Is it Time to Overreact to Vaccines?

A little over a year ago, every morning began with a briefing and announcement of the number of people infected with coronavirus. Even if one didn’t follow the briefing itself, it was important to hear at least the number of infected people during the day to know where things were going. At that time, we never got into an “epidemic wave” but the authorities and the population totally focused on the virus – ​​ on the contrary to the next two, which led to a record mortality. Over a year later, we are monitoring a number again, but this time it is not the number of the infected, but the number of the vaccines given per day. They are published shortly after midnight, so the day often starts with that information. A large part of the population would agree that last March the authorities overreacted in regard to the measures. Well, maybe now is the time to overreact regarding to the vaccines, because it will not happen by itself.

For at least six months the authorities have underestimated the issue of vaccination. At the end of last year, a wrong decision was made when buying vaccines. Who and how decided and what arguments they had is another issue – a huge mistake was made regarding the vaccines order and the country turned out to have very few vaccines in the first months of the year. This gaff was corrected by the solidarity of the European partners, who found a mechanism to compensate the countries that had messed up the original order. However, the last couple of weeks have clearly shown that the slow vaccination in our country is not only due to the lack of vaccines in the beginning.

An odd strategy was also chosen, in which the young were prioritized over the old. Across Europe, there is not only a much higher vaccination rate, but the vaccines are also given to the bigger extend to the elderly. This is logical giving the fact that the European Commission’s strategy is to prioritize the elderly by vaccinating 80% of the population over the age of 80 by the end of March 2021. Some countries really did it. We on the other hand are still infinitely far from that goal. The population over 80 years of age in our country is nearly 336 thousand people. As of March, we may have had a problem with vaccines, but to this date we have applied over 1.2 million needles. Vaccines are already available – about 2.5 million doses delivered so far, but there is no good plan, organization, desire, etc. Words that are subject to politics.

The new caretaker government is in a unique situation to be able to do something really significant. Most cabinets justify the word “caretaker”, i.e. they mainly maintain the stability. Without a parliament and with a short horizon, it is difficult to do something big. However, this caretaker government has found itself in an environment where it has enormous powers not only to organize elections but also to change the environment. The Recovery and Resilience plan, which is a bit like “Schrödinger’s cat” – both ready and unprepared, submitted and not submitted, gives the cabinet the freedom to rewrite big chunks of the public commitment over the next 4-5 years. Whether and how they will do so is not the issue of this text. The other big policy, however, is the vaccination, which depends entirely on the executive branch and should be widespread in the next two months.

The statements by the caretaker Minister of Health in the past few days suggest that the approach to the vaccines will change and adults will be prioritized. Some changes have been made in the organization and logistics. However, the general underestimation of the vaccination process by politicians seems to remain. The vaccines are presented as some kind of a sector issue – the minister will explain something on television and it doesn´t seem that they have been given the total priority. There is no hint of an overreaction on the topic, but the data suggest that there should be one.

Before the end of the summer, Bulgaria must have fully vaccinated over 4 million people. We repeat – 4 million people with a completed vaccination cycle as of August 31, 2021. These are the 70% of the adult population who are the official EU target and the whole of Europe is chasing. And if you see the pace in Europe – most countries seem to be catching up. In our country, as of this date, we have applied a little over 1.2 million needles, and about 480 thousand people have completed the vaccination cycle – a mass of people with two needles and a small number who have a single-dose vaccine. This means that the vaccination process has reached nearly 750,000 people. To each vaccinated person with at least one needle so far we have to add more than 5 others by August 31.

The calculus about a month ago showed that about 25,000 people a day had to be vaccinated (excluding the second needles) to reach the goal at the end of August. This against the background of an average of 10-15 thousand needles in April. The numbers today show that for the remaining 102 days until August 31, 2021, we need to put an average of nearly 32,000 needles (excluding the second doses) to reach the 70 percent. In this account, we are even running away from the main goal and we are just trying to cover 70% with at least the first needle by the end of August. At the moment, in record days we reach 37-38 thousand doses per day, but this includes revaccination or at least 10 thousand needles per day. Separately, we lose two days during the weekend, in which the numbers are very low. During the record previous week, the average number of vaccines given per day was about 25 thousand, and the first needles were most likely below 20 thousand.

All of this is important because there is no guarantee that the rate of vaccination will continue to increase naturally. On the contrary, the first waves of mass vaccination cover the most willing, and sooner or later it will reach groups that show less or now interest at all. With the onset of the summer and the attenuation of morbidity, there will a relief the topic may be completely left in the background – as it happened the previous summer. If we just keep moving on auto pilot, it will not be surprising if at the end of the summer we wake up with half the European goal reached, i.e. 30-40% vaccinated. In the context of ongoing ad hoc decisions on pandemic rules and frameworks in Europe, this can put us off the board of “immunized” countries.

The latter is important because the talk about vaccines in our country, incl. by the ministers of health, goes beyond the scope of the regulation and often makes some own accounts for collective immunity – we total the sick and vaccinated, we claim that it could be less than 70%, etc. Others get vaccinated and forget about the whole debate, as they already have a certificate. However, the danger is, that if we collectively fail to reach a large number of vaccinated, a personal certificate may not be enough. In other words, if in Germany and Austria 70-80% of their population has been vaccinated after the summer, and here we are at 30-40%, will the rules for travel between the three countries be the same? We may not impose a lockdown in the autumn, but if Europe, in one form or another, classifies us as a risky country, we will still not be able to forget about the pandemic.

In order to change the trajectory of vaccination, we need a political decision for bringing the vaccination as a total priority for these two months. Whether it will be with a carrot or a stick is a separate issue, but the responsibility is now with the caretaker government. Even the purely logistical issue requires more attention. On the one hand, it is important to have as many points of contact as possible – that is why GPs are important, on the other hand – the specifics of the vials and doses require some consolidation of the people in groups. These are not unsolvable problems if they are defined as a priority.