The administration of a third Covid jab to the general population continues to cause misgivings among a good part of the scientific community and continues to fuel controversy between countries and experts.
But within Spain’s Ministry of Health that controversy does not exist. Internal documents from the department, headed by Carolina Darias, clearly show a commitment to administer an extra dose of a coronavirus vaccine to the general population, beyond the elderly in nursing homes and people with weakened immune systems, which has been agreed so far.
The Health ministry revealed its preferences in private on 16 September in an internal report of the Public Health Commission, which included several references to the need for this ‘booster’ dose. In that document - in which the third jab was given the green light to people with very high-risk immunosuppressive treatments and to residents in care homes for the elderly - the ministry stated, "Evidence is available in other countries that the effectiveness offered by a complete schedule of vaccines against Covid over time wanes, especially in the elderly”.
The Public Health report referred to studies carried out in Israel and in the UK to support the need for a booster dose in the entire population to counteract the loss of efficacy and referred to "a strong immunity-lowering effect in all age groups after six months"; and that the Delta variant causes a significant drop in the effectiveness of the vaccines with only two doses.
Meanwhile, the European Medicines Agency (EMA), which has, for weeks, been evaluating the request of Pfizer / BioNTech to include the possibility of administering additional doses of Comirnaty, could rule early next month on this controversial issue. "A decision from the EMA is expected in the week of 4 October," says the Ministry of Health report.
However, the official document makes it clear that Spain does not have to follow the EMA's guidelines, as it did last spring when it limited the use of the AstraZeneca vaccine to those under 60 years of age despite the European regulator urging it to be used without an age limit.
The Ministry of Health’s preference for the third dose - despite the fact that organisations such as the World Health Organization (WHO) or the advisory committee of the United States Food and Drug Administration (FDA) still do not see evidence of its need - is not new. On 23 July, Carolina Darias herself, in a radio interview said, "Everything seems to indicate that we will have to give a third dose," and she suggested that it could be an annual jab.
In May the European Commission closed a 1.8-billion-euro deal with Pfizer for the supply of vials until 2023.