Italy could vaccinate the wrong people, depending on death toll

Looking at the daily data tracked by the continuing number of coronavirus deaths in ItalyIt would be impossible to say that the country had been armed since the end of December with various vaccines.

At a time when the pandemic turned into a race for these vaccines and a more deadly variant emerged, most Western European countries have successfully reduced their death rates through a combination of blockages and vaccinations. The death rate in Italy, however, is very similar to what it was three and a half months ago, despite receiving the same dose report than other members of the European Union. Wednesday, the country has reported 627 other victims of the virus, the highest daily figure since early January.

The question of what went wrong in Italy now puzzles a severely battered nation that believed they had overcome the worst. Many factors are at play. Italy, the second grayest country in the world, has more elderly people to be vaccinated than most. In February, according to mobility data, it was a little more open than other major European countries, which caused the virus to spread further; He has since returned to take drastic action. At the same time, the deadliest variant first detected in Britain dominated here and in other parts of the continent.

But some scientists and data analysts say Italy’s vaccination campaign is also to blame. The country, they say, has vaccinated too many bad people, prioritizing young workers and leaving the elderly vulnerable.

“Things haven’t been done properly over the past three months, that’s clear,” said Sergio Abrignani, an immunologist and new member of a scientific committee advising the government. “Otherwise, we wouldn’t have 300, 400 dead every day like now.”

Italy’s situation offers lessons for other countries facing their own tough decisions about who prioritize with limited vaccine supply. European countries, including Italy, have mostly aligned to dedicate the first doses to frontline health workers and residents of nursing homes. But if the main goal is to avoid fatalities, the end result for Italy seems to be: once the job is done, continue to dose the elderly and be very selective about the young workers who might be eligible.

The data shows why Italy is still so exposed: among the countries of the European Union, ranks last for 70-year-old immunization, a group still very vulnerable to the ravages of the virus. Only 2.2% of this age group are fully immunized. All other age groups in Italy, including those people in their 20s and 30s received a higher proportion of total protection.

They are also paying for an initial decision to devote their first phase only to health workers, whether they are on the frontline or not, rather than vaccinating this group more slowly while simultaneously targeting the elderly. Most 80s had no protection until March, a rate which places it behind other European countries. Since then, he has been running to catch up. But it is the people infected weeks ago who are dying.

As a result, the profile of the average victim has changed little. At the end of December, this victim was on average 81 years old. Now, the average age is 79.

“Every minute of these delays (in the vaccination of the elderly) results in a dramatic loss of human life,” said Piero Ragazzini, general secretary of a union of retirees.

The starkest contrast to Italy comes from France, which devoted the vast majority of its doses to the elderly and administered at least one dose to 50% of 70-year-olds. If France is well known for its skepticism about vaccines and got off to a slow start, Prime Minister Jean Castex insisted at the end of February that the country was ahead of the others in vaccinating “the right people”. Anyone aged 70 and over in France became eligible for a vaccine at the end of last month.

Countries make a good comparison as they have been quite similar in terms of lockdown and mobility rules in recent months.

Over the past week, France has recorded 1,900 deaths from COVID-19. Italy registered 3,000.

“We need to continue to vaccinate people over 75 and increase vaccination for people with co-morbidities, as statistics show us that they have a higher likelihood of being hospitalized or severely affected,” Castex said.

In assessing why Italy has deviated, some experts point to a decentralized health care system, in which the country’s 20 regional governments have great latitude in determining who gets vaccinated. Although the central government health ministry has established guidelines on who to prioritize at the start of implementation (frontline health workers, nursing home residents, people over 80, and then essential agents), some regions have widely opened their doors to mid-career workers, but they only started giving doses to people over the age of 70.

In recent weeks, Italian newspapers have been filled with stories about the vaccinations of cooks, models and magistrates. Several regional surveys have been launched. Italian Prime Minister Mario Draghi, who took office in February, in Parliament accused some regions of “neglecting” the elderly, rather than favoring groups “which have probably gained priority because of their contractual force”.

Since several weeks, Italy is administering injections to middle-aged workers because it has no other choice. The national drug regulator had recommended that the Oxford-AstraZeneca vaccine be used only for people under the age of 55. But officials say even after this directive was lifted, with AstraZeneca approved for the entire population, regions were slow to adjust their strategies.

There are also questions about why some young people were vaccinated. According to government data, some 250,000 people in their 20s and 30s received their dose even if they are not teachers, health workers or law enforcement personnel, the essential groups. The Department of Health did not respond to a question about the rationale for vaccinating these people.. In government data, they are classified as “altro”, that is, “other”.

“In some areas, journalists have been vaccinated. In others, they vaccinated avocados, ”said Roberto Burioni, professor of microbiology and virology at Vita-Salute San Raffaele University in Milan. “University professors have now been vaccinated and are working remotely. I don’t see the logic behind it. It’s so foggy. “

Abrignani said that following Draghi’s comments, the situation appears to be improving. The doses given to people aged 70 and over have accelerated over the past week.

But Matteo Villa, a researcher at the Italian Institute for International Political Studies, which has tracked the coronavirus, said previous mistakes, especially the slowness in vaccinating those over 80, are still unfolding for now.

Villa is planning whatand Italy has so far saved 4,000 lives with his vaccination campaign, but whatwe could have been up to 12,000, under the optimal model.

He said there was an argument for inoculating key workers in later phases, but that These doses should only be given to people over a certain age.

“I can tell you they vaccinated the wrong people because they also vaccinated me,” Villa said.

He is 37 years old. She got her vaccination appointment a few weeks after her 92-year-old grandmother received a dose. Neither of his parents, aged 60, has been vaccinated.

“If you look at the lethality of the virus, you shouldn’t get the vaccine now,” he said.

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