Public Health is one of the great forgotten areas of medicine and healthcare. We only remember it when it becomes essential, as in the case of the Covid pandemic. It is a specialty that needs more resources and work tools to fulfill a key function such as taking care of the health of all citizens, as was evident in the ‘Take care of your health’ meeting. Prevention of viruses and diseases’, organized by ABC Salud in collaboration with Moderna.
Public Health is something that those responsible for this area have very much in mind, says Elena Andradas, general director of Public Health of the Community of Madrid. For this expert, investing in prevention programs “is one of the best investments in health.” And this, she says, “implies that we must always be very attentive, be agile in the face of innovations that can occur in the short and medium term and that we must have a close relationship with the pharmaceutical industry and work directly with scientific societies.” .
Vaccination is the cornerstone of Public Health in terms of disease prevention. If anyone had forgotten, Covid has reminded us.
For everything to work, whether at the autonomous community, national or European level, Andradas highlights the “interoperability” of information systems. “It is no longer useful to have exclusively records and information systems, but what we really need is to have data updated in real time.”
Furthermore, Andradas points out, training is necessary at all levels, mainly for health professionals. «We have to be prepared to be able to detect new possible threats early».
One of the pillars of Public Health is collaboration between different entities and private companies. The pandemic has left us the example of this collaborative work, says Juan Carlos Gil, general director of Moderna for Spain and Portugal. “From the beginning of the pandemic, the situation in Europe was analyzed and it was decided that Spain was going to be a strategic point of development and investment to guarantee the production and distribution of vaccines, facilitating access to patients in Europe.”
Prevention programs are one of the best investments in health
General Director of Public Health of C. Madrid
Spain has been a strategic partner of choice from the first moment. «The company decides to invest in its production centers in 3 basic pillars: production of active substance; manufacturing of the final product and packaging, and the last and most recent investment we have made is a laboratory of analytical excellence for quality control, where we are carrying out distribution for more than 60 countries.
Moderna has invested close to 500 million euros annually in Spain in 2021 and 2022 to ensure that these centers are operational and its general director states that they intend to continue in this vein. “We make a clear commitment to science and it cannot be done without going hand in hand with scientific societies, such as the Spanish Association of Vaccinology (AEV), or with universities,” says Juan Carlos Gil.
In this sense, Jaime Jesús Pérez, president of AEV, highlights that this scientific society has set itself the challenge of working for and with other medical specialties in which vaccines are not its main field of action. «We have to introduce vaccines so that they are part of their corpus, exactly as pediatric specialties do.».
The population is another line of action. And for this, Pérez points out, “it is important to have the media.” Furthermore, in this last year the AEV has introduced two strategic lines: a specific committee dedicated to patient associations in order to convey to them the importance of vaccines in many pathologies and a communication campaign for the general population about respiratory diseases.
Spain is a strategic point for the production and distribution of vaccines
Juan Carlos Gil
General Director of Moderna for Spain and Portugal
The acceptance of vaccines by the population is essential for public health and prevention programs to work. Ángel Gil de Miguel, from the Vaccine Advisory Committee of the Ministry of Health, explains that for many years in Spain, pediatric vaccination has worked excellently.
It is in adolescence when coverage begins to decrease. «We work with new technologies – mobile phones, social networks, etc. -, but we know that the biggest challenge we have is in the adult population. “We want to vaccinate before older people are at risk and that is why strategies are being proposed to vaccinate people between the ages of 60 and 65.”
Ángel Gil believes that the best strategy to improve this situation is to involve community and family medicine so that they are clear that vaccination “improves the quality of life of patients.”
But assessing the acceptance of vaccines among the population is complex, acknowledges Pérez, for whom, as a study published in the journal ‘Pediatrics’ pointed out, a continuous observatory is needed to determine why the population is not vaccinated. “It is not enough to measure vaccination coverage, but there should be a system that tells us why those who do not get vaccinated do not do so.”
We want to vaccinate before older people are at risk
Angel Gil de Miguel
Madrid City Vaccine Advisory Committee
Last year, coverage was 65% for flu and, in the 70 and 80 year old group, 67% for Covid. That is, “we have two thirds who comply with the recommendation and one third who do not.” And here it is worth remembering some figures: the flu, depending on the year, can cause between 4,000 and 15,000 deaths, and vaccination can prevent up to 26,000 deaths in 1 year.
As has already been said, vaccination saves lives. And at the same time, Ángel Gil points out, vaccines help support the health system. “We have the money we have and the sustainability of the health system depends on prevention.”
A flu and an admission due to flu has a cost of between 5 and 6 thousand euros. It is obvious that vaccination is a tremendously cost-effective measure and that guarantees that we can continue to have hospitals available for pathologies that require admission. “That a person dies from the flu because they have not been vaccinated should not happen in our environment,” acknowledges Ángel Gil.
The mRNA technology, used for Covid vaccines, represented a change in the manufacturing of vaccines, since it allows us to provide solutions for patients in a much safer, faster and more flexible way, says Juan Carlos Gil.
We have to introduce vaccines in other specialties in addition to pediatrics
Jaime Jesus Perez
President of the Spanish Association of Vaccinology
In the future, Modern wants to continue working in the short term on respiratory diseases. Two years from now, “we are going to launch a flu vaccine, a flu and Covid combo, a flu, syncytial virus and Covid combo and one for individual syncytial virus. There are four vaccines that we are going to have on the market before 2025, but over the next 5 years the platform is going to give us the versatility to launch 15 new products on the market not only in the respiratory part, but we will also make progress in rare diseases. , in immuno-oncology and in cardiovascular diseases.
We have technology, collaboration, distribution, would we be prepared for a new pandemic?
We have certainly had the opportunity to learn what we really need to strengthen to be prepared for new threats, says Andradas.
Fortunately, adds Ángel Gil, “in Spain we have a fantastic epidemiological surveillance network. The proof is that in the middle of the pandemic a problem with monkeypox arose and was quickly detected, all the measures that needed to be taken to control it were implemented.
Juan Carlos Gil adds two important points: we must reinforce the public systems we have for prevention and public health and, furthermore, to be prepared for a pandemic, it is not only enough to identify that something different is coming, but also how to fight against it and to stop it. What we have to do is bet on the innovation, not only in technology, in biomedical science, in biotechnology, but also the adaptation and sustainability of those elements in your country. Right now we enjoy a privileged situation with our facilities in Spain. “We are already working on the following pandemics, it is one of the commitments we adopted with the WHO.”
And finally a message for the population now that we are facing a new Covid vaccination campaign, experts point out. It is worth remembering that during the first year of vaccination, two million deaths were avoided worldwide, and 456,000 in Spain.. A public health report from the United Kingdom has assessed that if the population is vaccinated en masse, 4,000 deaths will be avoided this year. These data tell us that, although Covid is fortunately not what it was in 2020, we must get vaccinated, but also against flu and everything that is on the vaccination schedule.