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A shot in the arm: All your Covid vaccination questions answered

14:17 02/04/2021
As head of the Communicable Disease department at Brussels health and welfare agency Cocom, Inge Neven is co-ordinating the region’s coronavirus vaccination campaign. The Bulletin spoke to her about the centres and the schedule at the heart of vaccination conversations in the capital.

The Bulletin: Much public opinion has it that the vaccination campaign is going too slowly. Are we behind other EU countries?
Inge Neven:
The statistics fluctuate from week to week, but in general we are really average. It depends on the delivery of the vaccines, but every EU country has the same quota, the same amount of vaccines per capita. And every country is trying to use the vaccines as soon as possible. We are using every dose we get, but we can’t use vaccines that we don’t have. That’s where we’re blocked. We’re lacking vaccines, which means that the campaign is not going as quickly as in other countries such as the UK and Israel.

TB: Why do those countries have more vaccines per capita?
IN:
It’s related to the negotiations with the pharmaceutical suppliers. That’s out of my remit, but it was negotiated at the European level. I think that’s a good thing that we worked as the EU and not as individual countries – because then for Belgium the situation probably would have been worse. In the UK or Israel or the US, they may have accepted higher prices. I think it’s very difficult to judge our negotiations compared to other countries.

We hoped that it would be going much quicker than it’s going today. All the capacity is there; we have the capacity in Brussels to do 370,000 vaccines a month. We could even go higher if we had to. But at this point we haven’t even been able to do 100,000 jabs a month because we don’t have the vaccines. That is really frustrating. Then you get all these conversations about little things that aren’t working, and you lose the big picture.

On the other hand, we have much reason to be positive because six months ago, no one expected that 13% of the Belgian population would be vaccinated by now. So it’s actually good news. But we always see the glass as half empty instead of half full.

Inge Neven
Inge Neven  ©James Arthur Gekiere/BELGA

TB: After some initial hiccups at Heysel, how smoothly do you think the vaccination process is going so at Brussels’ nine centres?
IN:
It’s going smoothly in the nine centres that are open. We postponed the opening of the 10th centre in the military hospital because of a lack of vaccines. It’s also in the far north of Brussels, and we see that the centres located in more populated areas are filling up quickly. Heysel is larger – it has four times the capacity of the other centres – and it’s less centrally located, so it’s harder to get it really filled up.

We do see that we have to send out a lot of vaccine invitations to fill up all the appointment slots. We are already vaccinating people in their 60s, while Flanders, for instance, is still vaccinating people who are over 80. That’s because the response rate is lower in Brussels – also compared to Wallonia, though less so. We also has some trouble with reservation technology, but this is getting better. So we have spent some time improving the system to make it as easy as possible to get an appointment. We have put a lot of focus on that accessibility.

TB: Flemish politicians are confident everyone will be offered a first jab by 11 July. Is that realistic for Brussels?
IN:
If Flanders can do it by the 11th of July, then so can we. We get the same ratio of doses, in function of the population. But I think we have to look at the deliveries of vaccines in the coming weeks and months before we can set a hard deadline. We have been delivered less than promised in the first quarter. For the second quarter, we are not confident about the delivery of the Moderna and the AstraZeneca vaccinations. For Pfizer, we see that volumes are increasing, and Johnson & Johnson vaccines are expected to arrive in the second half of April, which is good news.

In any case, not everyone will have both doses by then, not in Flanders either. That won’t happen until September or October. But I really hope we will have given everyone their first jab by July. It really depends on the delivery of the vaccines.

TB: Some countries are increasing the time between the first and second dose to get more of the population vaccinated…
IN:
We see in the nursing homes that the best response is after two doses; people aren’t getting sick anymore once they’ve had both jabs. There is ongoing research in other countries to see what the effect is of increasing the time between the two doses. That would be the only way to really accelerate it at this point.

Vaccination figures for Belgium
Vaccination figures in Belgium as of 1 April  ©Sciensano

TB: Brussels is slightly behind the other regions in terms of the percentage of the population that is vaccinated. Why is that?
IN:
If you look at the number of people being vaccinated, we are in line with the other regions. The reports are based on where people live. So we started with vaccinating hospital and nursing home workers, and half of them do not live in Brussels. In other words, we have been vaccinating a lot of people coming to Brussels to work from Flanders and Wallonia. So those numbers are being attributed to them and not to us. That’s a bit of a pity. We are trying to get the authorities to change the way the figures are calculated, but it’s quite difficult, and we need to choose our battles. Now that we are vaccinating the greater population, it will be less of a difference. But right now it looks like we are doing less well than the other regions, and that is not the case.

TB: Are there reserve lists for people to get doses in place of people who don’t show up?
IN:
Yes, people who have not received an invitation but are currently eligible – that’s people over 69 years of age right now – can call to get an appointment. If there is no available slot at their centre, they can get on the waiting list. All nine centres maintain their own waiting lists. Centres can add people to the waiting list, such as at-risk patients. At the end of each day, people on the waiting list are called to use up any doses leftover because of the no-shows. So at this point, only people aged 69 and over or at-risk patients can be added to the waiting list. They are put on the list by a doctor at the centre.

TB: Are most people showing up for their vaccination appointments?
IN:
Yes, that is really quite good. Last week we administered about 28,000 vaccinations, a very good result. We are calling everyone who doesn’t show up to make a new appointment. They might have to wait awhile to get another appointment, though.

TB: The vaccination invites are based on data held by mutuelles. What about EU workers and diplomats with special ID cards and others who aren’t in the Belgian system?
IN:
The European institutions are organising their own vaccination campaigns, which sometimes includes family members as well. Anyone with an ID card can make an appointment. If they don’t have an ID card, they can call their embassy to arrange something. Anyone living in Brussels who is 69-plus and hasn’t received an invitation can call the centre to make an appointment. And as the age limits decrease over the coming weeks, younger people who are not in the Belgian system can also make an appointment.

Brussels' coronavirus website: https://coronavirus.brussels/en/home-2/

Photo, top: ©Benoit Doppagne/BELGA