In the catastrophic accident that the pandemic has been for the world, vaccines arrived at the end of 2020 as the coveted lifeboats that would save the castaways. After a first stage of great anxiety to be the first to climb them, rich countries now see how many of their citizens prefer to remain in the water, at the risk of drowning. At the same time, the delta variant, the most contagious since the virus began to spread in China, is generating new epidemic waves that, while less virulent than previous ones in countries with high vaccination rates, are re-engaging health systems and eliminating patches of normality that had been recovered.With this panorama and a herd immunity that experts estimate closer to 90% than the 70% that was considered at first, more and more governments are betting on giving a push to citizens to get on the boat, restricting activities and freedoms those who refuse vaccination or even imposing it on their officials. The option of forcing the general population to receive the puncture is not being considered, at the moment, in most Western countries.
In Spain, the problems of vaccine advancement sound like a distant debate: the vaccination rate remains constant and last week it became the country among the 50 most populous in the world with the highest percentage of people with the full dose (although Canada has it surpassed this Tuesday, according to data from Our World In Data, a repository promoted by the University of Oxford). According to the latest report from the Ministry of Health, 55.7% of the population has received the complete guideline, while the average in the European Union is 47% and in the United States, where the process began earlier, it does not reach 49 %.
Here the debate on restricting leisure time to the unvaccinated, as Galicia or the Canary Islands have raised, is due more to a strategy to stop the expansion of the fifth wave than to encourage a vaccination that, for the moment, does not need incentives: all the bands of age are going en masse to the health centers when it is their turn.
Although the Canarian president, Ángel Víctor Torres, has come to raise the obligation of the vaccine among public employees.
Spain leads the complete vaccination against coronavirus among large countries
The Minister of Health, Carolina Darias, acknowledged this Wednesday that some community has proposed using the vaccination certificate to limit leisure to the unimmunized in the Inter-territorial Council of the National Health System.
“But it was not on the order of the day, now what we have to do is continue vaccinating and reach the indicated milestones, such as reaching 70% of the vaccinated population at the end of August.
We are not having vaccination problems, on the contrary: what people want is to get vaccinated as soon as possible.
And we hope it continues like this ”, he has settled.
Measures to vaccinate in western countries
The United States, which was one of the most advantageous countries in the early stages, has tried various tactics to encourage its citizens to inoculate against COVID-19 in the face of vaccination stagnation. From cash — the New York City Council pays $ 100 for the first shot — to free beer. But the population figure with the full guideline is still stagnant and the White House was this Wednesday considering mandatory among federal officials. It is something that other administrations have also announced, such as the State of California and New York City. If not vaccinated, they would have to pass PCR tests weekly. Even private companies, like Google or
The Washignton Post
, will require a vaccination certificate from their workers, according to
The New York Times
Get your first dose of the # COVID19 vaccine at a City run site and you'll get $ 100.
It's that simple.
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- NYC Mayor's Office (@NYCMayorsOffice) July 28, 2021
In France, health workers who do not want to receive the injection can lose their job since September and the Government does not rule out doing the same with teachers, caregivers in residences, firefighters or civil security military, if broad coverage is not achieved. In the Gallic country, from August a health certificate will be necessary to access public places such as bars and restaurants, even on the terrace. It will also be necessary to travel by plane or long-distance trains. The measure has been in force since last week to access any cultural and sporting event where more than 50 people gather, including tourist attractions, cinemas and theaters.
Italy will impose similar measures in August and Germany is considering them. These movements have unleashed a storm in the countries that are applying them. Some political sectors of the transalpine country, especially linked to the populist right, have tried to obstruct the implementation of these measures that they consider excessive. Matteo Salvini, the leader of the far-right Liga, for example, has pointed out that it is not necessary to vaccinate young people. Prime Minister Mario Draghi, a great defender of vaccines for all, has responded forcefully: "An appeal not to be vaccinated is a call to die." In Germany, in addition to protests, there is a struggle between those in favor of maintaining individual freedom to get vaccinated and those who want to be tougher and demand the vaccination certificate for certain activities. In France,Last week 114,000 people demonstrated against the measures.
