‘Encourage rather than coerce’ the unvaccinated

by Lorraine Williamson

MADRID – They represent barely 9% of the population over the age of 12. However, they occupy 60% of intensive care beds in Spain. Experts argue for more encouragement and explanation instead of (in)direct vaccination coercion. 

RTVE in Spain writes, there are still 3.9 million people, over the age of 12, who have not received a single dose of the COVID-19 vaccine. This is according to data from the Ministry of Health. Secretary Carolina Darias claims that currently, 60% of those admitted to intensive care are unvaccinated. 

According to the minister, these figures confirm the high protection that vaccines offer against the serious symptoms of the disease. Nearly 100% of people over 70, the age group most vulnerable to the coronavirus, have been fully vaccinated. 

New corona wave Europe 

The new wave of coronavirus, coinciding with the arrival of the coldest months of the year, is wreaking havoc. Especially in some European countries, where vaccination rates are significantly lower than in Spain. New infections have led to restrictions including total confinement in Austria, compulsory vaccination, or requirements to show a corona certificate. Meanwhile, protests against these and other measures in several European cities are growing grim. 

German minister: “Vaccinated, cured or dead” 

In Germany, the acting health minister, Jens Spahn, has assured that by the end of winter the Germans will be “vaccinated, cured or dead”, in a direct message on Twitter to the population that has not been vaccinated against COVID. According to him, this is due to the ‘highly contagious Delta variant’. 

Spanish regions decide on Covid passport 

In Spain, the increase in infections has led several autonomous communities to put the implementation of the Covid passport on the table. This is for activities with a high risk of contamination, such as catering or nightlife. Courts will decide this week whether more regional governments with the Balearic Islands, Galicia, and Catalonia will join their strategy to demand this document. This is a proposal that has been generally welcomed. However, in the Basque Country, the Supreme Court has just rejected the request to make the COVID passport mandatory in restaurants and entertainment venues. 

Tightening up measures against unvaccinated people 

There are also proposals that go a step further. This is due to the high impact on hospitals the unvaccinated 9% of the population has. They plead for tightening of the measures against them. For example, Luis Enjuanes, a CSIC scientist, assures the pandemic that Spain is currently experiencing is that of “the unvaccinated”. Unvaccinated people cannot be forced by law to be vaccinated. But in statements to RNE, Enjuanes says many measures can be taken. 

Failure to cooperate with society must have consequences 

“If they don’t cooperate with society, then that society doesn’t cooperate with them. You are not vaccinated, you cannot work for the government. If you are not vaccinated and you have a problem due to an infection with this virus, the Spanish social security will not take your treatment on sight; You are not vaccinated, you cannot go to public centres … ”, explained the scientist. 

Reach the unvaccinated ‘through pedagogy’ 

Daniel López Acuña, epidemiologist and former director of WHO’s Health Action, does not want to go that far, although he calls not getting vaccinated “a social irresponsibility towards public health”. 

“You have to explain it well so people understand why not getting vaccinated effects themselves and others,” he told RT.VE.es. “Surveys show only 4% – 5% of the population resist vaccination for one reason or another.  But this is with untenable arguments, ambiguity, and lack of evidence. We still have a percentage of the population that you can work with to complete the vaccination. Furthermore, it is very important to do it through pedagogy, without this being an obstacle to taking restrictive measures. Especially in regions where the incidence rates are high” he continues. 

Covid passport obligation not the most important solution 

According to López Acuña, a mandatory Covid passport for certain high-risk activities, even if it is launched across Spain, is not the main solution to stop contamination. This is because 90% of the population is already vaccinated.” 

The epidemiologist recalls that those who are vaccinated “can also become infected and transmit the disease”. Therefore, he urges “to strengthen protective measures with a mask, keep distance and avoid crowds; in addition to further restrictions as incidence increases.” Stimulate” instead of “force” 

ASSSA - health insurance in Spain

Carmen Cámara, secretary of the Spanish Society of Immunology (SEI) “understands the anger of Enjuanes”, but clarifies that “in a country with such a favourable vaccination level as Spain, introducing these obligations ultimately gives wings to the unvaccinated, because they reason that people who smoke should not be treated if they have pneumonia.” 

