Why the national vaccination schedule can change weekly

At the beginning of this week, Minister Hugo de Jonge (Public Health, CDA) finally revealed the vaccination plan for the Netherlands. There was a great need for this after months of uncertainty.

Criticism soon followed: in his letter to the House of Representatives, the minister is said to be too optimistic about deliveries and take too little account of delays. This although the minister already indicated in this letter that it concerned ‘expected deliveries’.

Nevertheless, the vaccination schedule must provide ‘guidance’, De Jonge said today. The fact is that for some vaccines we do not know when they will be available, and for other vaccines it is unclear whether they will come to our country at all. And there are even more uncertainties in the current schedule.

Last Monday’s schedule. Can’t read the text above? Then click here.

1. Great uncertainty about deliveries

Manufacturers share their anticipated delivery schedules with anyone who requests it. But these can sometimes be overtaken by current events within a day.

When exactly vaccines are delivered and in what quantities, it therefore remains unclear for a long time. In the case of pharmaceutical company Pfizer, it was only on the day that the vaccine was approved by medicine watchdog EMA (December 21) that the first delivery would follow very soon. Although that turned out to be a small, symbolic delivery.

Another example is Oxford / AstraZeneca. Their vaccine is very important for the Netherlands, due to a large order of 11.7 million doses. Today it was announced that this vaccine will receive the green light from EMA at the end of this month. Provided the makers can demonstrate that it is safe. And then we still have to wait for the delivery.

2. Time between injections

So far, all available vaccines require two shots per person. But discussions have arisen in various countries about the time between those two injections. If you make it longer, the advantage is that you can give more people their first injection more quickly, which partly provides protection against getting sick.

But the question is whether this is safe with all vaccines. The cabinet has asked the Health Council and the OMT to look into this. Their advice on this is expected to be published this month.

3. Whoever keeps, has what

Practice only shows how many syringes can be obtained from one vaccine bottle (ampoule). The last example here is the vaccine from Pfizer / BioNTech. According to their prescription, that was five syringes from an ampoule.

But the vaccine administrators found out that using a special type of syringe left some residue of the drug. Something that the RIVM calls spillage.

What turned out? This leftover is sufficient for a sixth syringe. Which means that with the same number of ampoules, up to 20 percent more people can be vaccinated.

4. Whether or not to buy extra via Brussels

The Netherlands has been given the opportunity to purchase additional vaccines at various times. This has two causes: manufacturers sometimes give the EU the option to order additional vaccines, and sometimes the EU still has vaccines ‘left over’ because other Member States do not buy all the vaccines to which they are entitled via the agreed distribution key.

The latter was recently the case with Moderna’s vaccine. The Netherlands could have bought more doses of this, but would have to wait until the fourth quarter of 2021 for delivery. The Netherlands has decided against this because of that waiting time.

What the cabinet is probably doing is purchasing more Pfizer vaccines. Today it was announced that the EU has a deal with pharmaceutical companies Pfizer and BioNTech to purchase an additional 300 million doses – a doubling. The Netherlands is entitled to 3.89 percent – which comes down to 11.67 million doses.

Part of it would already be delivered before the summer. Which would mean, for example, that a number of people over 60 will get their turn a lot faster than in the current schedule.

5. Some vaccines never come

The cabinet is currently aiming for seven vaccines, according to Minister De Jonge’s letter to parliament. One of these is that of the German pharmaceutical company CureVac, which is still looking for test persons. Another manufacturer is Sanofi. It reported disappointing research results last month.

The question is therefore how these studies will develop and whether and when these vaccines will be marketed at all. The deliveries of CureVac and Sanofi are respectively from the first and third quarters of this year in the schedule of De Jonge, but that seems an optimistic estimate for the time being.

Finally, there is also still much uncertainty about the supply of the partly Dutch Janssen vaccine. It could be that this vaccine will be allowed on the European market next summer, but for that too we have to wait for the definitive research results.


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