The National Vaccination Strategy establishes a time interval that must be respected before the first dose is inoculated.
It is not uncommon in recent months to receive messages or photos from family and friends announcing that they have already been vaccinated. Something that seemed unthinkable just a year ago. As of today, they are 19 million people who have received the complete guideline. And in this context, it turns out that you no longer only need to know how the virus works and what measures to take to protect yourself, but also when to get vaccinated and how often. Some doubts that may appear to a greater extent among the more than three million people who have had the disease.
The latest update of the National Vaccination Strategy makes it clear. In the document, the Ministry of Health recommends people who have been infected with coronavirus wait at least six months until the first dose of the Covid-19 vaccine is inoculated. The text establishes these measures for everyone who “has a positive test for active infection -PDIA- dated prior to vaccination or a positive result of [anticuerpos] IgG by high performance serology (ELISA or CLIA), independent of the protein detected”.
However, Health makes different recommendations depending on age and time of infection. People 65 years of age or younger who are diagnosed with SARS-CoV-2 infection before receiving the first dose will receive nothing more than one inoculation of the vaccine “preferably from six months after the onset of symptoms or diagnosis of infection”.
Dr. Julián Domínguez, head of the Preventive Medicine service at the University Hospital of Ceuta, points out that “there is no medical reason behind” this recommendation. In his opinion, it is due more to a vaccination strategy issue, because it is understood that if the disease has passed, those six stipulated months are established as enough for the patient to generate antibodies.
In fact, as the document from the Ministry of Health also reflects, infected people will only receive one dose. In the words of Dr. Domínguez, this first inoculation of the vaccine for those infected is a booster dose, due to the natural antibodies that they already have. But in addition, the Ministry of Health goes further and states that “in the event that [la primera dosis] is administered before these six months have elapsed, the dose will be considered valid and it will not be necessary to administer more doses”.
Thus, Domínguez explains that there is no risk of getting vaccinated before the six months recommended by Health. The only effect it would have is a heightened immune response because “a tremendous elevation of antibodies” occurs, he says. The inoculation of the vaccine supposes a reinforcement so that the cells remember that they have to be activated because there is an antigen.
Given the Health recommendations, other doubts may arise, such as, for example, what to do if you have received the first dose at a time when the disease was developing and one was unaware due to the lack of symptoms. In this case, what the document stipulates is that “a second dose will be administered after six months from the onset of symptoms or the diagnosis of infection.”
But what happens if an infected person is given the first dose before the recommended six months have elapsed? As clarified in the National Vaccination Strategy, “the dose will be considered valid and it will not be necessary to administer more doses”.
As explained at the beginning of this article, the Health document makes different recommendations depending on age. In this sense, people older than 65 years with a diagnosis of SARS-CoV-2 infection before receiving the first dose “a two-dose regimen will be administered when they are fully recovered and the isolation period has ended.” In other words, it is not recommended to wait six months after infection to administer the first dose, because it is understood that the risk they can take if they are not vaccinated is greater.
Something similar happens with people over 65 years of age who have been inoculated with the first dose and present Covid-19 infection. In these cases, what Health recommends is to complete the regimen with a second dose when they are fully recovered and the isolation period has ended, guaranteeing the recommended interval between doses. Similarly, in this case, they will not wait six months either.
Are serological tests needed?
The recommendations included by the Ministry of Health in its National Vaccination Strategy may give rise to the idea of carrying out a serological or virological test before or after vaccination, but it is not necessary. This is also stated by Dr. Domínguez, since “it is presumed that the majority have not passed the disease” and, therefore, “vaccinating is the logical thing to do”, because there is no risk to health.
The only thing that would be achieved by carrying out massive serological tests before receiving the first dose of the vaccine is to hinder the work of laboratories and collapse services such as Primary Care. “With covid, it is happening that we do not apply what has been studied in more than a century of medicine,” says Domínguez, who gives the example of vaccinations such as pneumococcus, in which tests are not carried out to check if the disease has previously been passed. . “Generally, it is blindly vaccinated,” he adds.
The doctor concludes that what a person with a previous or current diagnosis of Covid-19 has to take into account is that the vaccine leaves cellular immunity“that you, in addition to having antibodies, have your cells underneath that respond when exposed to antigens.”
In any case, points out the specialist in Preventive Medicine, with the coronavirus the usual pattern of other types of infectious diseases has not been followed and, therefore, it cannot be compared. He insists that what is needed “is more scientific evidence to know if it is better or not necessary to vaccinate if the disease has passed, and if it is, when it should be done”, but “we will know that over time . They want to answer questions that need a response time”.