Obligation for healthcare professionals 

Cámara, who works as an immunologist at the Hospital La Paz in Madrid, is in favour of “not forcing, but stimulating appropriately”. Therefore, it seems appropriate to ask for the Covid passport for certain leisure activities. “I do think that you should be strict with healthcare professionals because vaccination should be mandatory there. It seems to me great irresponsibility against immunocompromised and sick patients if they do not,” she tells RTVE.es. 

The Netherlands 

Cámara gives the example of the Netherlands, where 80% of the population over the age of 12 has been vaccinated. This is versus more than 90% in Spain.  And, furthermore, “the Netherlands has a lot of difference in terms of serious illness.” “With these high vaccination percentages, small percentages are important,” she assures. Then adds another factor; in the Netherlands, it is no longer necessary to wear a face mask indoors. Whereas, this is an obligation that has remained in force in Spain all along. 

The Threat to People with Immunity Problems 

CSIC researcher Matilde Cañelles believes that Luis Enjuanes’ statements “takes a debate that is now taking place to an extreme, but is often taken too literally because what he wants to emphasize is to what extent the unvaccinated person kills all people.” around them, especially those who, although vaccinated, are unable to develop a sufficient immune response”. 

The immunologist explains that the vaccinated can still get infected, but much less infected than an unvaccinated. “First, because it’s harder for the disease to develop, even if it’s asymptomatic. Later, when the immune system fights the virus, it does it so much more efficiently. Therefore, the infection is less severe and less likely to infect further.” 

Likewise, she says, it forces us to think about those people with immune problems, such as the elderly or cancer patients, who make up a significant percentage of the Spanish population. “When incidents occur, you always have vulnerable people who will suffer a lot of damage. I think that people who don’t get vaccinated often don’t know that there are people who don’t develop immunity,” Cañelles continues. 

‘Fighting vaccine rejection with information’ 

She emphasises the need to fight vaccine rejection ‘with information’. “I think there is a group that does not get vaccinated because they do not have all the information ready about the possible consequences of an infection, such as about blood clots from COVID-19, or the consequences of lung Covid. Moreover, many do not know that some people simply don’t develop immunity. If they were confronted with all that information, most of them would be vaccinated without pressure or obligation,” she says, although she knows a small part will never respond. vaccinated, no matter how much information they were given. 

“Excessive” measures can be “counterproductive” 

The president of the Spanish Association for Vaccination (AEV), Amós García Rojas, believes that in a situation like the one Spain is currently in, “taking excessive measures may even be counterproductive”. “Denying public health to people who don’t want to be vaccinated enters a complicated spiral because the same rule of three requires us to avoid public health for those who smoke,” he says. 

García Rojas believes that with the vaccination coverage that exists in Spain, “added to a set of measures that are reasonably achievable, we will save the day”, explaining that measures should be linked to the areas where most infections occur, such as “closed and poorly ventilated areas, in which we also don’t wear our masks”. 

Few pure deniers 

He continues: “Most people who have not yet been vaccinated are not deniers, as there are very few pure deniers,” pointing out that there is an age group with a higher percentage of unvaccinated people: between the ages of 30 and 39. “This is because they have no risk perception and think that this SARS-CoV-2 thing belongs to the elderly, not to them. What you have to show them is that unfortunately there are also complications for young people without vaccination.” 

“Then there is another group of people who are still afraid of the vaccine. You have to convince them that what society and the health of d really helping the population move forward is as simple as using common sense, which in science is nothing more than scientific reasoning. What scientific reasoning tells us today is that we need to vaccinate. We need to advance science and thus raise awareness,” said García Rojas. 

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