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  • @ Cynthia Adina Kirkwood

Portugal: 2nd Phase of COVID-19 Vaccinations

Updated: Apr 13



The second and final phase of Portugal’s vaccination rollout begins on April 12 and aims to pick up the pace by, largely, using age as a criterion starting from the youngest at 79.


The first phase, which began in December, suffered a shortage of vaccines. If contracted vaccines are delivered on agreed timescales, the second phase will present the opposite challenge, according to Expresso (April 1).


In April, 1.8 million doses are scheduled to arrive for a total of 8.6 vaccines over the second quarter, when the goal is 95,000 daily administered doses. By contrast, in January, February and March, there were 2.6 million doses and a goal of 22,000 daily administered doses.


“These are the numbers that will allow the daily rate of vaccinations to rise in April until reaching 100,000 inoculations per day, with peaks that should reach 150,000 in the following months, “COVID-19 Task Force Leader, Vice-Admiral Henrique Gouveia e Melo, said in Expresso.


The majority of expected doses in April are the Pfizer vaccine and, at the end of April, the single-dose Janssen (Johnson & Johnson) vaccine.


From July to September, 14.9 million vaccine doses are scheduled for arrival and, from October through December, 9.5 million doses.


Gouveia e Melo anticipates a faster rollout with fewer “groupinhos”, or small priority groups, slowing down the process. Teachers and school workers, for example, were added to the first phase. He said that if we continue to vaccinate in small groups, we would accumulate doses in the warehouse.


“It is necessary to end vaccination by groups of diseases and move towards vaccination by age,” said Gouveia e Melo, according to Diario de Noticias (April 1). “It does not make sense to keep the majority of the population waiting for all groups to be vaccinated.”


There will still be prioritized patients. However, they will account for only 10 percent of those in the second phase, reported SIC Noticias (April 7). The new altered list includes patients of all ages who suffer from serious chronic heart, kidney and lung diseases; neurological diseases; cerebral paralysis; epilepsy; those with transplanted organs; active malignant neoplasm; obesity, and diabetes (Type 1), according to SIC Noticias (April 8). Diabetes (Type 2) and hypertension have been dropped from the list.


The Directorate-General of Health (DGS) characterizes its vaccine rollout as flexible and adaptable. Besides the change in prioritized patients, the rollout, initially, consisted of three phases and has been reduced to two, according to SIC Noticias (April 7). Also, the first phase was extended by two weeks.


Since the beginning of the vaccination rollout on December 27, this is the second time that the criteria have been changed with regard to age, reported Diario de Noticias (April 1). The first time was in January after several experts protested that people aged 80 and older were not included in the first phase, which did include health workers. The doctors argued that this age group, which recorded a high number of COVID-19 deaths in Portugal, would be at greater risk if not protected by vaccination.


The recent recommendation of restricting the AstraZeneca vaccine to those 60 and older is not expected to slow down the vaccination process.


The Pfizer vaccine is the most widely distributed vaccine in the country. Portugal has administered 1.4 million doses of the Pfizer vaccine as compared with 388,000 doses of the Oxford AstraZeneca and 128,000 doses of the Moderna vaccines, according to Expresso (April 8).


“The European Medicines Agency (EMA) Risk Assessment Committee on Pharmacovigilance (PRAC) reported on April 7 that there is a possible link between the administration of AstraZeneca’s COVID-19 vaccine and the occurrence of thrombotic events in atypical locations,” stated the Directorate-General of Health (DGS).


“. . . These phenomena are included in the summary of the drug’s characteristics as adverse reactions. COVID-19 is a serious disease associated with the risk of hospitalization and mortality. Overall, the EMA considered that the benefits related to the prevention of COVID-19 outweigh the risk of these adverse side effects.”


Why, then, has the AstraZeneca vaccine, which has been renamed Vaxzevria, been recommended for those 60 and older? According to the DGS:


Specifically:


-- Above 60 years of age, there was no association between the use of this vaccine and the occurrence of these thrombotic phenomena;


-- Under 60, there is an association with rare and above-expected thrombotic phenomena, which are still under investigation;


-- The decision to vaccinate always takes into account a balance between the benefits (preventing the disease) and the risks (adverse reactions of the vaccine);


-- As age advances, the risk of complications from COVID-19 increases, and the risk of thrombotic events that are being associated with this vaccine decreases. In younger populations, the risk of complications from COVID-19 is low, especially in people without disease, and it is in these populations that thrombotic phenomena under investigation have been found.


A total of 2,109,087 COVID-19 vaccine doses have been administered, reported by the DGS on April 11. Those who received both jabs: 598,901. Those who received the first jab: 1,510,186.


Portugal has a population of 10.3 million.




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