In Spain, 7.7 million people over 12 years of age have yet to be vaccinated. Most are young people in the process of completing their schedule over the next few weeks. But there is also a small portion among the groups summoned for months that have not received any puncture: 7.4% in the group between 50 and 59 years old and 15.4% of the forty-somethings. Vaccination in these groups is already progressing very slowly and, especially among the former, the percentage is stagnant. About two million people over the age of 40 have not received a single dose. Experts insist that, overall, the rate of injections is very favorable, but there will be niches that are difficult to reach, because those involved cannot or do not want to be vaccinated. And they illustrate some of the clear profiles of people who act like this: deniers, those who have doubts, those who have contraindications, those who have just passed the infection and have to wait a while to get pricked, and even, a group whose vaccination status is not reflected in the statistics, such as foreigners in an irregular situation.
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The Valencian Community has been the first to launch a campaign to catch up with these laggards. He will send you messages with several possible dates so that they can choose and go to be pricked. There is no longer a dose problem: between the massive arrival of vials this week, the holidays and the fact that there is less and less population to be immunized, some autonomies, such as Murcia and the Basque Country, even have gaps and they are calling their population to go to vaccination centers.
Spain, however, continues with an enviable injection rate. With 62.2% of the population with full guideline, only Canada is ahead among the 50 most populous countries in the world, according to Our World in Data, a repository of the University of Oxford. The point of stagnation shown by other countries, such as the United States, Israel, Germany or France, has not yet been reached. The experts consulted advocate maintaining the process without giving incentives or penalties to those not vaccinated, reports Paul linde. Fernando García López, president of the Research Ethics Committee of the Carlos III Health Institute, maintains that “it is better to convince than to coerce, something that can polarize”. “In Spain there is no important anti-vaccine group to fight, as is the case in other places,” he says.
A survey held in June by the Spanish Foundation for Science and Technology (FECYT) points out that the total reluctance to receive the drug is barely 4% of citizens, when last October they were almost a third of the population. Amós García, president of the Spanish Vaccination Association, believes that “anti-vaccines are absolutely marginal here, a minority group, and they will not have weight in the vaccination campaign. I would not lose much effort in this group ”, ditch, because he considers that convincing them is impossible.
There are no official figures for the rejection of vaccination or the exact reason for the refusal. Carlos Orquín, 32, is a journalist, but He worked for a few months as an administrator giving appointments for vaccines in a hospital in Barcelona and recounted his experiences in this newspaper. The no’s were marked as “does not want” or “doubts.” The former, he points out, were blunt “and the conversation ended immediately”, there was not much room for debate; the latter, on the other hand, expressed their reluctance, but there was an option to re-fish them: “The latter were afraid and had many doubts. Many said they were going to wait until later ”, he adds.
The Ministry of Health estimates that they are not around 0.6% of the population consulted, but a spokeswoman clarifies that in this percentage they can be both anti-vaccines and people who have not answered the phone when they have been called. In the communities, the figures are around 1%: in Castilla-La Mancha there is 1.17% of rejections, although the reasons are not specified; in the Canary Islands it is 1% and in the Valencian Community, 1.13% of the population summoned to be vaccinated has expressly refused to do so (medical contraindications are also here), as stated last week by the Minister of Health, Ana Barceló; in Andalusia, the rejection is 0.63%, according to the Ministry of Health.
In Health, the rejection of the general population does not worry, but it does in some groups, such as social health workers. Although the percentage is minimal, they are in contact with very vulnerable people and each professional in this group who refuses the injection can cause a tragedy by introducing the virus into a nursing home, for example. At least five autonomous communities They have asked for compulsory vaccination for these professionals and, in some cases, also for health workers, but it is something that the ministry does not propose today. Last Wednesday, the head of the department, Carolina Darias, presented a document of technical recommendations to take extreme precautions in these centers, which included carrying out two weekly tests for unvaccinated employees and even evaluating the possibility of changing their job.
