• Vaccines The sterile debate of compulsory vaccination in Spain

  • Reinforcement Who will receive the third dose, when and with which coronavirus vaccine

Exactly one year ago, April 28, 2021, the vaccination report indicated that 23.7% of the population in Spain had received at least one dose.

In the month of April, more people were vaccinated than in the previous three months: it was difficult to pick up the pace, but

with spring came the acceleration


With slight variations between Autonomous Communities, vaccination would begin in May in the 50-59 year-old band and in June that of 40-49 year-olds.

People queued for up to two hours at some hospitals in early May, eager to get their dose.

The last week of June the holidays were imminent:

almost 10,000 people made an appointment to be vaccinated at night in the Zendal


It is worth remembering this now that there is hardly any talk of vaccination and the debate on masks will be diluted and when it seems that there is no more pandemic -despite the fact that the incidence figures do not stop rising in those over 60 years of age, part of those vulnerable which must be monitored at this time, according to the new Health surveillance strategy- because there are

still a considerable number of people unvaccinated

, despite Spain being one of the countries with the highest vaccination coverage.

According to the latest vaccination report (now published once a week, every Friday), currently 39,210,144 people have received at least one dose, that is, 92.9% of the population over 12 years of age (INE data ).

Health indicates that the population to be vaccinated is 42,185,033, that is,

almost 3 million people are missing (2,974,889) who have not received a single inoculation


On the other hand, there is the pediatric population (from 5 to 12 years old), where of the population to be vaccinated (3,815,164), 54% have at least one dose (2,058,317), that is,

1,756,847 children remain to be vaccinated.


Focusing only on adults, is it about 3 million deniers?


Pure deniers, of pure ideological strain, frankly I think that in this country there are very few, they can be 1-2%

, no more. And the sample is that the vaccination coverage in general childhood vaccination, not just Covid, they are higher than 95% in our country," emphasizes Amós García Rojas, president of the Spanish Association of Vaccinology (AEV).

For this epidemiologist and vaccinologist, unvaccinated people can basically be classified in that

small percentage of pure deniers, in people who have medical contraindications

to vaccines or "

people who understand that they are not exposed to risk

, that the risk does not go with them because It is a disease that fundamentally affects elderly or sick people and because of their age they are somehow 'immunized' to the problem".

Desensitization for allergy sufferers

Regarding medical contraindications, for example, allergies, from the Spanish Society of Allergology and Clinical Immunology (Seaic) they point out that they do not have specific figures to be able to argue why the population, specifically allergic, has not been vaccinated against Covid .

However, and in terms of contraindications, Dr. Nancy Ortega, president of the Seaic Drug Allergy Committee, comments that, in general,

vaccines can be administered to almost 99% of people


"The only thing that varies is that, for example, a transplant recipient who has low defenses may need more doses of vaccine against Covid-19 than healthy people with normal immunity. In the case of the population that is allergic to some component of the vaccines, normally a vaccine is sought that does not contain said component that generates a reaction to the patient.In fact, lately the vaccine has been administered through a technique called

desensitization in small doses

, which are progressively increased until reaching the total dose needed.

García Rojas highlights another possible group: "People who are not deniers but

are afraid of the vaccine

. And what do we have to do with these people? Well, fundamentally pedagogy, pedagogy and pedagogy. Make them understand that what allows society to advance is apply something as simple as common sense, which is nothing more than applying scientific reasoning, and that

there is no point in having a problem when there is an instrument that prevents that problem: vaccines


The president of the AEV concludes: "If we have stopped drinking rainwater, if we have stopped drinking unpasteurized milk, what we cannot do is get rid of instruments that have confirmed their validity in the context of the fight against communicable diseases, such as are the vaccines. Those people who mistrust must be made to see that the most harmful, most terrible side effect that a vaccine has is precisely not giving it. I think that fear can be a more considerable factor than that of pure deniers."

As vaccination is not mandatory in Spain, Health does not have information on people who do not want to be vaccinated or their reasons, beyond the results of

the Monitoring Study of the behavior and attitudes of the population related to Covid-19 in Spain (COSMO-SPAIN)

-the WHO

Behavioral Insights on Covid-19

survey coordinated in Spain by the Carlos III Health Institute-.

In addition to the various rounds conducted at different times of the pandemic on people's concerns, knowledge and behavior, there is

a study of the unvaccinated

, which has two branches: a preliminary social media study and a panel study .

The survey on social networks was carried out between October 1 and 19, 2021 in a total sample of 2,312 participants over 16 years of age, to whom the form was launched through WhatsApp and networks such as Facebook, Twitter and LinkedIn.

Of these, 1,998 had not received any dose (the others had not completed the vaccination schedule).

In the case of the panel study, it was open between November 8 and 23, 2021. Of the almost 20,000 people invited to participate, 1,051 complete interviews were finally obtained from unvaccinated people (963) or without the complete guideline.

Main reasons for the unvaccinated

In both surveys, among the reasons given for not taking a single dose, they highlight that

they have been developed very quickly, are not safe or are in the experimental phase

(72% in the network study and 55% in the panel study);

that they are bad for health or

they are concerned about their side effects

(50% in networks and 22.2% in panel);

that vaccines

are a business

(44% and 28.5%);

"I am healthy and I do not need to be vaccinated"

(41% and 22.3%);

and that

the vaccines against Covid-19 do not work

(around 40% in networks and 21.2% in panel).

