Social value as well as personal benefit, and persuasion before coercion. These are the principles that have guided the vaccination of children in Spain for decades and, as a result, the country has one of the highest vaccination coverage rates in the European Union. Given these good results, the administration did not consider it necessary to make any changes in the fight against the coronavirus. No special strategy is also needed among healthcare workers or staff in retirement homes, where a positive case can have devastating consequences for patients or residents.
Data available in Spain show that staff at Spanish hospitals and health centers have responded en masse to the country’s Covid-19 vaccination campaign, with percentages close to 98%. The participation rate is a little lower among nursing home staff, at 90%.
A similar situation is not found in other countries of the continent. France and Greece announced Monday that vaccination will be compulsory for healthcare workers after the outbreak of the fifth wave, proof that hesitations persist among many professionals in the sector.
“Healthcare professionals must have received their second [vaccine] dose before September 15, ”French Health Minister Oliver Veran said this week, adding that anyone who refused to be vaccinated would not be able to work or be paid.
Fortunately in Spain we know very well the benefits that vaccines have for each of us and for society as a whole.
Amos García, President of the Spanish Association of Vaccinology (AEV)
The measure was adopted in France after weeks of weak progress in vaccination among health workers after coverage reaching 60%. “We must go towards the vaccination of the entire French population, it is the only way to return to a normal life,” said French President Emmanuel Macron, who included this compulsory vaccination plan in a package of measures targeting the entire population of France. a country where vaccine resistance has increased dramatically over the past two decades.
In Greece, Prime Minister Kyriakos Mitsotakis has been equally energetic. “We are not going to close the country again just for the fault of a few,” he said. “It is not Greece that is in danger, but rather the Greeks who have decided not to be vaccinated. While the government has not made public vaccination data among health workers, the trend in the country is worrying: the pace of the vaccination campaign has slowed down at a time when barely 41% of Greeks have full vaccination coverage, a shortfall in points compared to Spain.
The Greek bioethics committee had recommended compulsory vaccination for all healthcare workers and those caring for the elderly as a “last resort” if efforts to promote vaccination among them did not work.
“In Spain, fortunately, we know very well the benefits that vaccines have for each of us and for society as a whole,” says Amos García, president of the Spanish Association of Vaccinology (AEV). “The coverage that we are achieving among the population and reaching among the health workers is both very high. “
With the current percentages, this specialist believes that the implementation of compulsory vaccination would be “counterproductive”. “It is always better to persuade than to coerce,” he said. “And doing it when it’s not necessary can have an unwanted effect and lead to rejection of vaccinations and strengthen the arguments for the few who oppose them. “
José Miguel Cisneros, head of the infectious diseases department at the Virgen del Rocío hospital in Seville, agrees that “the rejection of vaccines is marginal in Spain, unlike what is happening in countries like France”. He cites as an example the acceptance achieved in his hospital, where more than 99% of the nearly 9,000 staff members have been vaccinated.
“Spain must continue the strategy it has used so far because it has achieved very good results and because individual freedoms must be preserved as much as possible,” he said. “When we take advantage of a situation very close to an optimal situation, with vaccines accepted as something that contributes to the common good in a way that goes far beyond individual benefits, I see no reason to bring changes, ”concludes Cisneros.
The Ministry of Health insisted on voluntary vaccination as one of the principles that should inspire the campaign, which started at the end of December. With coverage in hospitals and other health centers of around “99%”, according to the ministry, there is no reason to follow the example of France or Greece.
The data offered by the Spanish regions are also very high, although in some cases they are declining. Catalonia reports that 90.2% of its healthcare staff have been fully immunized (92.5% have a dose), of which 88.1% are nursing home workers (90.4% with a dose).
Andalusia puts the figure above 90% for the two groups, while 95.6% of health personnel in Valencia benefit from full protection offered by vaccines, as do 88.3% of residential staff. seniors. This percentage rises to 100% and 97.5%, respectively, for those who received the first dose.
In the Canary Islands, 99.4% of healthcare workers and 81.3% of social workers are fully immunized, with almost 100% of both groups having received the first dose. In the Balearics, the figures are around 90%.
In Murcia, authorities say 97.5% of healthcare professionals are fully vaccinated, while 100% have the first dose. Meanwhile, 93.3% of social workers have a dose and 89.3% are fully immunized.
Some regions did not provide data or refused to respond to requests for information from this newspaper, but all the sources consulted suggest that there is little difference from one territory to another, and the percentages are similar throughout Spain.
Despite these positive data, we must “continue to work to obtain the maximum possible coverage”, argues Amos García. The danger is clear, as was evident in May at a retirement home in Girona, where the coronavirus caused the death of an elderly lady who was in poor health and had been vaccinated. Of the 37 workers at the center, 17 had chosen not to be vaccinated. A number of residences in Spain have suffered epidemics in recent months, where the presence of unvaccinated staff has facilitated the circulation of the virus.
“In cases where the staff are dealing with very vulnerable people and where lives are clearly at risk, I consider it necessary to open the door to start the debate on [making the vaccines] mandatory, ”continues the president of the AEV. “But it would be better to focus on each case and look for concrete solutions.” »
The common position between experts and regions is that before introducing major changes that could end up being complicated and creating resistance, the good results of the Spanish strategy suggest that the current course should be maintained for now, and that more drastic measures should only be adopted when strictly necessary. The Balearic Islands, for example, have introduced a decree “which allows the introduction of compulsory vaccination in specific communities if it proves necessary”, although for the moment the authorities have not had to resort to this option. .
The Ministry of Health and the regions agree that, in any case, any modification must be decided by the Interterritorial Council of the National Health System (CISNS), which brings together the central Ministry of Health and the regions. So far, only Galicia has decided to make vaccination compulsory. The Ministry of Health appealed to the courts to the Constitutional Court, which has yet to issue a final decision. “You can only restrict fundamental rights through national legislation,” central government spokeswoman María Jesús Montero said at the time.
With reports by Margot Molina, María Fabra, Mikel Ormazabal, Isabel Valdés and Lucía Bohórquez.
english version by Simon Hunter.