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A man being vaccinated in Cordoba in October 2022. Valerio Merino
Fifth Covid jab for over 60s and vulnerable recommended by Ministry of Health in Spain
Vaccination campaign

Fifth Covid jab for over 60s and vulnerable recommended by Ministry of Health in Spain

The coronavirus vaccine, which is also recommended for healthcare workers, pregnant women and essential personnel, will be administered in autumn or winter, at the same time as the flu jab

Álvaro Soto

Madrid

Monday, 28 August 2023, 11:07

Spain's Ministry of Health is already preparing the next vaccination campaign against Covid-19. It will coincide with the flu campaign and will be focused on the older population and those suffering from some type of chronic illness. In a document that has already been approved by the Interterritorial Council, the national Health Commission has ruled out a general vaccination campaign for the entire population, but does highlight several 'target' groups.

Specifically, the health experts recommend that in autumn or winter (the dates for the start of the campaign have not yet been finalised) the vaccine against Covid-19 be administered to all people over 60 years of age; to people in nursing homes, centres for the disabled, prisons, those people under 60 years of age with chronic diseases such as diabetes, morbid obesity or cancer; all pregnant women and women in the postpartum period (up to six months after delivery who have not been vaccinated during pregnancy); and those living with people who are highly immunosuppressed (e.g. transplant recipients).

Experts also recommend the jab for all healthcare workers and essential personnel, such as law enforcement, firefighters and civil defence services.

Specialists are considering vaccinating the same groups against influenza, together with Covid, and adding others: including people working in poultry, pig and mink farms or with wildlife, such as farmers, veterinarians, hunters or environmental agents. After a few months in which cases of avian flu have been reported, the aim is to «reduce the chance of a concomitant infection of human and avian or swine viruses», which would lead to a risk of «recombination or genetic exchange of both viruses», one of the greatest fears of scientists, who see this as the possible origin of another pandemic.

For most of those who make up the target groups for Covid vaccination, if they have attended all previous calls from the Ministry of Health, it will be the fifth jab, although for the most advanced (people suffering from higher-risk diseases) it will be the sixth dose. The previous one, in which compounds adapted to the Omicron variant were used for the first time, began to be administered in September last year, but the vaccination call was not as successful as the previous ones had been.

According to the latest vaccination data from the Ministry, published at the end of June, only 61% of those over 60 years of age have received the two booster doses.

One big question remains to be answered: which vaccine will be used. The European Medicines Agency (EMA) and the European Centre for Disease Prevention and Control (ECDC) recommend that the vaccines to be administered in the next campaign should be monovalent (having only one component corresponding to an original strain of the virus that causes Covid) against the XBB subvariant of the Omicron strain, «preferably XBB 1.5», the one that has been circulating most widely around the world in recent months. The problem is that the EMA has not yet approved any monovalent vaccine adapted to the Omicron subvariants, although it expects to do so in the coming months. Whether the vaccination campaign starts earlier or later may depend on this. «It is expected that the new adapted vaccines will be available before the start of the season,» the document notes.

Contagions and hospitalisation

Covid infections spiked during the first part of the summer, although they are already declining. The highest levels occurred in June and July, according to data provided to the ECDC by the Ministry of Health, although this information does not reflect reality, as most infections have been unaccounted for since spring last year. More reliable is the statistic on hospitalisations due to Covid, which remains at very low levels. The majority subvariant, as it has been for months, continues to be the XBB family, with its respective derivatives, and EG.5 has also been detected, but both belong to the Omicron lineage, and those who have received three doses of the vaccine, and have also been infected at some point, have a hybrid protection that limits the severity of the infections.

«As has happened since the beginning with Covid, cases have increased when there have been more social interactions, which shows that it is not a seasonal virus. In recent weeks there have been deaths among vulnerable people, but the health system has not been overloaded,» stresses the president of the Spanish Society of Immunology, Marcos López Hoyos, who is opposed to mass vaccination of the population and stresses that it is not so much the over-60s, but the vulnerable population. «More than age, we should look at the vulnerability of the individual to decide whether they should receive a new dose or not, and doctors would have to play an important role in this,» explained López Hoyos.

Professor of Microbiology at the San Pablo CEU University Estanislao Nistal believes that the increase in infections in summer, and the general attitude of the population, who know when to put on a mask or stay at home, show that «people have already accepted that Covid is like the flu, a disease that will stay with us».

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