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In November, the World Health Organization’s WHO expert group, SAGE, published a report with recommendations on which groups should take priority in vaccination.
The group of experts paints different scenarios. In a situation where there is widespread social spread and access to vaccines is very limited (1 to 10 percent of the population), the group believes that health professionals at high or very high risk of becoming infected and infecting others should end up at the top of the list.
According to epidemiologist Tove Fall, a professor in the Department of Medical Sciences at Uppsala University, this is the situation in Sweden at the moment. She believes that this is a difficult priority, but that there are good arguments for vaccinating health workers early.
“Right now it’s a big problem with staffing, which means that major outbreaks in wards can have far-reaching consequences while at the same time running the risk of infecting patients,” he says.
The last few days have The vaccination strategy of the Swedish Public Health Agency has been criticized from various quarters. Both Sahlgrenska University Hospital and the Skåne Care Association want to give priority to certain healthcare personnel.
The Swedish Medical Association now joins those who want parallel vaccinations for healthcare workers to start as soon as possible.
When the supply of vaccines increases, we must be able to vaccinate both those most at risk of becoming seriously ill from COVID-19 and health care personnel, says TT President Sofia Rydgren Stale.
Bo Lundbäck, senior professor of clinical epidemiology of lung diseases at the University of Gothenburg, believes that Sweden should do what Finland does. There, healthcare staff caring for corona patients are among the first in line, for example staff in intensive care units and emergency rooms.
– Then follow all the rest of the care and nursing staff, so that the elderly and users do not get infected, and then the elderly and the multiple sick. I think you can get the most benefit and faster reduction in the spread of infection if you do what the Finns do. So those who work close to patients cannot spread the infection in the same way as now, he says.
Epidemiologist Anna Mia Ekström.
Photograph: Martin Stenmark / Karolinska Institutet
Anna Mia Ekström is clinical professor of epidemiology of global infections at the Karolinska Institutet, but also works as chief infection physician at a hospital. She believes this is a difficult trade-off, but still thinks it is ethically reasonable to prioritize the elderly and staff in nursing home care and elderly care, which were not prioritized when there was a shortage of protective equipment this spring.
– Previously, the Swedish Public Health Agency has been criticized for not doing enough to protect the most vulnerable who are at risk of becoming seriously ill and dying. If they hadn’t prioritized them now, they probably would have been criticized for that too, he says and continues:
– But in reality, it is only a matter of a few weeks difference between the elderly and the staff of vaccinated nursing homes, to the point that all hospital staff also have access to vaccines.
State epidemiologist Anders Tegnell at the Swedish Public Health Agency believes that Swedish healthcare is built on a clear platform, which means that people in greatest need should receive care first. The authority has no direct plans to change the strategy, but Tegnell says it is willing to talk with the regions.
– You must also remember that if you give priority to someone, you give priority to someone else. The amount of vaccine was determined, Anders Tegnell told DN on Thursday.
Anders Tegnell at Tuesday’s press conference.
Photo: Henrik Montgomery / TT
Tegnell also believes that he understands how the WHO reasons, that its prioritization is reasonable given the appearance of medical care in many other countries.
– We have pretty good protection for healthcare workers in Sweden. Not many countries have it like Sweden.
Are health professionals in Sweden really that well protected?
– Yes, in intensive care you have very good protective equipment compared to many other poor countries. This is Vårdhygien’s assessment, we are not experts on that, he says and refers to the expert functions of the regions working to prevent the spread of the infection.
However, you haven’t seen any comparative studies between different countries.
– But I know they have a very good protective equipment. In the outbreaks that have been identified, the infection has been seen mainly among colleagues, he says of Sweden.
Tegnell points out Since the authority only gives recommendations, in practice it is up to each region to prioritize their vaccine as they wish.
However, among the members of the Swedish municipalities and regions, SKR, there are no plans to change the vaccination strategy.
– It is the responsibility of the FHM to develop the order of priority, and the regions support it according to the agreement that exists with the state on how vaccinations will be carried out. There is no active discussion on our part about changing the priority order, Emma Spak, head of the medical and health care section at SKR, tells TT.
Read more:
Tegnell does not want to change vaccine strategy, despite health criticism
Doctors critical of vaccine strategy: “They cannot allow intensive care to collapse”
