8 in 10 did not receive second dose of Covid and why the world is applying another prescription

The gap between Argentines who received one and two doses against the coronavirus it could be even more important than today if China had guaranteed the government a sustainable supply of vaccines beyond the 4 million Sinopharm received. As this was not possible, they had to apply the two million arrived in April to second doses.

This exogenous limitation will allow those who have been vaccinated with the first dose of Sinopharm to be able to fully immune. There was no certain data to support that a single injection of this Chinese vaccine guaranteed immunity.

It was a stopgap in the procrastination paradigm, elected in March by the Argentine authorities: that is to say, wait at least three months so that people vaccinated with the first dose get the second.

With AstraZeneca, the British have found that 12 week interval they potentiate the antibodies for more than 21 days. With Sputnik V, however, we don’t know. A single dose has been proven to provide 79% effectiveness, while the second increases it to 92%.

The problem is that Sputnik’s second component is more difficult to bring to the country, which – along with the AstraZeneca hole since new deals haven’t been made with other labs – caused the health deficit that Argentines suffer today.

According to statistics from the Our World in Data website, in Argentina 8 out of 10 people vaccinated they did not receive the second dose. The Vaccination Monitor translates the proportion into absolute figures: according to the latest data, the country arrived on Monday at 10 million vaccines applied and fair 1.95 million people got the second dose.

This is one of the averages lowest in the world. Among countries that have already applied the first dose to at least 10 percent of their population, Argentina escorts Canada in the world’s largest second-dose deficit. Canadians have also opted for this same procrastination policy and there less than one in 10 vaccines received the full schedule.

However, Canada has already successfully applied the first dose to 44.3% of its inhabitants, while Argentina recently reached the 17.7 percent. Another country that decided to postpone the second dose is the UK. Despite this, half of Britons vaccinated with the first dose (52.6%) received the second. The European average gives between 30 and 50 percent people vaccinated with the first dose also had their supplement.

In the United States, there is a strong scientific debate on the possibility of accelerating the first doses to the detriment of the second, but in view of the fear of Covid variants, the authorities prefer for the moment to continue on the path more conventional and safe: 46.7% received one dose and 36.9% received two.

In Argentina, hardly 4.1 percent of the population received the complete diagram. In Canada, 3.7%. The Argentine government said its decision was to vaccinate everyone in the country with both doses. The question is to know when the Gamaleya Institute will be able to deliver the second part, which is now almost legendary.

As for AstraZeneca, the emergency arises with the 580,000 people who have already received the first dose of Covishield (Indian version) and the million vaccinated with the doses provided by Covax (all from AZ). The first batch of almost 4 million vaccines that the laboratory would bring before the end of May – 22.4 million bought by Argentina -, enough to supplement the second doses of those already vaccinated and then continue to apply the first doses.

The world stage

The most balanced country between the first and second dose is Israel (62.8 and 58.9%), followed by Chile (47.5 and 39.2%), the United States (46.7 and 36, 4%) and Uruguay (38.7 and 26.9%). The world average: 9 percent population, the first dose was administered and the 4.6 percent, the second. Argentina almost doubles the first mark and falls below the second.

Regarding the criterion for the delay of the second dose, there is divergent looks. In Brazil, people who do not show up to complete the vaccination schedule are concerned. “The data shows that the person is protected with two doses. With one, she did not complete the plan and is not properly vaccinated, ”said Isabella Ballalai, vice president of the Brazilian Immunization Society. 16.8 percent of the population was initially inoculated and the 8 percent, in second.

International organizations have advanced different positions on the deferral criterion. European Medicines Agency (EMA) warned without flexibility that approved Covid-19 vaccines “should be used as described in the product leaflet “.

The WHO Strategic Advisory Group of Experts on Immunization underlined, in early 2021, that in exceptional cases and depending on the epidemiological situation of each country – and the availability of vaccines – the period between the two doses could be extended by a limited time. They established that the maximum delay should be six weeks.

Scientific studies have established that delaying second doses (due to the fact that the first dose could be applied to more people) reduces deaths, new infections and hospitalizations. Although this generates uncertainty about the validity period of the vaccines with only half a program, without timely reinforcement.

A possible immune response weak against variants like that of Manaus or that of India (which are already circulating in Argentina) could open the window – according to experts – to another Covid more flowery: that is to say the opportunity for the virus to reincarnate in new variants, more dangerous and deadly. At the individual level, the application of a single dose serves to cushion the emergency. The latent risk jeopardizes public health in the future.

When analyzing the immunization policies of different nations, it is curious to observe how a ubiquitous element is essential to the achievement of a better balance between the first and second dose: the “Pfizer Factor”. The countries which have contracted the same vaccines as Argentina (AstraZeneca, Sputnik V and Sinopharm), but also that of Pfizer, have achieved skip the second dose for a few.

This is the case of the United Arab Emirates, which vaccinated 51.4% of its population with the first dose and the 38.8 percent with the second. At much lower levels, Peru has Oxford, Sinopharm, and Pfizer: half of their vaccinated received the second dose. Or Colombia, which has Oxford, Sinovac and Pfizer, applied 8.6% of the first doses and 5.3 seconds.

In the middle there are cases like Hungary, which, in addition to the vaccines Argentina has, has Pfizer and Moderna and has managed to get more than half of its vaccines vaccinated. already have both doses (47.1% received one).

Mongolia, the same case, but only with the supplement of Pfizer, vaccinated 54 percent of the population with one dose and at 19.6, with two. Montenegro – the same vaccine portfolio as Mongolia – applied the first dose to 16.5 percent of its population and 5.3 per second. Serbia, with these same marks, inoculated 33.5 with the first dose and at 25.6 with the second.

In the last hours, a British investigation became known, published in the journal Nature, which indicates that the postponement of the second dose of Pfizer’s vaccine by three months increases the level of antibodies. The group tested is limited: 175 patients over 80 years old.

This work also concludes that the carryover was depleted during the extended interval. T cell response, keys to maintaining immunity over time. They found that the immune architecture was better forged in those waiting for the second dose only three weeks, as the Pfizer manual says.

Why do the vast majority of countries that have successfully started their vaccination campaign show better balance than Argentina between the first and the second dose? The answer lies mainly in availability. It is likely that the decision of the Federal Health Council (Cofesa) would not have been the same if the vaccines purchased by the country had arrived on time.

The government does what it can – more than it wants – trying to tame an unfavorable reality produced in part of the global context, but above all decisions taken at the end of 2020 that have not yet been corrected so far in 2021.

From now on, it acts by default: the rest of the two million Sinopharm is applied as a second dose because in the short term there will be no new Chinese lots; the second dose of AstraZeneca is postponed under the auspices of a study which verified that a three-month interval is better than the standard 3 weeks, and because the first delivery of those from Oxford would only arrive at the end of May when it was scheduled for March; and it hardly applies the second component of Sputnik V because Russia – on the “light” version – communicates to the planet that there is not enough stock.

PS