Getting to vaccinate 100% of the susceptible population is impossible, specialists assume. To begin with, because there is always a group, although tiny, of people who cannot be vaccinated because they have medical contraindications, either due to allergies to some component of the vaccine or due to interactions with other drugs they consume. “Like those allergic to polyethylene glycol, which is like the drop in which vaccines go to cells,” says Alberto Infante, emeritus professor of International Health at the National School of Health of the Carlos III Health Institute. “And also people with multiple or severe allergies look at themselves with a magnifying glass. You have to see each case, “he says. The Spanish Society of Allergology and Clinical Immunology has clarified, in any case, that vaccines are not contraindicated generally in people with any type of allergic disease.
Among those who cannot and those who do not want, however, there is also another collective that dances in uncertainty. They are the ones who, without being radical anti-vaccines, have doubts. Those who fear its effects, collateral damage and its effectiveness. The president of the vaccinologists clarifies: “They have doubts because they are afraid, but with these people you can talk and dialogue.” And also, as a third party, Toni Trilla, head of Epidemiology at Hospital Clínic de Barcelona, third party, “can be convinced over time.” In this group, he adds, there is a subgroup of “apathetic” that has also been seen in the United States: “They are people who do not think about getting vaccinated, they pass. They are on vacation or working and are not worth the arguments that this is health. I don’t know if we would have this in Spain ”, the expert weighs.
Another group that cannot be vaccinated, and now more numerous among young people after the fifth wave, is that of people who have just passed the covid. According to the vaccination strategy of Health, if they are under 65 years of age they have to wait six months to start or complete the vaccination regimen, a time that the Generalitat of Catalonia has reduced to two months in this community. In the last half year, more than a million and a half people of all ages have been infected. Those who have to wait to have overcome the disease will be left behind, Infante admits, but maintains that they are not a problem: “Normally they will end up vaccinating because they have seen the wolf’s ears.”
Migrants in an irregular situation
The last group that escapes from the system and, even, from the statistics are people in an irregular administrative situation. They are not even within the calculation of the 9.2 million that remain to be vaccinated because they do not appear in any registry. According to Pedro Campuzano, health reference of the state programs of Doctors of the World, they are, above all, people without a health card, such as migrants in an irregular situation or people who are in a regular situation, but without the document of access to the health system, such as they can be regrouped ascendants. It is contemplated that these people get vaccinated, but it is difficult to find them. “There is a part that may be afraid to relate to the Administration and demand their rights, especially those who are going to proactively seek the vaccine. But there is also an effect of the hoaxes and they do not want to be vaccinated, although this has improved over time. Precisely, a part of our cultural mediation work is health education ”, Campuzano resolves.
The homeless are another vulnerable group, as are those who live in settlements without a fixed residence. These profiles, for which the strategy already foresees the single-dose Janssen vaccine to protect them from a single puncture, are difficult to locate and require proactive strategies. In Barcelona or Madrid, specific campaigns have already been carried out with the homeless and in Seville there is also an attempt to bring this group closer to the vaccination points.
But more proactive strategies are lacking, Campuzano claims: “In the autonomies the protocols are in place, but on the ground it is not being easy because the regulations are not known or the people do not know about this possibility. No proactive action has been taken to communicate that this possibility exists. They get lost, they bundle them up and they take them from one place to another. That is one of the bottlenecks ”, ditch.
Experts point out that once the bulk of the population has been vaccinated, escape niches must be analyzed and recruitment strategies reinforced with tailored campaigns. Amos García points out that ”When it reaches 70% [el último hito marcado por el Gobierno para alcanzar a finales de agosto] you have to keep building. The deniers distort the situation and make a lot of noise, but they have little weight ”. We must continue vaccinating, Infante agrees: “We have a month left to see how we finish. We will arrive with a large population covered with more than 40 years and it will be less than 30. But from there we must not take out that the youngest have not wanted to be vaccinated, but that it may not have been good for them. Self-citation has limits. You have to be proactive and call and call again. As of September 1, the 18 to 30-year-old group must be located and offered the vaccine again ”.
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