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People between the ages of 50 and 75 with serious illnesses such as heart, respiratory and kidney failure, nursing home employees and users, and healthcare professionals involved in direct care should be the first to get vaccinated against COVID. -19, if the preliminary proposal of the committee of experts appointed by the General Directorate of Health (DGS) is approved. There will be about 250 thousand people in each of these groups, therefore, a total of around 750 thousand, according to a source linked to the PUBLIC.
In a second phase, there will be 45 thousand members of the security and civil protection forces and people between 50 and 75 years old with chronic diseases, such as diabetes, cancer, chronic obstructive pulmonary disease, among others, totaling about three million, according to the same source.
As for those over 75 years of age, according to the SIC, which advanced the news, they will be left out for the moment because “neither the pharmaceutical companies nor the European Medicines Agency presented [para já] sufficient evidence on the effectiveness of the vaccine in this age group ”.
The technical group for vaccination against covid-19, which will meet again this Friday, was based on the analysis of hospitalizations in intensive care and on existing studies that point to pre-existing diseases associated with more serious cases of the disease. In intensive care, the majority of inmates are between 50 and 79 years old. In this context, in pre-existing diseases associated with more serious cases of covid-19, kidney and heart failure stand out, as well as chronic obstructive pulmonary disease (COPD).
The elderly residing in nursing homes are part of these priority groups, since they are especially susceptible due to age and associated diseases and taking into account the severity that the covid-19 outbreaks have caused in these structures.
The proposal will also be discussed with the workgroup appointed this week, coordinated by the former Secretary of State for Health Francisco Ramos, and who is in charge of outlining the entire vaccination plan against covid-19, that is, logistical aspects such as storage, distribution and vaccination places, as well as the vaccination strategy, safety and communication with the population.
Vaccination in health centers
Vaccination sites have not yet been decided, but this should be done, at least in part, we health centers, although other solutions can be found for this, which will be the largest operation of its kind ever carried out in Portugal, said a DGS source, after Graça Freitas, the director general, said this week at a conference of press. that vaccines will be “sent to pharmacies located in decentralized places” in the country.
What Graça Freitas wanted to say is that “the vaccines will be sent to the pharmaceutical services of the Regional Health Administrations, which will then distribute them to the units of the country’s health centers. [onde são dadas todas as vacinas do Plano Nacional de Vacinação], not for community pharmacies ”, explained a source from the DGS to the PUBLIC, admitting that, eventually, other solutions could be found for this massive vaccination, similar to what is being projected in other countries.
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But these issues have yet to be defined by the workgroup which has a month, until Christmas Eve, to present the vaccination plan, according to the joint office (Ministries of Defense, Interior and Health) that was published this Thursday in newspaper of the Republic. At its core, the group includes representatives from the DGS, Infarmed (National Medicines Authority), Armed Forces and Civil Protection, with technical support from other entities.
With a period of six months, renewable if necessary, the group has 30 days to deliver the necessary documents to define the vaccination plan, in terms of all logistics (storage and distribution of the different vaccines) and strategy (identification of vaccines). priority groups, monitoring of results and adverse reactions). It must also define a communication plan with the population and provide “objective, clear and transparent information about the process”, as specified in the dispatch.
But in health centers – where all the vaccines of the National Vaccination Plan are administered and also that of seasonal influenza (this year the latter is, for the first time in a small part of the target population, to be administered also in pharmacies to people 65 and over. and over) – “Nothing is known yet” and “it is feared that everything will be done on its knees”, says the president of the National Association of Family Health Units, Diogo Urjais. “Even the flu shot [que envolve muito menos pessoas, 2 milhões nos centros de saúde] It is being an adventure and there have already been units that have had to look for alternative spaces because it is not possible, due to the pandemic, to have people crowded in the waiting rooms and there was even, in some cases, the need to vaccinate also on Saturday so as not to impair the activity. assistance ”, he described.
Diogo Urjais, recalling that primary health care professionals are “overloaded with work”, argues that it is essential that there is a “clear and transparent articulation and that, if necessary, other entities intervene, such as” municipalities and pharmacies ” .
Pharmacies “tired of uncoordination”
Although pharmacies have already offered to help in this mass vaccination operation, the president of the Ordem dos Farmacêuticos, Ana Paula Martins, says that neither the associations nor the pharmaceutical distributors have been contacted. “If the idea is not to have to build spaces [para este efeito]In this context, the collaboration of pharmacies will make sense, as is being studied in other countries, but we have to see if we have the capacity ”. It will also be necessary to see if pharmacies would be willing to collaborate, after the negative experience of vaccination against influenza this year, he emphasizes: “People are exhausted, they are tired of lack of coordination.” Despite having orders for more than 900,000 vaccines, pharmacies received only about half. Half are already administered and the other “200 and a thousand” have already arrived, but they are not enough for all, laments the president.
As for vaccination against covid-19, he argues, there can be no delays. “A vaccination operation for eight million people [o primeiro-ministro já anunciou que Portugal está preparado para comprar 16 milhões de doses de três tipos de vacinas] it is very complex ”, points out Ana Paula Martins. In addition to transportation and all logistics, “it is necessary to prepare communication with the population so that, after all this investment, there are no people who do not want to be vaccinated.” But the president is confident that Francisco Ramos, who has “a long political career (he has been secretary of state five times)”, “will quickly define a plan.”
