Pomos in cloudy waters

2021/04/28 Galarraga Aiestaran, Ana - Elhuyar Zientzia Iturria: Elhuyar aldizkaria

• COVID-19
• Medikuntza
• Farmakologia
• Osasuna

What happened with the AstraZeneca vaccine has created a whirlpool that mixes information and concern. The waters were no longer completely calm: there were and there are people who renounce vaccines (all), but also some favorable looked with suspicion at covid-19 vaccines, especially because they have developed them very quickly and had doubts about their safety.

Transparency is critical to building trust and has been transparent by the European Medicines Agency (EMA). He is responsible for European pharmacovigilance and has the mission to collect, investigate and make decisions on all incidents caused by drugs. In the case of vaccines, this follow-up is particularly close as the authorization granted is emergency. We are in an emergency situation.

It is common for clinical sessions to show undescribed or measured effects on a large population. It has also occurred with covid-19 vaccines. Many of these conclusions have been positive. For example, they have seen that, in addition to avoiding the disease, they are able to reduce to some extent the transmission of the virus; that they are safe for pregnant and lactating women; that the interval between the two doses of AstraZeneca can be extended, so it is possible to put the first dose to more people than they thought; that the vaccine is safe and effective for older people; and that in some with persistent COVID eliminates symptoms.

Together with them a series of adverse effects have been described, so rare, that they have not resulted in the withdrawal of the vaccine or the imposition of strict limitations. The proportions in which they occur have been measured, it has been noticed that if it affects certain people they are not delivered and have been included in the package leaflet. Pfizer vaccine, for example, has produced anaphylactic shock (very severe allergic reactions) in few people who did. Therefore, this vaccine will not be given to people who have this risk.

With the AstraZeneca vaccine they discover that it may be related to rare thrombotic events. This relationship is being investigated and, while clarifying the causal effect, it is added in the package along with other side effects. SEM has realized all this with transparency and has confirmed that the vaccine is safe and effective. The same has been said by the World Health Organization and other international reference organizations.

However, some European countries have decided not to vaccinate AstraZeneca in some age groups. Not everyone has defined the same age range, nor how they will act with those who have received a single dose (if the second will be from AstraZeneca, if they will be given from another house or if they will leave them with one). That is what the whirlpool has caused. Because decisions have not been shared and have not been based on scientific criteria.

Last Sunday Felix Zubia Olaskoaga explained in this same newspaper that the AstraZeneca vaccine has much more benefits than risks. Like him, there are many (we are) who try to resolve doubts and concerns, but it is not an easy task when the waters are so turbulent.

Citizens need handholds, numbers and tests that give them confidence. And fortunately there is clear evidence of vaccine efficacy and safety. In Spanish nursing homes, for example, covid-19 caused two deaths last week, which two months ago were 791. For its part, the most widespread vaccine in the world is that of AstraZeneca: It is broadcast in 115 countries and, outside Europe, have found no reason to interrupt or restrict vaccination. Finally, in countries where vaccinations are very advanced (Israel, some places in the United States...) preventive measures have begun to become more flexible.

Vaccines will not provide a definitive solution. Much is needed to introduce the majority of the population and you cannot know when group immunity will be achieved or if it is achievable. For a while it will be necessary to maintain our prevention measures and it may be necessary to establish other strategies (the Zero Covid strategy, for example, is yielding good results in some countries). But for the moment, vaccines are the strongest prey to get out of the whirlpool.