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08 July 2021 Infections rise, but still no impact on hospitals, between lack of supplies and vaccination hesitation, in three weeks the first administrations are halved and on the delta variant, 5.75 million over 60s are at risk of serious illness. The Gimbe foundation notes this in the usual weekly monitoring referring to the period 30 June-6 July. "The problem is not the Delta variant, but all over 60 not yet vaccinated about 2.3 million. Get vaccinated." Nino Cartabellotta, president of the Gimbe Foundation, writes on Twitter.
Over 60 at risk
In Italy, the Achilles heel of the vaccination campaign is represented by the more than 5.75 million over 60s at risk of serious illness, without adequate coverage against the Delta variant. The Gimbe Foundation has launched the alarm, which today publishes the Covid report on the week 30 June-6 July.
In detail, 2.29 million (12.8%) have not yet received even a dose of vaccine with large regional differences (from 22.6% in Sicily to 7.7% in Puglia) and over 3.46 million (19 , 4%) must complete the cycle after the first dose: 2,495,962 with AstraZeneca, 837,052 with Pfizer-BioNTech, 128,878 with Moderna.
In the meantime, monitoring reveals an increase in new cases (+ 5%), against a decline in hospital indicators (-24.2% hospitalizations; -30.7% intensive care) and deaths (-26.4%) ' .
Monitoring: behind with the deliveries of doses
Compared to the supplies estimated in the vaccination plan, about 20.9 million doses would remain to be delivered, 27.4% of those originally planned: even without considering the CureVac vaccine that did not pass with successful clinical trials, in the absence of further deliveries this week, the 2nd quarter will close with over 13.6 million doses less.
Administration
As of June 30 (update at 6.10 am), 57.1% of the population received at least one dose of vaccine (n. 33,823,702) and 31.1% completed the vaccination cycle (n. 18,410,229).
In the last week 3,823,828 million doses were administered, a slight increase (+ 1.6%) after the decrease of the previous week: however, 4,294,989 million doses are still “in the fridge”.
The 7-day moving average stands at 541,210 inoculations per day.
As for the coverage of the priority categories, 86.7% received at least the first dose of vaccine, with some regional differences: if Puglia, Umbria and Lazio exceed 90%, Sicily stops at 76.2% .
Over 80
Of the over 4.4 million, 3,930,326 (87.7%) completed the vaccination course and 273,892 (6.1%) received the first dose only.
Range 70-79 years
Of the more than 5.9 million, 3,365,081 (56.4%) completed the vaccination course and 1,860,324 (31.2%) received the first dose only.
Age range 60-69
Of the over 7.3 million, 3,557,990 (47.8%) completed the vaccination course and 2,514,299 (33.8%) received the first dose only.
Therefore, 2,384,966 (13.3%) over 60s have not received even a dose of vaccine, with significant regional differences: from 23.8% in Sicily to 8.1% in Puglia.
The trend of vaccination coverage by age group now confirms the flattening of the curves of the over 80s and the 70-79 and 60-69 age groups, as well as recording a sharp decline in the last three weeks for the 50-59 age group, already at coverage less than 70%.
Delta variant and vaccination strategy
To date of the 17,886,878 over 60, 2,384,966 (13.3%) have not yet received even a dose of vaccine and 4,648,515 (26.0%) are waiting to complete the cycle with the second dose: 3,154 .159 with AstraZeneca, 1.286.101 with Pfizer-BioNTech and 208.255 with Moderna. In all, therefore, over 7 million people over 60 are partially or totally exposed to the risk of serious illness who do not have adequate coverage against the variant.
While not currently knowing the exact prevalence of the Delta variant in Italy, its greater contagiousness and, above all, the documented limited efficacy of a single dose of vaccine require a re-evaluation of vaccination strategies to minimize its clinical impact and that on health services. .
Two priority objectives: on the one hand, to reach the largest possible number of over 60s who have not yet received even a dose of vaccine, on the other hand to anticipate the administration of the second dose in this age group as much as possible.
However, if for mRNA vaccines the minimum interval between the two doses can be brought back to the original one (21 days for Pfizer-BioNTech and 28 days for Moderna), this is the case with AstraZeneca. In fact, if the recall would be formally permitted by the indications of the package leaflet starting from the fourth week following the first administration, ministerial circular no. 5079 of February 9, 2021 recommends an optimal interval of 10-12 weeks to ensure greater efficacy of the vaccine.
Gimbe's advice
If to counter the spread of the Delta variant, territorial services must return to the field by enhancing contact tracing, sequencing and screening at the borders, to limit the impact of severe Covid-19 and hospitalizations it is necessary to accelerate the administration of the second dose in over 60s. a univocal strategic choice is needed, without leaks forward by the Regions, aligned with the authorized indications of vaccines and adequately communicated to the population, also because, in relation to the stocks of vaccines available, new vaccinations and recalls of the under 60s may have to suffer a slowdown.