global bank for IP and open-sourced data as part of a common front against the new coronavirus.
However, as it turned out, rival pharmaceutical companies have largely kept their findings to themselves rather than sharing them as global public goods.
Tuesday’s deal “shows that solidarity and equitable access can be achieved”, said Alvarado.
CSIC president Rosa Menéndez said she hoped the move would serve as an example for other research organisations.
‘Preposterous’ tests hoarding
The medical charity Doctors Without Borders (MSF) said the test could quantify three different types of antibodies — and crucially, differentiate vaccinated people from those with natural Covid infection.
“This feature will become very important for measuring the number of Covid-19 cases in countries and the impact of control measures,” it said.
In welcoming CSIC’s move, MSF diagnostics adviser Stijn Deborggraeve said it was “preposterous” in a global pandemic that tests were being monopolised by “a handful of privileged people and countries”.
The Geneva-based MPP is a UN-backed international organisation that works to facilitate the development of medicines for low- and middle-income nations.
The antibody test licensing accord is the third Covid-related deal that the global pool has struck in a month.
Last week, the MPP reached an agreement with US pharmaceutical giant Pfizer to make its prospective antiviral Covid-19 pill available more cheaply in 95 low- and middle-income countries via sub-licensing to generic drug manufacturers.
The MPP signed a similar deal last month with Pfizer’s US rival Merck for its prospective oral antiviral medicine molnupiravir.
Covid: Europe region faces 700,000 more deaths by March – WHO
bbc– A further 700,000 people could die of Covid by March in Europe and parts of Asia, the World Health Organization has warned.
The death toll already exceeds 1.5 million in the 53 countries of what the WHO terms as its Europe region.
The WHO warned of “high or extreme stress” in intensive care units in 49 of the nations by March 2022.
Europe is facing a surge in cases, prompting Austria to return to lockdown and others to consider fresh measures.
A number of countries – including France, Germany and Greece – could also soon make booster jabs a requirement for their citizens to be considered fully vaccinated.
But several countries have seen fierce protests against new measures. The Netherlands saw several nights of rioting over a partial lockdown.
In its assessment, the WHO warned Covid was the top cause of death in its Europe region.
“Cumulative reported deaths are projected to reach over 2.2 million by spring next year, based on current trends,” the WHO said on Tuesday.
Confirmed Covid-related deaths recently doubled to almost 4,200 a day, it added.
In Russia alone, the daily death toll has been recently topping 1,200.
A high number of unvaccinated people and the prevalence of the Delta variant in some countries were key factors behind high transmission rates in the Europe region, the WHO said.
The WHO Europe director, Dr Hans Kluge, urged those who were still unvaccinated to get the jab.
“All of us have the opportunity and responsibility to help avert unnecessary tragedy and loss of life, and limit further disruption to society and businesses over this winter season,” he said.
As well as European nations, the WHO also considers Israel and ex-Soviet states like Tajikistan and Uzbekistan as making up the region.
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