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The availability of vaccines, when they happen and at the rate at which they happen, will continue to need to be accompanied, for many months, by the fulfillment of the other essential rules to keep our social and economic systems responding in the period when they are not yet has achieved immunity ”, said the Minister of Health, Marta Temido in the presentation of the vaccination plan against Covid-19, in Lisbon.
The Minister highlighted the technical rigor of the plan’s coordination team for the distribution and administration of vaccines. The vaccination-related process does not start now, since Portugal has, since June, been following the European Union’s process on the development, production and availability of vaccines, he said.
Marta Temido stated that “the vaccines to be distributed will have a universal and free character”, will be “administered according to the characteristics of the medicine”, and “made available at the National Health Service, using the NHS chain as much as possible, and then eventually expandable to other points in the health »system, with secure logistics and records that allow monitoring the process.
The Minister also mentioned that there are still technical uncertainties, of production by the pharmaceutical industry and approval by technical entities, in the session chaired by Prime Minister António Costa.
Plan
The coordinator of the working group that prepared the plan, Francisco Ramos, stated that the objectives of the plan are “to reduce mortality and hospitalization in Intensive Care Units, control outbreaks in the most vulnerable populations, and preserve the response capacity of the services universal ‘.
The priority groups were defined based on known data, which show that people over 50 years old are 97% of deaths, 91% of hospital admissions and 81% of intensive care admissions. There are other diseases that are important risk factors, especially coronary, renal and pulmonary.
Phases 
According to the plan, in the first phase, people aged 50 or over with one of the diseases mentioned above will be vaccinated, residents of nursing homes and long-term care units and their professionals, health professionals and essential services, representing on the 950 thousand people.
In the second phase, two groups of people will be vaccinated: those over 65 without disease, and those between 50 and 65 who have diabetes, cancer, liver and kidney failure, obesity and hypertension, representing the first subgroup, 1, 8 million and the second plus 900 thousand.
In the third phase, the rest of the population will be vaccinated if the industry is able to produce vaccines at sufficient speed; if not, new priority subgroups will be created, which will be vaccinated at the rate at which vaccines are produced.
Vaccination in Portugal starts in January, as in the whole of the European Union – the vaccine will be distributed to all countries at the same time -, but still undated, as it depends on the approval of the vaccines and the pace of production.
In time, the first phase should take place in January and February depending on the pace of vaccine supply, and may extend until April. The second is expected to take place in the second quarter.
Locations
The vaccination points will be those of the National Health Service, which has 40 years of experience, stabilized circuits and routines and 1200 points that exist throughout the country.
Residents in nursing homes and hospitalized in long-term care units will be vaccinated in these places, by the nursing teams themselves or by teams from the health centers, the professionals will be vaccinated by the respective occupational health services. The remaining 400 thousand Portuguese in the first group will be vaccinated in the 1200 points of the NHS.
There is still no detailed plan for the second phase, which implies the expansion of the vaccination network, depending on the pace of vaccine supply.
There will be a very tight record, strengthening the common electronic vaccine registration, as health services have to make sure that whoever takes a first dose gets the second dose immediately, with date, place and the guarantee that is administered to same vaccine in the second dose.
In the first phase, the system will be the call of 400 thousand people for health services, through health centers, or, for those who do not use the SNS by medical declaration.
Due to the novelty of the vaccine, there will be clinical follow-up and effectiveness studies.
In logistics, contrary to the normal decentralization of the SNS, there will be command and control of the entire operation at the Ministry of Health, supported by the Armed Forces and security forces.
Communication
There will have to be a very wide communication, which generates confidence in the population: a website with all the relevant information and telephone lines to support the population and professionals.
Francisco Ramos, like the Minister of Health, highlighted the uncertainty that exists throughout the process, referring that until the approval of a vaccine by the British authority of the medicine, the only information about the vaccines came from the pharmaceutical companies that are producing them.