June 13, 2021

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Steep route to community immunity | government

As in other jurisdictions in the United States, the projected date to achieve herd immunity to Covid-19 in Puerto Rico is uncertain due to the availability of half of the vaccines estimated to be received per week, the Department admitted yesterday of health.

“Right now, it is mathematically difficult (to achieve herd immunity), really,” said the designated Secretary of Health, Carlos Mellado.

Faced with these expressions, the epidemiologist Melissa Marzán and the demographer Judith Rodríguez, who have been analyzing the situation of the pandemic, spoke about local efforts and admitted that the amount of vaccines that arrive is a variable that no one can control. They are also aware that availability has made projections vary, as is the case in the United States, where states have canceled immunization appointments due to the limited number of vaccines they are receiving.

Health’s projection was to have 70% of the population immunized by the summer, but counting on that it would receive 80,000 vaccines a week and only a little over 41,000 are arriving.

“With 41,450 (vaccinations per week) it is difficult to reach that goal and especially when we know that in this phase of (vaccinating those aged) 65 years or older we have more than 600,000 patients and we are still running the phases of the first responders, which they are also being caught in the centers. We also have teachers, ”Mellado reported.

With these data, he assured that a date cannot be estimated to achieve herd immunity and we would have to wait for the performance of the next deliveries of the Pfizer and Moderna vaccines.

“Right now I would not dare to venture (to give a date) because we are waiting – like the other states – for the quantity of vaccines distributed in Puerto Rico to increase and that could change as the quantity increases”, stated the official.

To questions from THE SPOKESMAN, specified that to achieve immunization of 70% of the population there must be a weekly delivery of between 80,000 to 100,000 vaccines.

“We have communication with the staff of the Centers for Disease Control and Prevention (CDC, for its acronym in English) every day and they also have the vision of increasing the amount of vaccine by territory and by state, but they have not happened. We continue to have the same amount of vaccines to serve the population, “he added. He indicated that “every day there is talk of giving us more vaccines.”

He stressed that Governor Pedro Pierluisi has also had direct communication with different people from the CDC and the federal Department of Health about the lack of more doses on the island.

Priority for those over 65

The epidemiologist Marzán warned that given the current reality, the strategy to achieve community immunity for 70% of the population “is complex.”

“Given this variable that cannot be controlled, the priority should be to complete the vaccination of health professionals and accelerate the vaccination of adults over 65 years of age in order to impact mortality and eventually the incidence rate,” he recommended.

He added that achieving herd immunity implies that the population will be protected from severe disease and thus the incidence can be reduced.

“As vaccination accelerates in the most vulnerable (the elderly) and the population continues with prevention measures, there should be signs of improvement. Otherwise, we will continue to not control the epidemic. This implies a percentage of positivity greater than 5%, daily hospitalizations over 300 and sustained mortality ”, he warned.


Health’s projection was to have 70% of the population immunized by the summer.> Carlos Rivera Giusti / EL VOCERO

Marzán also indicated that vaccination is not a strategy that works alone. “We need the entire population vaccinated or to be vaccinated to continue with prevention measures,” he reiterated.

Pending the next executive order

On the other hand, the demographer Rodríguez expressed that the situation with the slow flow of vaccines means that we must be cautious with the next executive order for Covid-19, which would come into force in early February.

“The first step is that you have to be careful and you cannot make so much flexibility because we have reached a level that (cases) are between high and low, but if we do not have the vaccine, it will take time, because to have that period of time where we thought we were going to have a greater number of people covered, ”he said.

He insisted that “we got to have an immensely large rebound and now we are in a downturn, but if they had plans to open some things earlier —including schools—, I think all of that is delayed because then we would be putting a reduction that we are experiencing with what we are doing so far ”.

Rodríguez urged the government to have diagnostic tests available and to maintain the tracking systems.

“We had a population segment that are the old and are going to be discovered due to the limitation of vaccines; Well, that means they are at risk ”, said the demographer.

Health awaits improvement

As the number of vaccines that arrive increases, the Secretary of Health assured that they will continue to be administered in an equitable manner. He indicated that the number of doses arriving in Puerto Rico could increase soon. “There is talk of maybe the end of February,” he said.

“Puerto Rico has a high uptake of people who want to get the vaccine very high. If they send us 100,000 weekly vaccines, 100,000 vaccines we are going to distribute, but we have that limitation (of the number of doses that arrive), “said Mellado.

The number of 41,450 first-dose vaccines received per week is divided among the vaccination centers administered by the Puerto Rico National Guard (GNPR), CVS and Walgreens pharmacies, and other entities such as the College of Surgeons, the College of Nursing Professionals and the Vaccination Coalition of Puerto Rico (VOCES).

Mellado said that for this week they distributed 7,000 vaccines – of the 11,000 that Walgreens receives weekly – and with that amount they will vaccinate in the 178 centers for people over 65 who do not belong to the long-term care program that the pharmacy chain serves. . “We collaborated with the National Guard to go to those centers and vaccinate them this week,” he said.

As of yesterday, Salud had 352,050 doses received, of which 321,965 had been delivered to vaccination centers. According to the Secretary of Health, as of yesterday Walgreens had vaccinated 1,970 people and CVS 350.

Adjustments to availability

The Undersecretary of Health, Iris Cardona, indicated for her part that it cannot be lost perspective that the established vaccination priorities have not been altered and have continued with the corresponding phases of people over 65 years of age and the first responders in emergencies of Health.

“One million people need to be vaccinated first than the second million people that we are going to catch in phase 2, where we hope to have enough vaccines,” he added.

He recognized that if Health continues to receive 41,450 doses, the rhythm of immunization in phases can be delayed, but they are hopeful that a new vaccine will emerge that will help increase the number of doses received in the country.

Cardona clarified that “vaccine shortage as such, that term is not really correct because we have a population allocation that is equitable when you look at it and compare it with the states (of the United States).”

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