Is the vaccination campaign in Italy really slowing down?

Is the vaccination campaign in Italy really slowing down?

In summer, the decline in doses and administrations should be very slight, but the acceleration phase seems to be over. This has to do with discarded vaccines, hesitants and the search for missing over 60s

(photo: Mat Napo / Unsplash) A bit of chaos seems to have been created in the continuation of the vaccination campaign, between politics and communication issues , between the commissioner structure of General Francesco Paolo Figliuolo and the Regions. The subject of the dispute, as the chronicles tell, is the alleged slowdown of the administration: announced by the regions with lots of suspensions, postponements and interruptions already in progress, but at the same time denied by Figliuolo himself, who refuses to talk about delays in the Corriere della Sera.

But how are things really and, essentially, who is right? As we will see, this is a rather complex situation, because we should first of all agree on what to mean by the word "slowdown". According to official data, however, nothing has changed compared to when about ten days ago here on Wired we tried to estimate the end of the vaccination campaign, which today is in September, probably towards the end of the month.

First: the absolute numbers

According to what has been communicated several times by Figliuolo (and by no one doubted), during the month of July a total of 14.5 million doses of messenger rna vaccines, of which 12.1 million by Pfizer and 2.4 by Moderna. This corresponds, compared to the month of June, to a decrease of 800mil of doses, or 5% fewer supplies. As to whether it is reasonable to describe the transition from 15.3 million doses to 14.5 as a real slowdown, rather than a substantial stabilization, opinions are mixed.

To these doses should then be added - without considering the issue of stocks inherited from recent months - the homologous AstraZeneca administrations, since a fraction of those who received the first dose of the Anglo-Swedish vaccine will certainly want to continue with the same formulation also at the second injection. Including these administrations, according to Figliuolo it is reasonable to hypothesize a total of doses administered in July equal to 15.5 million, or 500 thousand per day.

Second: the interrupted progression

More than crushing the foot on the brake, causing an effective deceleration, what is already happening these days seems to be more like taking the foot off the accelerator. Beyond metaphor, the data already clearly show that the phase of progressive acceleration that has characterized the vaccination campaign so far seems to be over. If from January to June every month more doses were administered than the previous one, with an average daily increase of 70-80 thousand doses from one month to the next, now the phase of increase seems definitely over. Then we can discuss whether we are in the presence of a flat curve or a slight decrease, but the real news is rather the indisputable interruption of the ascent phase.

Reasoning in terms of the seven-day average, for example, the peak was reached in the second week of June with 586 thousand doses per day, while from the end of June onwards the data are rather stable between 500 thousand and 550 thousand doses. If we had maintained the average trend of the last few months we should be well above 600 thousand doses, instead the prospect for the coming weeks seems to flatten towards half a million.

Third: not just a question of supplies

In determining a change in the course of the vaccination campaign, not only the slight drop in deliveries of messenger rna vaccines affects, but also a series of other equally (or perhaps even more) impacting factors. A first element, of course, is the substantial suspension of the use of AstraZeneca vaccines and the drastic reduction in the administration of the Janssen formulation: being able to essentially count on only two vaccines instead of four, it is difficult to accelerate the campaign further. To this we must add that until recently the arrival of the CureVac vaccine seemed imminent, which was then skipped due to the poor efficacy of the highly anticipated European messenger rna vaccine.

But not only. A slowdown in the vaccination campaign, especially in terms of new bookings, is also attributable to the need to administer the second dose of Pfizer and Moderna to those who have already received the first, as well as to satisfy the people who received a first dose of AstraZeneca and prefer to continue with heterologous vaccination.

Furthermore, in many regions - given the data from the campaign held so far - it is considered a priority to intercept and convince people over 60 who are still missing to vaccinate: there are over 2.5 million all of which 345 thousand over 80, 780 thousand between 70 and 80 and 1.6 million between 60 and 70 years. In percentage terms, the result achieved so far is considered very good over the age of 80, with 92% coverage with at least the first dose; average for the seventies, which are 87%; scarce for the 60-year-olds, at 81%; still insufficient for the fifties, stuck at 72%. In short, it seems more reasonable to focus on the weakest and most fragile people than to proceed with an avalanche vaccination of the youngest.

Finally, there is also a perceived (or announced) slowdown effect for purely political reasons. In essence, proceeding swiftly with the vaccination campaign is now a source of pride for the regions, which therefore have set very tight and gradually accelerating vaccination calendars. Therefore, faced with the substantial stagnation of supplies, in several cases we find ourselves having to review the plans and proceed with postponements and suspensions of reservations, often scheduled in recent weeks with a time frame that has proved too optimistic. It is no coincidence that the question of the alleged delay in supplies has also become - or above all - a subject of political conflict.

What the regions have announced

Each region, in the face of today's supply prospects, reacted differently. Putting together the information reported by the media on the basis of communications from the individual regional health systems, for example, an interruption of new bookings of one or two weeks for Lazio is expected, while Emilia Romagna has suggested the possibility of blocking bookings of the under 50s until mid-August and Puglia has for now postponed them by a week (but a further postponement could come). Umbria has completely suspended the administration of the first doses, while Tuscany has announced a week of suspension for bookings in August and September. Campania reported a 38% drop in supplies, against which there are still no specific measures, while Lombardy is one of the regions that has not made any changes to the vaccination plan official, even if the possibility of a suspension of reservations.

In all cases, however, the rationale is to keep the vials in order to administer the second doses at the right times. So until you are guaranteed to be able to cover both the first and second doses, you give priority to the latter by sacrificing the others. However, everyone agrees that the situation is and will remain fluid, both in terms of the number of doses entering our country, and in terms of distribution among the different regions. Because even fine details such as anticipating or postponing a regional supply by a few days can make the difference in practical terms for the management of flows in individual vaccination centers.

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