PILAR PÉREZ
@pilar_pj
Madrid
JAVIER AGUIRRE
Infographics
@javagured
Madrid
Saturday, 26 December 2020 - 19:13
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Direct.
Latest news on coronavirus
Immunization.
Vaccination campaigns against the coronavirus, community by community
The vaccine is here.
The hope of embracing each other again and recovering life 'from before'.
Ten months and almost 8,600 kilometers to reach the arm of the first Spaniards.
The most fragile, those in which the first wave of the coronavirus pandemic claimed the most lives.
However, entrusting 'normality' to immunization still raises
doubts and unknowns
.
Never before has
such an ambitious mass vaccination campaign
been brought to the table
.
One of the premises is the almost improvised management and organization capacity, like everything else in this pandemic.
Because not all questions have an immediate answer: who, how, when, where ... In Spain, there is
extensive experience in the field of vaccination
, both in influenza campaigns, and in those marked through the vaccination schedule.
Our country can even boast of having high vaccination rates among the child population, with coverage above 95%.
But everything organized with time: the flu is planned in March-April and the doses arrive a month before, all the variables are controlled.
This campaign has managed to vaccinate this year, according to data from the
Gripometer
at 25.2%.
That is,
in almost three months, almost 12 million Spaniards have been immunized.
Faced with the coronavirus, the situation is different.
Everything is exceptional
.
But experience, they say, is a degree and here it exists.
10 years ago, the campaign against influenza A was launched. It required an extra effort that is also required today, both at the administrative and medical levels.
From the industry it is recalled that at that time it was about putting about 30 million doses, although only the goal of two was achieved, the rest had to be destroyed.
From influenza A, as well as from the continuous vaccination campaigns against the seasonal virus, there are many actions that can and should be copied, according to sources from the laboratories, in order to be successful in the mission.
The distribution of the Pfizer-BioNTech vaccine, the first anti-Covid vaccine to cross Spanish borders, waiting for it to join forces with Moderna in January, puts logistics and distribution capacity to the test.
This Sunday the first unknowns are resolved: who, the people in the nursing homes, the first-line health professionals and the social health workers and the large dependents.
From this Sunday until the end of March, Health has predicted that they will receive the first doses that arrive in our country.
It is enough to remember that with the 20 million doses of Pfizer-BioNTech,
10 million Spaniards will
be vaccinated
and that in order to immunize 15 million in June, the corresponding doses of Moderna will be required.
The theory that gives an answer to the where and how is easy on paper, but
the flexibility in the ability to adapt
"that this situation requires calls into question the management capacity of the system," they say from the industry.
The doses will arrive weekly, about 350,000, since the release of the batches occurs after production and a distribution between the member countries of the EU, up to 200 million in total (plus an extra 100 million additional).
Therefore, 4,591,275 doses will be delivered from the Guadalajara facilities for 12 weeks, which will serve to immunize 2,295,638 people.
Health has also agreed with the laboratory that each
container has a number of doses on demand
, so that, from the minimum of 195 vials to the maximum of almost 900, there are no surplus problems.
The distribution to the communities will be guarded by the Civil Guard.
Here, the state of alarm co-governance model dissolves the centralization achieved so far and leaves the end of the chain in the hands of the 17 health systems.
This step, as was done in influenza A and seasonal campaigns, has the logistical capacity of Spanish distribution.
From the employer's association, Fedifar, which represents 98% of the drug supply operations, is counted on them to make the last part of the journey to the
13,000 vaccination centers
.
In Spain, companies such as Cofares, Hefame, Bidafarma and Alliance Healthcare are prepared to acquire this mission, which more than cover the storage and distribution needs to any point of the peninsula.
In this sense, the autonomies have already
equipped themselves to avoid problems in breaking the cold chain
.
"This can be one of the problems that leads us to lose doses", explains from Semergen (Spanish Society of Primary Care Physicians), Jose Ignacio Peis, coordinator of the Preventive Activities and Public Health working group.
It should be noted that the
Ministry of Defense has acquired three freezers
, as well as other communities such as Murcia, Castilla y Léon, Cantabria and the Balearic Islands.
If the total doses were to arrive in the first batch, they would be necessary, but Health has indicated that shipments will be periodic, weekly.
From the SEFH (Spanish Society of Hospital Pharmacy), Olga Delgado, explains that "they have already carried out tests that the designed container system works for delivery in the staggered format that has been planned."
Perhaps the most delicate thing is
that end of the chain: the injection of the dose
.
Each community has designed a plan in which all Primary Care is involved in it.
"It may be that they should consider a reinforcement, a new aid from the military health. Because the PA is already quite 'hit' and saturated in this second wave," they warn from the industry.
Peis puts the accent on that organization that AP uses in its anti-flu campaigns
, with the difference that in these first months it will be an active vaccination, it is the system that has to make patients go to be vaccinated with a previous appointment, and not the other way around, as against the flu.
For his part, Florentino Pérez Raya, president of the Nursing College Organization, underlines the
current training of nurses that enables them to administer this and other vaccines
.
"In this case, we are faced with an immunization with special characteristics for transport and conservation and it also implies a
reconstruction
. The latter is something that is also done with other drugs and with a few small instructions there should be no problem."
Health confirms that there are a number of important details when it comes to handling this vaccine, not only due to the thawing process.
Peis explains that "
these vaccination teams have to be coordinated
very well, that is, appointments, since the vials are multidose (five people from each)."
Thus, Pérez Raya explains that "we have distributed practical information to the 316,000 nurses in Spain. And the same will be done as the others are approved. And if necessary,
free training
will also be designed
for all nurses know how to handle this product
, for greater safety towards patients. But, in any case, we believe that there will be no notable incidents, the professionals are prepared. "
KEY POINTS TO ACHIEVE THE OBJECTIVE
Active search for individuals.
Contrary to other campaigns, in this it is the Administration who cites the patients and they should not skip it to organize the doses.
Organization of vaccination groups.
Both Primary Care physicians and nurses have sufficient experience in performing the task.
Training.
From the Collegiate Organization they have trained Nursing to handle the vaccine, the so-called reconstruction process.
One vial, five doses
.
All of the above serves to take advantage of each vial, since five people will be immunized from each one.
According to the criteria of The Trust Project
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