In a time not so long ago when coronavirus vaccines were scarce in Spain, Janssen's, a single dose, promised to be the panacea to accelerate towards the goal of 70% of the population with a complete schedule in summer. But the problems in its manufacture and the infrequent side effects caused by the drug have left it restricted to a small part of the population: only two of the 37.2 million people vaccinated have been inoculated with this serum. Among them, the campaign selected seasonal workers, homeless people and other vulnerable groups that are difficult to access precisely because they only required a puncture. Now that the Ministry of Health has prescribed a second dose for them to strengthen immunity, the autonomous communities have the task of locating them again.
They are setting up the same networks to capture them and start revaccinating them from November 15, through the censuses they did for the first puncture, or through NGOs and associations that have access to these groups. But it is not always easy, since they are homeless people or, in the case of seasonal workers, many immigrants, often without papers, who move around wherever there are campaigns.
The bulk of those who were vaccinated with Janssen, however, do not respond to these characteristics. Most were people who were lucky for this drug, just as they could have been for any other. Although at the beginning of the vaccination some septuagenarians began to be pricked, it was a minimal number. When side effects appeared in the attenuated virus vaccines (Janssen and AstraZeneca), it was restricted to those between 40 and 70 years old: in older people, the health authorities decided to inject only messenger RNA (Pfizer and Moderna) due to its greater effectiveness, and in younger people it was ruled out because they presented the most severe reactions.
An exception was made for minors under this age in people who were expected to be difficult to locate, among whom, in addition to those mentioned above, aid workers, sailors, Erasmus students and, due to the rush of the European Championship, the players of the national team were also included. Spanish soccer. Not all communities provide the number of vulnerable individuals to be recruited for the second dose. The Comprehensive National Strategy for Homeless People calculates that some 33,000 citizens are in this situation, although it is a document from 2015 and the organizations in the sector estimate that the number is considerably higher and that it may be more around 40,000. On the other hand, the agricultural sector employs approximately 300,000 temporary employees, of which around half are foreigners, according to the Ministry of Agriculture. Ultimately, communities have to locate tens of thousands of people for that booster dose.
Manuel Sánchez, president of the Andalusian Third Sector Board, which brings together a dozen NGOs, explains that the first dose "was complicated." “But we left satisfied because people had to be psyched up, who believed that covid was a story and it was not real. There was ignorance and disbelief in religious groups that deny the pandemic. There are many people, scattered and some unreachable that our technicians had to mentalize, ”he relates.
The Lleida Red Cross was this summer the interlocutor of the Department of Health of the Generalitat to vaccinate the thousands of seasonal workers who lived in settlements in the Segrià region. A spokeswoman for the entity assures that no one has contacted them for the second dose, but she admits that "it is an impossible mission." "This summer they identified the people who vaccinated even in the settlements themselves, but they are workers who move throughout the country in campaigns from south to north and now they will be very difficult to detect," she laments.
In Lleida, 10,500 workers in the agricultural sector were vaccinated this summer, not all of them were seasonal workers. In the province, 18,000 doses of Janssen were injected and, taking into account that more than 23,000 seasonal workers were needed, almost all of them were destined for this group. The delegation of the Department of Health in Lleida has informed EL PAÍS this Friday that it has not yet received the guidelines and protocols to try to contact people already inoculated with a first dose, who now need a second, and are difficult to contact, whose figure is unknown.
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These difficulties in Catalonia contrast with the statements of the Minister of Health of Aragon, Sira Repollés, collected by Cadena SER: “In principle, we do not anticipate that we will have any special problems. We have a perfectly delimited census of people who have been inoculated with the Janssen vaccine and, either through the self-citation process or through the active appeal, as we deem appropriate, we will proceed with the vaccination without any problems.
Temporary workers were a sector that was viewed with great concern, since their precarious living conditions were one of the triggers for the second wave that began in the summer of 2020. The circumstances are now very different. The decision to inoculate a second dose has been propitiated because it has been proven that the Janssen vaccine protects less than the messenger RNA ones and that, with an extra dose of these (Moderna or Pfizer), protection can be considerably increased.
But the levels of protection maintained by those who received Janssen remain very high. A Health study shows that the effectiveness against hospitalization is between 86% of Janssen and 98% of the complete vaccination cycle with Moderna or the so-called heterologous pattern of AstraZeneca with another dose of messenger RNA vaccines. The difference is greater for symptomatic infection: 64% for Janssen versus 90% for AstraZeneca and a second dose of Pfizer or Moderna, which is the immunity that those vaccinated with Janssen are now expected to achieve.
Immigrants are generally young people who already had a very low risk of becoming seriously ill from covid. Even if they are not located for a second vaccination, the risk to their health is minimal. It is somewhat higher for homeless people, who suffer from very precarious living conditions that shorten their life expectancy by between 20 and 30 years.
Gonzalo Caro, from the NGO Hogar Sí, emphasizes that the lack of a roof over which to live not only undermines the right to housing, but also to health. “It is going to be difficult to locate many of these people. Some were in shelters, where they do not live permanently. Others are on the street and although there are organizations that have their circuits, they are not infallible”, he points out.
When it comes to re-vaccinating as many homeless people as possible, even if there is no census, the worst that could happen is that those who have not received any vaccine get their first dose, while those who did receive Janssen complete the guideline. "But not having a home makes it impossible to monitor the health of these people, of whom 20% do not have a health card," concludes Caro.
Ferran Busquets, director of the Arrels Foundation to help the homeless in Barcelona, assured EL PAÍS this Friday that, despite having asked Health about the second dose of Janssen, he has not received any response. “In Barcelona about 1,100 people sleep in the open. In our entity, 62 people were vaccinated thanks to the Drassanes outpatient clinic moving to our day center. The problem that there is going to be with the second dose confirms that, once again, the homeless seem like second-class citizens who find it difficult to have access to basic rights such as health.”