The Vaccination Strategy against the coronavirus includes as of this Friday the option that the under 60 years who have received the first dose of the vaccine AstraZeneca They can complete the regimen with this same serum and not with Pfizer’s, provided they sign an informed consent.
The Bioethics Committee considers “ethically and legally recommended” that the population group involved sign a consent if they refuse to receive the second dose of Pfizer in favor of repeating with AstraZeneca
The Ministry of Health has included this option after the Bioethics Committee has issued its report, although it is not binding, in which it considers “ethically and legally recommended” that this population group – the majority of essential workers – sign a informed consent specific if you refuse to receive the second dose of Pfizer Please repeat with AstraZeneca.
Health and the autonomous communities already approved last Wednesday to allow those under 60 vaccinated to receive the second dose of AstraZeneca if they refuse to do so with Pfizer, although the minister Carolina Darias he wanted to make it clear that “it is not a matter of choice.”
And it is not, said Darias then, because the Public Health Commission decided a day before, on Tuesday, that this group receive the second dose of the mRNA vaccine [Pfizer], although it was very divided because the proposal went ahead with ten votes in favor; seven, against; and three abstentions.
Health advises combining vaccines
That same Tuesday, Carlos III Health Institute forwarded to Public Health the preliminary results of the clinical trial launched with 678 volunteers that confirmed the efficacy and safety of combining both vaccines.
However, the Ministry decided to send a query to Bioethics to find out its opinion on whether it is correct, from the ethical point of view, complete the regimen for these patients with the Anglo-Swedish serum and, in that case, if it should be under informed consent.
For the committee, a second dose of AstraZeneca could be applied to those people who refuse to do it with Pfizer “not as an expression of any power of choice, but for the sake of collective health and their own individual health”
The committee has concluded that “the criteria for decision-making in the vaccination strategy should not be altered and allow people under the age of sixty who received a first dose of said vaccine to choose the second dose vaccine.”
Both individual self-interest, “based on the absence of sufficient information” on the risks derived from this vaccine, and the group represented in the Vaccination Strategy, together with the different ethical-legal principles, “report against accept the freedom of choice of the vaccine by said population group ”, he argues.
“Notwithstanding all of this, a second dose of Vaxzevria” (trade name of AstraZeneca) could be applied to those who refuse to do so with Pfizer “not as an expression of any power of choice, but for the good of collective health and your own individual health”, Explains the committee.
But he clarifies that he will be able to do it “as long as, obviously, there is availability of this vaccine ”.
As of March AstraZeneca had to have delivered 12,232,200 doses to Spain, although only 5,713,800 have arrived to date; Of these, 4,896,673 have been tapped: 4,896,082 people have the first one and only 591 people have completed the pattern.
The communities currently have 817,127 doses without pricking, according to the latest vaccination balance published daily by the Ministry of Health. On Wednesday, the minister pointed out that this week other 261,000 of this laboratory.
It is expected that this week Spain will receive 261,000 doses of the AstraZeneca vaccine
In the Bioethics report he recognizes that the situation generated by the pandemic is “difficult to manage not only for political leaders and scientific experts themselves, but also – and sometimes even more – for citizens”: “Decision-making in Such difficult contexts must know how to combine the virtue of the decision with the achievement of the aims pursued ”, he continues.
“It seems ethically and legally recommended that people who refuse to be vaccinated with a heterologous scheme sign a specific informed consent protocol, which documents their rejection of vaccination” and that “they have sufficient information on the risk of thrombosis syndrome with thrombocytopenia ”Associated with AstraZeneca.
This written consent “would operate in this case very concrete and exceptional not only as a written confirmation that the individual has made a decision to refuse to be vaccinated in a heterologous vaccination schedule, but also that they are aware of the risks of the decision of only accepting to be vaccinated with a second dose of the same vaccine that he received in the first dose ”.
Health has also incorporated into the Vaccination Strategy the consent that those who reject Pfizer by AstraZeneca must sign and their express request to repeat it, stating that they know the risks of this.