Other less mentioned reasons were:

the coronavirus does not exist

(12% in networks and 3.5% in the panel), because

they have already had the disease and are therefore immunized

(9% and 17.9%), because

they do not believe that they are going to be infected

(9% and 5.2%),

due to health problems or medical indication

(8% and 5%), because

they do not believe in vaccines in general

(7% and 5.2%), they have religious reasons or ethical (6% in networks), believe only in natural medicine (5% and 3.2%), have

a phobia of needles

(curiously, a reason in which there is a lot of difference between both studies, 5% in networks and 84 % in panel), being pregnant (3% and 3.2%) or the vaccination center is far away (2% and 3.4%).

These surveys also contemplate the intention of vaccination in the future.

In the network study,

almost 60% of those who had not been vaccinated responded that they did not intend to do so in the future

, 33% were not sure, and 8% said they intended to be vaccinated in the future.

Of this more than 40%, they were asked under what circumstances they would do it, allowing more than one answer:

66% when time passes and they verify that the vaccine is safe

, 24% will be inoculated if they can choose the vaccine and 16% when you need to be vaccinated to be able to travel.

9% stated that they will do so when other vaccines are available (safer, more effective, with attenuated virus, intranasal, Spanish, etc.).

In the panel study, 26% of the respondents who had not been vaccinated responded that they did not intend to be vaccinated in the future, 43.5% were not sure, and 30.6% said they intended to be vaccinated in the future.

This 74% not sure or that they will do it later

were also asked under what circumstances they would do it: 57.3% indicated that when some time passes and they verify that the vaccine is safe,

22.7% when they need to be so to be able to travel

and 19% if you can choose the vaccine.

10.7% answered that they will be vaccinated when they are assured that going to the vaccination center will not have legal consequences and 9.4% when they can be vaccinated close to home.

"Fed up" with so many doses

The president of the AEV points out another question.

"I also think that the weariness weighs heavily,

people who dose by dose by dose are fed up with the situation and have less and less adherence to vaccination


That does not explain those who do not have any dose, but those who have taken one and have not completed the regimen, or have completed it but do not want to take the booster.

In this sense, there is a

significant jump in the intention to get the booster dose

between the January CIS barometer (still immersed in the middle of the sixth wave with omicron wreaking havoc) and that of February: while in January, an

84.5 %

of those who had a complete schedule answered that they were willing or had already been vaccinated with the third dose, in February a



"We are not going to make the virus disappear, it has come to stay. What we have to do is work to avoid the bitter, terrible, dramatic face that the pandemic has had, which is linked to ICUs and deaths, and this we achieve it with the vaccine, fundamentally by vaccinating the vulnerable", emphasizes García Rojas.

But also

completing the guideline

(protection increases with two doses compared to just one)

and vaccinating those who have not yet done so, since these almost 3 million in Spain do not have the immunity guaranteed

by the rest of vaccinated citizens.

"With the circulation that the omicron variant has had, possibly many of them have already been infected without realizing it or some have found out and have had a mild picture. But those who have not,

hardly have guaranteed immunity with these vaccines because they are not sterilizing

, that is, they do not prevent infection Logically it is true that vaccinated people transmit less than unvaccinated people, so as vaccine coverage progresses, these people are not protected against the disease, but they will represent let's say not an excessively important role in the development of the pandemic", indicates García Rojas, who is convinced that many of those unvaccinated will do so in the future "

because the objective reality will be imposed more and more

: that there is a very large percentage of the population vaccinated and nothing has happened, except that serious cases of the disease have decreased precisely thanks to the vaccine.

This reality will prevail,

as has happened with other vaccines in the history of vaccinology


For its part, Health is not going to make this vaccine mandatory for those almost 3 million laggards, since it emphasizes that

in Spain no vaccine is mandatory

-not even that of Covid-19- and it is "an example of collective responsibility" that Spain has always shown, as seen in the high rates of general vaccination and now in this pandemic, where

we are "an example of success in vaccination against Covid-19"


"The Ministry of Health recommends vaccination to all citizens, both for their own protection and for the protection of the community. The Spanish have come, and continue to come today, responsibly to get vaccinated with the different doses recommended by the authorities The data speak for themselves, more than 40 million Spaniards have received the full vaccination, and more than 23 million have received the booster dose," they point out from Health.

So that all those unvaccinated can do so, there are enough vaccines in the refrigerators, aside from those that have yet to arrive (soon Novavax, the first based on a protein platform and authorized on December 20 last by the European Commission, of which the first doses arrived in Spain at the beginning of March, as indicated in update 11 of the

Vaccination Strategy against Covid-19 in Spain

, dated February 8).

Thus, at the end of this month of April, the Executive details that there are

709,600 doses of AstraZeneca temporarily stored, 2,544,060 doses of Moderna, 765 of Janssen and 11,871,092 of Pfizer.

That is, more than 15 million doses

of vaccine against Covid (15,125,517).

The data was provided in writing by the Government in a response to the Popular Parliamentary Group of Congress where it was noted that

a very small part of the vaccines received have expired

"due to the adequacy of logistics to changes in the vaccination Strategy".

"Vaccination rhythms can be changing, making it difficult to estimate the necessary doses at the administration points. In general, vaccines have particular storage conditions and a specific expiration date that can be increased, in certain cases, as long-term stability data become available", is indicated in the response to which Europa Press had access.

Being involved in such a large-scale vaccination campaign, the Autonomous Communities thawed vaccines to make them available to ever larger vaccination points.

"This has led to the thawing of some vaccines that cannot be frozen again and whose validity period is shortened once thawed," adds the Government.

In other words:

there are enough vaccines for the whole world to be immunized

, another thing is that people want to do it or want to complete the guideline.

In this case, and given less adherence to the booster dose,

it is possible that some vaccines expire because they have been made available to the public based on forecasts

that vary with the evolution of the pandemic situation.

And they cannot be used in another way, for example, by donating to third countries because donations cannot be made when the vaccines are close to expiration, but directly from the manufacturing plants.

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