The threat to Swedish vaccination will be

Israel, Great Britain, Chile, the United States, Serbia and Malta. The list of countries that are ahead of Sweden in the number of doses of vaccine administered against covid-19 can be long. Sweden ranks first at 30th, with 12.3 doses administered per 100 people (according to Our World in Data).

Despite this, the national vaccine coordinator, Richard Bergström, has never been particularly concerned. This is because Sweden has had something that many other countries have lacked: an almost unusually high willingness to vaccinate. Because the big challenge, he says, comes when vaccines are offered to the general public.

– So, countries like Sweden will change due to a greater willingness to vaccinate. The EU can send fewer doses to countries that don’t use its vaccine, he told TT some time ago.

Richard Bergström is known for his optimism. To him, the glass always seems half full. But the fact is that the Swedish willingness to vaccinate is among the highest in the world. Or at least it has been.

Within the so-called childhood vaccination program, all children are offered protection against eleven diseases, where the triple call, which protects against measles, rubella and mumps, is a cornerstone.

In 2019, vaccination coverage for this vaccine exceeded 97 percent in Sweden, something like a world record. Even historically, for example in the last pandemic in 2009, the Swedish willingness to vaccinate turned out to be unique.

Sensitive program

Joakim Dillner, a professor of infection epidemiology at the Karolinska Institutet, has also long believed that the Swedish willingness to vaccinate would be an important weapon in the fight against the coronavirus.

But that was before all the side effect reports related to Astra Zeneca’s covid-19 vaccine.

Now the cat knows, he says.

– I dare not speculate. But in older age groups, willingness to vaccinate will likely remain high, because they have a lot to gain from it. The slightly younger groups, on the other hand, who are perhaps more vaccinated for solidarity reasons, are more difficult to comment on. There, the willingness to vaccinate will probably be lower than you previously thought.

Furthermore, he sees the cessation of the Astra Zeneca vaccine presented this week as a threat to the vaccination program as such.

– In 2013, Japan discontinued vaccines against the human papillomavirus (HPV) due to a suspected side effect. The matter was investigated and no connection was found, but the program has not started yet. That was nine years ago, says Joakim Dillner.

For a vaccination program, he says, there is nothing to sniff out. There is often a very sensitive infrastructure around the program that can easily be damaged. It’s about logistics, access to trained personnel, administration, premises, and much more.

– It’s like starting an oil tanker. What worries me, if this stop to the Astra Zeneca vaccine is prolonged, is that the program will be damaged, says Joakim Dillner.

The blue-yellow will

Another question is how strong the Swedish willingness to vaccinate must be. That is, what proportion of the population must be immune so that we can achieve the immunity of the flock that is the target of ongoing vaccinations, so that the spread of infection is reduced and preferably completely ceased.

When this immunity arises it is different for different diseases. However, a general rule of thumb says that the more contagious a disease is, the greater the proportion of the population that must be immune to prevent the spread of infection.

It is not known exactly where this limit goes for the virus that causes covid-19, although the situation has probably worsened due to the “British variant”, which is more contagious.

– Before, I thought about 75 percent should be immune, but now we probably have to go up to 85 percent. No one knows exactly, but that’s what I guess, says Joakim Dillner.

Regardless, he says, this is an “overwhelming majority.” However, the question is: will Swedish be enough?

Johan Nilsson / TT