The Spanish exception: vaccination continues from strength to strength while in Europe it loses steam | Society

The vaccination rate in the European Union is beginning to slow. Italy and France have stagnated in recent weeks in the number of doses they put out per 100,000 inhabitants, while in other countries, such as Germany and Poland, the rate at which punctures are administered has clearly decreased since mid-June. . The curve, ascending until then, reached its peak a month ago and since then it has not stopped descending, to the concern of its health authorities. Among the large European countries, Spain is the exception. It gives more vaccines depending on its population than the rest and the drop in the rate that is observed in recent days is less pronounced.

Faced with the evidence that vaccination is beginning to peak in much of Europe, countries are studying how they can convince those who doubt. The European Union had set itself the objective of having 70% of the adult population vaccinated with a complete schedule by the end of the summer. But i didn’t expect this summer. At a time of rising epidemic curve and with the threat of the rise of the delta variant, more contagious, there is still room for improvement, a large population susceptible to vaccination and some experts argue that group immunity will not be reached with 70% but with 80% or up to 90% of the immunized population. The experts consulted point out that, unlike other parts of Europe, support for vaccines in Spain is very high and its health system is more proactive in promoting vaccination.

The French Government has already made decisions: it will oblige health and nursing staff to be vaccinated and it will make social life indoors and mobility very difficult for those who are not immunized, because it will require a covid certificate to enter bars and restaurants and travel by train and plane. In October, in addition, PCRs will no longer be free. Germany, which in mid-June averaged 950,000 daily doses and now does not reach 600,000, is also studying persuasive measures to encourage punctures, although for now the authorities have ruled out the obligation for social health personnel. The Greek Executive has given residential workers until August 16 to get vaccinated and health workers until September 1. They could lose their job if they don’t.

The European Commissioner for the Internal Market, Thierry Breton, stood out last Saturday on his Twitter account that Europe has surpassed the United States in first doses, while it exports more than half of the vaccines it produces in its territory (the United States does not export anything), and pointed to the new challenge: “Overcoming doubts about the vaccine in Europe.”

The Spanish oasis in the rate of vaccination is explained, according to Amós García, president of the Spanish Association of Vaccination, by the high acceptance of vaccines in the country: “Spain is a very vaccinating country. Primary vaccination coverage rates exceed 95%. We have very conscientious health professionals who have internalized the bonanzas of vaccines ”. In France, for example, measles vaccine coverage is slightly lower than that of Spain, 90%, according to the OECD, and in Italy, although it is 93%, there were important outbreaks in 2019 due to the boom in anti-vaccine movements, also very present in the Gallic country.

Also with flu vaccination, coverage in Spain was 65.5% in 2020 among those over 65, while in Italy it was 54% and in Germany, slightly less than 39%. “All the anti-vaccine movements in Europe and the United States began to be in vogue at the end of the sixties, but in Spain they found an unfavorable ground because we had just emerged from a polio epidemic thanks to a vaccine. In some European countries, there are many anti-vaccine toilets. In Spain, those that exist are few and have little weight ”, resolves Alberto Infante, emeritus professor of International Health at the National School of Health of the Carlos III Health Institute.

“In Spain anti-vaccines are anecdotal,” agrees García, adding that the accessibility to injections, free and collected within the childhood vaccination calendar, has favored a climate of acceptance of these drugs. Also the presence of a solid, close primary care, branched throughout the territory and with the majority of its toilets favorable to vaccination. “We also have a very powerful national health system that encompasses all citizens. This power of the public is key and, in addition, it is a very proactive system ”, adds the vaccinologist.

In countries like Germany, where there is no public primary care system or digital medical record, it is the patient who must be proactive. Doctors are not civil servants: they work on their own, in their private practices, not in health centers or outpatient clinics. The system is very atomized. During the vaccination campaign, the regional health systems have not been calling the population by age group, as in Spain. Those who have been immunized have had to find an appointment in vaccination centers or in private doctors’ offices, and that was very complicated, also for those over 60, during the first months of the campaign. Now it is easy. There are plenty of quotes.

“In Germany the limiting factor of available doses no longer exists, but the pace is slowly decreasing. It seems there was even a spike just before the holiday season, when a lot of people wanted to get vaccinated early, ”says Hajo Zeeb, an epidemiologist at the Leibniz Institute for Preventive Research and Epidemiology. The pace is still high, he says, but from now on it will be difficult to maintain it because “a ceiling effect has been reached”. The expert believes that the second doses could be advanced to protect those who want it as soon as possible. In Germany these are put much later than in Spain. With Moderna, for example, at 42 days, when in Spain there are 28.

In Spain, the Government has launched campaigns to promote vaccination and communities have combined the individual appeal for vaccination (through an SMS or a direct call to the person) with the opening of self-citations. The autonomies, in addition, have launched repechage actions to attract citizens with ages of risk who lagged behind in the vaccination process. Catalonia, for example, has deployed vaccination buses and trucks provided by Seat as mobile points where you can click to facilitate access to drugs. In Germany politicians call for vaccination, and there are posters in the streets that encourage citizens to make an appointment, but they are generic calls.

With an eye toward the growth of the delta variant, which is up to 60% more contagiousAccording to the European Center for Disease Control (ECDC), experts recall the need to stop transmission quickly. “Group immunity should be achieved as soon as possible, but with the delta variant, the percentage of 70% of the vaccinated population to achieve it falls short. We are going to have to need 80% coverage ”, warns Joan Caylà, member of the Spanish Society of Epidemiology.

The experts consulted agree that in Spain it is not necessary to go to these extremes, much less force to be vaccinated. In fact, García explains, “taking such drastic measures in Spain is absurd and would serve to rearm anti-vaccine movements”. The doubts of the population, says the vaccinologist, dissipate quickly, “when people verify that negative theories about vaccines are false.” In October 2020, before the first preparations hit the market, the Spanish were very dividedAccording to the CIS, almost 44% of the population refused to be vaccinated immediately against the coronavirus, while 40% would be willing to prick themselves as soon as there was a drug. In January, polls turned upside down and Spaniards willing to be vaccinated immediately against the covid shot up to 72%.

So far this vaccination campaign, Spain has achieved almost total coverage of people over 70 years of age. In the 60-year-olds and the 50 to 59-year-old group, now immersed in completing the vaccination regimen, coverage has already been achieved above 95% and 90% respectively. As there is still room for improvement, Health has announced a campaign to promote vaccination and responsible social behavior with the collaboration of Olympic athletes.

Infante fears that vaccination coverage among those under 40 will drop “a little”, “although the symptoms that exist, for now, are positive because there are queues at the vaccination points,” he admits. Caylà, for his part, trusts that the coverage will continue to be good and that there will be no shortage of people who want to be vaccinated: “The only problem we have here is that we still receive few vaccines.”

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