At the end of 2019, the Ministry of Health agreed with the autonomous communities on a vaccination calendar that will be in force during this year. However, there are several differences between what the State will finance and the recommendations of paediatricians, who have published their particular calendar for yet another year.
The most notable disparities are in the absence of a vaccine against meningitis B (responsible for most cases of meningitis) and against rotavirus. “There is a lack of rotavirus vaccination and meningococcal B vaccination in infants, as well as meningococcal immunization with a tetravalent vaccine at 12 months of age. It is considered desirable that a collective economic effort be made by the autonomous communities and the Ministry, which allows the financing of a complete systematic calendar for children living in Spain”, assures the Spanish Association of Paediatrics.
Vaccines against meningitis and rotavirus also show a strange inconsistency. The Ministry ensures that the reports they have conclude that they are not cost-effective to finance them and, however, Health has allowed their purchase in pharmacies at a price that parents will have to pay in full. The vaccination guidelines for meningococcus B are three divided doses between 3, 5 and 12 months of age. Each of the doses is worth 106.15 euros. In the case of rotavirus, it depends on the preparation. The price of each dose is 93.66 euros for Rotarix (full vaccination 187.32 euros) and 69.50 euros for RotaTeq (full vaccination 208.50).
“The current epidemiological situation shows a decrease in the number of cases due to meningococcus B”, defends Health, which does not finance Bexsero
From the Ministry it is argued, in the case of meningococcus, that this injectable is available for risk groups and they assure that not extending protection to the entire population does not respond to an economic criterion. “The current epidemiological situation shows a decrease in the number of cases due to meningococcus B. The decision not to include vaccination at this time is not due to economic criteria but to the need for more information on its usefulness and safety,” they say. .
In this aspect there is also a debate in relation to the price of these vaccines. In the case of Bexsero, a study published by the Spanish Society of Public Health points out that “systematic vaccination is not cost-effective at the current price. Only at a price of 1.45 euros for the 3+1 or 3 .37 euros for the 2+1 regimen could be recommended based on its efficiency”. This opinion is not shared by the pharmaceutical company GSK, marketer of this injectable. “This work is based on the data of an effectiveness of the vaccine of 54%. In Spain there are no data on effectiveness at the local level but in the United Kingdom, where the vaccine has been applied since 2015, its vaccine committee said in October that the effectiveness in real life are around 74%”, they say.
Other absences that paediatricians lament are the whooping cough (Tdap) vaccination in adolescents and the human papillomavirus vaccination in 12-year-old boys. Regarding the first, pediatricians consider it appropriate to vaccinate again because “immunity against whooping cough is of limited duration.” Likewise, and despite the fact that the Human Papilloma Virus may have worse consequences in women, professionals remind us that the burden of neoplastic disease caused by this virus in men is also important.
If the differences between what pediatricians recommend and what Health finances are palpable, so are the vaccines financed by parents according to the autonomous community in which they live. Despite the fact that the Vaccination Calendar was approved with the consensus of both the Ministry and all the territories, some of the latter consider it a minimum agreement. , where parents have the meningitis B vaccine free of charge since the summer of 2019. In recent months, Andalusia is also considering including this injectable.
This situation of lack of equity is also criticized by the Pediatrics Association, who consider that the vaccination schedule should be unique. “This would maintain the principle of equality in the health offer,” they point out.