Fortify the strategy against Covid-19

Although the sense of danger has decreased in the population after the pandemic, SARS-CoV-2 is still circulating endemically and regains intensity in the colder months, when respiratory viruses surge. It is necessary to maintain vaccination among groups at higher risk of complications. This is stated by Dr. Ignacio Salamanca, medical coordinator of the Research Unit of the IHP Group, member of the Vaccine Advisory Committee of the AEP and member of the strategic plan of Andavac. The expert emphasizes that “current vaccines mainly protect against severe illness, hospitalization, and mortality, but do not completely 'block' infection or transmission. In this context, he values the incorporation of the HIPRA vaccine, which expands the range of available tools.

“Covid has not gone away and continues to maintain a constant, endemic circulation,” Salamanca emphasizes. The specialist acknowledges that, “on an individual as well as collective level,” the perception of the disease's importance has diminished; even “among healthcare professionals,” he admits. This sustained circulation is also accompanied by an increasingly recognizable pattern. “In the last two or three years, it behaves more intensely during the winter,” he explains, coinciding with the general increase in respiratory infections due to the cold and more indoor cohabitation.

Salamanca insists that this new 'normality' does not equate to trivialization. Although today the infection is often mild in healthy individuals, he alerts us to three reasons not to let our guard down: “first, because it has not left us; second, because it is very common; and third, because in healthy people some will have some type of more significant complication, but especially in vulnerable groups.”

The specialist focuses on the groups for whom prevention remains crucial. The recommendation, as he explains, focuses on “those over 60 years old,” “residents of senior and disability centers,” and people “from 5 years old with risk conditions,” such as patients with chronic diseases, immunocompromised individuals, or those with obesity, among other profiles defined by the health authorities.

Moreover, the expert focuses on individuals living with at-risk patients. “It is very important that they are vaccinated to create a barrier around the most vulnerable people that reduces the risk of transmission and, should infection occur, its clinical impact.”

Regarding the inclusion in the Andalusian vaccination schedule of the Bimervax immunization, developed by the Spanish company Hipra, Dr. Salamanca clarifies that “it does not replace the vaccines we already have, but it complements them. It is another element to reinforce the training of the immune system, even in people who have already had Covid or received other vaccines.

“It is a vaccine different from the mRNA vaccines. We are familiar with its platform; it is based on proteins (in this case, two proteins) and is accompanied by an adjuvant that enhances the response, as is the case with other vaccines. Additionally, it offers an alternative to individuals who have experienced severe adverse events with other platforms or who are wary of mRNA vaccines,” he states.

Guidelines in Andavac

According to the approach of the Andalusian Vaccination Plan, Andavac, the vaccine will be used in individuals 70 years or older, people 12 years or older with risk pathologies, individuals 12 years or older institutionalized in senior residences and disability centers, people 12 years or older who have an indication for vaccination against Covid-19, but have contraindications to receiving the mRNA vaccine.

“In terms of efficacy and safety, it is expected to act as a booster in people already immunized by infection and/or vaccination, and potentially with protection that complements the duration against severe illness,” the expert explains.

Additionally, it is a vaccine developed in Spain. “This can have a logistical advantage since mRNA vaccines require more demanding conservation conditions, and a different platform can facilitate storage and handling,” summarizes Dr. Salamanca.

In the fall-winter strategy, Salamanca endorses the coadministration of flu and Covid vaccines in a single act, especially in the elderly.

Lastly, the expert highlights that the value of vaccination also lies in the importance of preventing long Covid or persistent Covid, “a problem that has been relegated to the background with significant underdiagnosis and enormous clinical variability,” he emphasizes.