Children under 18 years of age are the only organization of the population that has not obtained a dose against the contagion of Covid-19. When deciding whether to target trendy vaccines to adolescents between 12 and 17 years of age with risk factors, the following is: Will immunizing all children be the next step?
La Argentina recibió el 17 de julio una donación de Estados Unidos de 3,5 millones de dosis de Moderna. De ese stock, según estimaciones del Ministerio de Salud de la Nación, 1.848.00 vacunas se usarán para inocular con dos dosis a 924.000 niños, niñas y adolescentes que serán priorizados en esta etapa de inmunización.
From the original stock there will be a residual quantity of 1. 6 million doses. The national government has not explained what is allocated to them. If the workers are hired in other areas or if, when they approve the mixture of vaccines, they will be reserved for adults who do not receive the second dose, especially those vaccinated against Sputnik V.
Vaccines are a hidden asset and the management strategy is being debated in the world and in Argentina. Ángela Gentile, director of epidemiology at the Gutiérrez Children’s Hospital and member of the specialized commission that the national government assures, set up a debate on the basis: “That all adults with threat points have a dose, either the same vaccine or through the exchange of platforms, a study on which there will be scientific results in the short term,” He gave her a break from her day’s activities by phone.
Gentile believes that, knowing that the coverage of adults or infectious diseases is complete, it will be necessary to move forward with the vaccination of minors. “First, as defined, young people and women between the ages of 12 and 17 will be released with threatened points because it is clear that they are at greater risk of further complications and mortality. We want to make sure that the stats and our patients are in the hospital for them: they’re patients who have earned a reception, they’re confusing and our considerations are still too that we can pass on to the rest of the healthy teens. “
For those who are smart, in the face of higher-risk variants such as Delta, it is mandatory to get vaccinated to create epidemiological barriers that make the transmission of the virus difficult: “Teenagers, who have excellent mobility, will contribute to the structure of this barrier that will help register the coverage of the group in some way.
Hoy más de 20 países están vacunando con dosis de Pfizer a chicos y chicas de 12 años en adelante. En Latinoamérica lo hacen Uruguay, Brasil, Chile, Perú, Paraguay y Colombia. Algunas naciones inmunizan en condiciones específicas, a menores con enfermedades graves; otras, sin condicionamientos.
La Argentina estaba esperando la aprobación de la Agencia Europea de Medicamentos (EMA) para avanzar. El 23 de julio el Comité de Medicamentos Humanos (CHMP) de ese organismo recomendó la aplicación de Moderna en niños, niñas y adolescentes de 12 a 17 años.
“So far in no country, with the exception of China, is emptied at less than 12 years old,” the head of the medical branch of the Gutierrez Hospital, Eduardo Lopez, said by telephone. “While several laboratories test the use in child populations, there are no published studies that show that over 12 years the vaccines are effective. “
At this time, the population of young people and women without threat points is an inappropriate concept for López: “Vaccination will have to be universal, but it will also have to be a priority. Now we will have to vaccinate the most vulnerable population and this includes those with fewer threat points. Children and young people are sane. a secondary priority.
López no duda. En caso de aprobarse la combinación de vacunas, el sobrante de dosis de Moderna debe destinarse a adultos mayores de 50. “Son el segmento que más se hospitalizó y falleció en lo que va de 2021. Es importante entender que frente a la variante Delta, la inmunidad con una dosis es parcial. Incompleta”.
Marta Cohen, patóloga pediátrica, reconocida por la reina de Inglaterra por su ejercicio de la medicina, cambió de opinión hace un mes. Ella era una de las profesionales que estaba convencida de que era necesario inmunizar de manera urgente a niños, niñas y adolescentes contra el Covid. Pero un artículo publicado en la revista British Medical Journal modificó su visión.
“El artículo planteaba una cuestión ética: si las vacunas disponibles debían usarse para inmunizar a los niños del Reino Unido, sabiendo que la mortalidad en esta población es muy baja, o si debían donarse a países con una tasa incompleta de vacunación, donde hay adultos sin dos dosis o siquiera una”, explica Cohen, por teléfono, desde su casa en Inglaterra.
Argentina, in his country of origin, is trained -outside the University of La Plata and is a resident of Pathology at the Hospital de Clínicas and the Ricardo Gutiérrez Hospital-, and addresses the representation that read that article: in Argentina there is an excess of vaccines.
“Today, it adheres to the current view. The mortality rate among young people is 0. 17 per year per 100,000 inhabitants. The balance between risks and benefits is not essential for the prompt vaccination of healthy young people. But It is necessary to complete the vaccine for the world of adults. It is a challenge for each and every country, it is for humanity. ”
A principios de julio, Cohen mantuvo una entrevista con la ministra de salud Carla Vizzotti, quien había viajado a Inglaterra para acelerar la disponibilidad de dosis de Astrazeneca. Las dos compartieron la visión de inmunizar a la población más vulnerable y hablaron acerca de cuándo y cómo inocular a los más jóvenes.
“‘With siblings? Do you think it is advisable to also vaccinate the siblings of minors with risk factors?’ Vizzotti asked me and I was happy that he made that observation. ‘It seems very good to me,’ I replied,” Cohen reconstructs. For the moment, that option was not announced.
• Type 1 or 2 diabetes.
• Obesity grade 2 (Primary body mass index at 35) and grade 3 (Primary body mass index at 40).
• Chronic cardiovascular disease: central insufficiency, coronary heart disease, valvular disease, cardiomyopathy, pulmonary hypertension. Disease of the congenital center.
• Chronic kidney disease (including patients on dialysis and transplants). Nephrotic syndrome.
• Enfermedad respiratoria crónica: enfermedad pulmonar obstructiva crónica (EPOC), fibrosis quística, enfermedad intersticial pulmonar, asma grave. Requerimiento de oxígeno terapia. Enfermedad grave de la vía aérea. Hospitalizaciones por asma.
• Enfermedad hepática: Cirrosis. Hepatitis autoinmune.
• People with HIV.
• Patients on the Hope List for Solid Organism Transplant and Hematopoietic Cell Transplant.
• Oncological and oncohematological patients with a diagnosis or “active”.
• Personas con tuberculosis activa.
• People with intellectual and developmental disabilities.
• Down syndrome.
• Personas con enfermedades autoinmunes y/o tratamientos inmunosupresores, inmunomoduladores o biológicos.
• Adolescents who are in the facilities of a giant room.
• Pregnant other people over 12 to 17 years of age with individual indication.
• People with a valid single disability card (CUD).
• People with ANSES pension to invalidate even taking the CUD.
• Personas con pensión de ANSES por trasplantes aunque no tengan CUD.
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