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The next steps to start the vaccination seem to be marked. On December 21, the Pfizer / Biontech vaccine received the green light from Ema, the European drug agency, then final approval from the EU Commission and Aifa, the Italian agency, will come gradually. Meanwhile, the vials must leave the production plants in Belgium and begin their journey to all 27 EU countries, including Italy.
Rebuilt by director Nicola Magrini in an interview on Corriere della Sera, the next phase will begin on December 25 when the vials, escorted by the army, arrive at Spallanzani in Rome and from there, between Christmas and Saint Stephen, they must arrive at the first delivery points for the official start of the vaccines on the 27 from December. then a symbolic date for all of Europe. The problem is that the certainties end on that day.
The Arcuri numbers problem
The next steps of the vaccination campaign to be carried out during 2021 are written in black and white in the plan that Super Commissioner Domenico Arcuri presented in early December. The problem is that this plane is as fragile as glass. A few shakes are enough to break it into a thousand pieces. And these shakes are starting to come from many places.
But what does the plan say? According to the data provided, the project expects to have 90% of Italians vaccinated by the end of 2021. In the official documents of the Ministry of Health there is a graph that indicates the forecast of progression of vaccination in the four quarters of 2021. According to this scheme by the end of March, at least 5% of the population should be immunized, approximately 3 million people, and should concern social-health workers and fragile people of the RSA.
In the second and third quarters, the numbers are expected to grow to 15% and 50% respectively. So, according to the plan, on the eve of the new school year, at least half of the population should be vaccinated against Sars-Cov2. Finally, within a year we should reach 90% of vaccinated Italians.
The plan is ambitious but has many unknowns. The certain figures of what awaits us for 2021 are not many and are limited to a time horizon that does not go beyond the beginning of spring. On December 16, during the State-Regions Conference, a report was presented to clarify how the plan will be implemented in the coming months. Not only with regard to the categories to be vaccinated, such as doctors, nurses, the elderly, but also how the doses should be distributed. At the moment we are starting with a first trance of the Pfizer / Biontech serum of 1.83 million vials that should arrive in batches. While a second delivery of 2.5 million units is scheduled for January.
The delivery of these doses, Magrini de Aifa explained, should be done in stages, around 300 thousand per week to be assigned to about 222 vaccination points in the different regions, points that by January 7 should grow to 289. Calculator In hand with these rhythms, the delivery of the first block should take place within a month, around the second half of January. At that point, the modern pharmaceutical company vaccine should also enter the delivery loop. Overall, Magrini said, “in the first quarter we plan to immunize 1.5 million Italians per month belonging to the categories designated as priority.”
Magrini’s projections are essentially in line with those of the Arcuri Plan. But the first problem arises when you start counting the doses. If we keep Magrini’s optimistic estimate, on paper we need at least 9 million doses by the end of March, while if we keep Arcuri’s roughly 3 million, the doses needed are around 6 million.
At the moment, however, there is no other data. With the two trances of the nearby Pfizer / Biontech on paper, it will be possible to vaccinate just over 2 million people. According to preliminary purchase agreements between the EU Commission and the pharmaceutical companies, Italy should be entitled to approximately 26 million doses of the Pfizer vaccine, eight in the first and second quarters and ten in the third. But there are no certainties about these numbers. Perhaps Moderna’s vaccine can come to the rescue, on which the EMA will speak on January 6, but even here the numbers are limited. Italy should be able to have only 1.3 million doses in the first quarter, therefore a little less than 600 thousand vaccinable, but as for Pfizer serum, also in this case we are faced with more forecasts than certain deadlines that we can set in the calendar.
With the figures and information available to us at this time, the maximum that can be obtained is about 2 million people vaccinated in the first trimester. A number well below expectations. And above all, a slightly long figure compared to the goal of 90% at the end of the year. Getting it means being able to vaccinate more than 50 million Italians in 9 months, figures that at the moment seem lunar. On the contrary, if the rhythm were the one indicated by Magrini, there is a risk that it would end in 2023. Surely the figures will increase when other vaccines arrive, such as AstraZeneca’s, but even on this there are more doubts than certainty, the company arrives late. after half a mess in the testing phase and it is still unclear if the first doses will arrive at least in late January or beyond. Fears also shared by infectious disease specialist Matteo Bassetti, heard by Nation: «It is clear that the AstraZeneca candidate does not seem to be a miracle: there is talk of a lower efficacy than Pfizer and Moderna, then the dose must be readjusted. AstraZeneca will likely delay shipping the doses until the third quarter of 2021 ”.
Although Italy has opted for 200 million doses of future Covid vaccines, problems continue to mount, such as that of the pharmaceutical company Sanofi. The Union had reached an agreement with the French group for the supply of 300 million ampoules, but the times are approaching. Italy was entitled to 40 million for the supply between June and December 2021, but the delay will postpone everything until 2022. And it is no coincidence that the tables provided by the Arcuri working group have been changed between the beginning of this month and the 17 from December. latest.
Doctors and the third wave also worry
The complicated risk of supplies goes hand in hand with other problems that the Italian system will have to face. First of all, the health workers needed for such a massive vaccination campaign. On paper, it is estimated that at least 15,000 operators, 3,000 doctors and 12,000 nurses are needed. The problem, Bassetti noted, is that the announcement was late. In fact, the apps only opened on December 16 and should be closed before the end of the year. Among other things, the figures are still not certain since to have sufficient economic coverage it will be necessary to go through an amendment to the budget maneuver. Second The sun 24 hours this amendment could even be omitted and then re-incorporated into a year-end decree.
The plan could take another hit in the event of a third wave of the pandemic. For a few weeks, the data for the second seems to be falling, but the fall is much slower than the rise that began in autumn. The risk is that at the end of the holidays there may be a new peak in cases and therefore that this may greatly complicate the vaccination operations. Arcuri himself, at the press conference on December 17, was very cautious on this point: «The contagion curve is now firmly frozen and continues on a downward trend, but unfortunately it has not flattened, it has not disappeared. It would be really difficult to launch the largest mass vaccination campaign perhaps in a condition of resurgence of the contagion curve, the possible and feared third wave ».
It remains to be seen what the effects of the latest measures taken with a view to the Christmas season will be. The truth is that the road continues uphill and there are many unknowns. It is difficult to keep the promise that 90% of Italians get vaccinated in one year. But it is also difficult to reach the minimum goals to have enough herd immunity to overcome the pandemic. According to the WHO, the circulation of the coronavirus can be stopped with vaccination coverage between 65 and 70% of the population, a figure that corresponds to about 40 million Italians. An important goal, but the numbers in hand still seem a long way off.
