In the picture, the team at the Gerencia de Atención Integrada from the Hospital of Tomelloso. From Left to right: Sofía Gómez, David Serna, Ana Belén Ortiz, Fátima Jaenes, Inmaculada Crespo.

Since the end of 2019, the new respiratory infection caused by a new coronavirus, called Covid-19, has been a new challenge to global society, especially at the healthcare and logistical level, causing so far more than 100 million infections and almost 2.5 million deaths worldwide. The evolution of the pandemic has paralyzed the world economy and our social life, emptying the streets of the main capitals of the planet. 

For this reason, the vaccines developed against SARS-CoV-2 represent a great hope to stop the spread of the coronavirus. In Spain, since the 27th of December last year, following the approval by the European Medicines Agency of the first two vaccines against the coronavirus from the pharmaceutical companies Pfizer/BioNTech and Moderna, the Spanish government has launched a vaccination strategy that aims to vaccinate the entire population before the end of summer 2021, positioning itself so far as the fifth EU country with the highest vaccination rate.

From the Office of Cultural and Scientific Affairs of the Spanish Embassy in London, we have been interested in the evolution of this vaccination strategy in the Gerencia de Atención Integrada del Hospital de Tomelloso, located in the Castilla-La Mancha region, in the center of the country, which is home to more than 60,000 users. There, David Serna, a nurse from the Preventive Medicine Service who, alongside his colleague from the Occupational Health Service, Ana Belén Ortiz, is coordinating the vaccination against Covid-19, attended to our AECID Collaborator for Scientific Diplomacy, Miriam Ruiz Ponce.

David explained that his hospital management is currently administering the vaccine from the pharmaceutical companies Pfizer/BioNTech and AstraZeneca, which are distributed weekly from the central services of the Castilla-La Mancha Health Service (SESCAM) located in Toledo. Depending on the type of vaccine, the vials arrive at the hospital premises frozen, as is the case with the Comirnaty vaccine (Pfizer/BioNTech) and are stored in an ultrafreezer capable of maintaining the vaccines at -80°C as specified in the manufacturer’s data sheet for subsequent reconstitution and inoculation of priority risk groups, while AstraZeneca Vaccine vials arrive refrigerated at -20°C and are stored in a refrigerator at 2-8°C until administration.

“We have completed the first stage of the vaccination process in 100% of the residents of the elderly centers, together with the workers who assist them, all the non-institutionalized dependent people who are in their homes and all the health and social-health staff of SESCAM”, says David Serna, pointing out that the process has been following the strategy set by the Ministry of Health. Currently, they are in the second stage of vaccination, having vaccinated with the first dose of Comirnaty vaccine the elderly groups over 80 years of age. At the same time, the first dose of AstraZeneca Vaccine has been administered to 100% of all healthcare staff outside SESCAM -pharmacists, dentists, physiotherapists, etc.- under 55 years of age. All other staff over 55 years of age will be vaccinated with Comirnaty vaccine when appropriate for their age group. David believes that by the end of March 100% of these groups could be immunized: “If we have the promised vaccines with us in time, it’s almost certain that by June the whole population managed by the Hospital of Tomelloso will be vaccinated.”

Regarding vaccine availability, David declares that in recent weeks they are seeing a delay in receiving new vials due to various manufacturing, shipping and logistical setbacks from the pharmaceutical companies. This is slowing down the vaccination process.

Reticence to the vaccine has been minimal, perhaps due to the impact that Covid-19 had in March in elderly residence and the hospital sector. However, David fears that due to the lack of knowledge and fear erroneously linked to the vaccine, the excellent vaccination rates in the health and social-health sectors in the adult-juvenile population may not be achieved. For this reason, he advocates a greater and more effective dissemination of how the vaccine works, since in the risk/benefit ratio, the benefit clearly wins out. This benefit has been reflected in the absence of rare or serious adverse effects, only mild effects such as muscle fatigue, fever and pain at the puncture area have been reported, typical effects of other vaccines such as flu. David has also emphasized that the Covid-19 vaccine is only contraindicated in large patients who are allergic intramuscularly to any component of the vaccine.

On the other hand, it was necessary to inquire about the existence of possible Covid-19 positive cases in people previously vaccinated with the first dose, to which David comments that they have only had 10 cases of this type. In addition, he clarified that these people developed symptoms believing that they were adverse effects of the vaccine, however, to be positive for SARS-CoV-2 they must have been infected at least 8 to 12 days before the onset of symptoms, so when they received the vaccine, they were already infected. Both in the case of a positive result in Covid-19 as in cases of a declaration of positive close contact of a person previously vaccinated with the first dose, the process of administration of the second dose is stopped and is not resumed until the isolation the end of its isolation time and the test result is negative against Covid-19, that is, isolation is prioritized versus vaccination of the second dose in these cases for over 55 years. However, in people under 55 years of age, the second dose is administered 6 months after having COVID-19. 

In short, David is excited and enthusiastic about the idea that the mass vaccination that is being carried out quickly and efficiently not only in the community covered by the Tomelloso Management but also at a national level may soon allow us to return to the normality we knew before.

David concluded his interview by reminding us that it is vitally important that both vaccinated and non-vaccinated people continue to take preventive measures to avoid the spread of the virus, such as wearing a mask, frequent hand washing and maintaining interpersonal distance.