The reasons for the brake to punctures are varied. The anti-vaccine movement, very active and influential in countries like the United States and France, where large pockets of the population advocate against inoculations, is part of the problem, but not the only one. The capacity of the health system to reach the entire population, the laziness of part of it, who feels outside the system or people who are simply afraid and prefer not to risk suffering side effects that although very infrequent ( much more than the possibility of becoming seriously ill from the coronavirus), they are possible. There is also what is known as the stowaway effect: people who want to wait for others to get vaccinated to take advantage of herd immunity.
Protests over restrictions to contain the pandemic spread across the world
Fernando García López, president of the Research Ethics Committee of the Carlos III Health Institute, explains that in each country we must find an answer according to their situation. "The measures to vaccinate French toilets, with relatively low coverage, are not the same as those imposed by the United Kingdom in residences, where they are very high and perhaps it would not be necessary, which has caused large protests" , he reflects. This expert, like others consulted, advocates first to convince and, before compelling, to incentivize with certain benefits, as some countries are doing. Compulsory vaccination is a conflict between the common good and individual freedoms that bioethicists tend to defer until it is not strictly necessary.
A paradigmatic case in the advancement of vaccination, such as Israel, has been stagnant for weeks. At the beginning of April, it reached 50% of the population with a complete pattern, but since then, in almost four months, it has barely advanced 11 points to stand at 61%. Prime Minister Naftali Bennett announced Thursday that the green pass or digital vaccination certificate would be reintroduced to allow access to cafes and restaurants, gyms, cultural and sports centers and places of worship, although the Government has not yet adopted the decision. “There are more than a million citizens (11% of the population) who are in a position to be vaccinated and have not done so. They are endangering the health and economy of all Israelis, ”warned the prime minister."Now that vaccines have been proven around the world to be safe and effective," he added, "the time has come for them to become immunized and stop threatening the health of their loved ones, especially the elderly." In Israel there is no defined anti-vaccination movement, except for some cases of active deniers on social networks, but the most disadvantaged communities, the Arab minority (21%) and ultra-Orthodox Jews (12%), have been the most refractory to receive the vaccines. two injections of Pfizer.the Arab minority (21%) and ultra-Orthodox Jews (12%) have been the most refractory to receiving the two Pfizer injections.the Arab minority (21%) and ultra-Orthodox Jews (12%) have been the most refractory to receiving the two Pfizer injections.
The residual anti-vaccine movement in Spain
The anti-vaccine movement is also residual in Spain, a country with a strong vaccination culture that is reflected in the high rates in children's campaigns. According to the latest survey by the Spanish Foundation for Science and Technology (Fecyt), the number of people who flatly refuse to get the vaccine in Spain went from 33% last summer to 4% last May. For this reason, most of the experts consulted agree that it is not necessary to impose any type of obligation, at least for now. Alberto Infante, a professor at the National School of Health, believes that it is not necessary to "give arguments to the anti-vaccines" for them to mobilize, as is the case in other countries. “You don't have to move different contexts, like French, here, where even the youngest are responding well. It would be counterproductive ”, sentence.
Federico de Montalvo, president of the Bioethics Committee of Spain, believes that the debate on the obligation does not hurt. Because although in his opinion today it is not necessary, we will have to see what happens in the future. With a herd immunity that experts already place near 90%, the debate will come when it is time to vaccinate children. Approximately 11% of the population in Spain is under 12 years of age, for whom there is still no vaccine, but it would probably be ready by the end of 2021 or the beginning of 2022. “The criteria for vaccinating them is either that it protects them or that it serves for herd immunity. For them there are surely more risks than benefits, since the vast majority have a very mild disease.Then we will have to ask ourselves if to achieve group protection it makes sense to vaccinate them or to force adults who have not been punctured yet ”, he points out.
Another debate is that of health personnel.
The General Council of Official Medical Associations (CGCOM) has made an appeal this Wednesday to all health workers to be vaccinated "in the face of some detected cases."
Its president, Tomás Cobo, explains to EL PAÍS that those who do not do so may be violating the code of ethics, since they put public health at risk.
"In the cases that have contact with patients, it would be necessary to consider separating them and putting them in other tasks," he says.
With information from
Silvia Ayuso, Lorena Pacho
Juan Carlos Sanz