Spain’s Covid immunization drive dogged by line-jumping politicians and other irregularities

Concern is rising in Spain over the number of individuals who have jumped the line to receive the Covid-19 vaccine. The list includes several mayors, a regional health chief and family members of medical workers. In these cases, the vaccine was administered even though the person did not belong to the first priority group of the ongoing campaign: residents and staff of care homes, other healthcare workers and people with serious disabilities. In some instances, this was due to a misunderstanding, and in others, the individuals jumped the line “to build confidence” in the vaccine or because there were “leftover doses.”

In the Valencia region, for example, the mayor of El Verger (Alicante), Ximo Coll, and his wife, Carolina Vives, who is the mayor of Els Poblets (Alicante), said they were having a drink at a bar when they received a call from the health center in El Verger. They were told that seven doses of the coronavirus vaccine were left over and were asked if they wanted to be vaccinated. They did not belong to the priority group, but the couple – both members of the Socialist Party (PSOE) – agreed, and received the first jab, along with five local police officers.

We must all lead by example, especially those of us who hold public office

Spanish Health Minister Salvador Illa

“There are lots of seniors and at-risk people who call me so that I can help them with something [...]. That’s why I thought they wanted me to get vaccinated, so I wouldn’t spread the virus,” Coll told EL PAÍS. The vaccine, however, does not stop an immunized person from contracting the virus and spreading it, but rather from developing a serious case of the disease.

One of the most common excuses for jumping the line is to stop doses from going to waste. Each vial of the vaccine contains between five and six doses, and once the vial is opened, the doses must be administered within a few hours or thrown out. In Catalonia, the mayor of Riudoms, Sergi Pedret, from the pro-Catalan independence party Junts per Catalunya (Together for Catalonia), said this was why he received the vaccine before the first priority group. The same excuse was used by the nursing home Casablanca in Madrid, where family members of workers and priests who visited the center were also vaccinated before it was their turn. In a press release, the medical director of the center, Vivian del Carmen Rodríguez, said the decision was made “with the sole aim of taking 100% advantage of the received doses and protecting the seniors as much as possible.”

But Spanish Health Minister Salvador Illa has dismissed this excuse. “The vaccination has to be planned with proper scheduling so that doses are not left over,” he said on Wednesday. There is no specific protocol about what to do if there are excess doses, although experts suggest that the dose should be given to those who belong to the next priority group.

Daniel López-Acuña, a former official of the World Health Organization (WHO), argues that if doses are systematically going unused “it is because not enough staff have been mobilized.” “The principle is to plan the population that is going to be vaccinated and the doses necessary,” he explains. “We are not going to waste vaccines, but we are not going to give them to the influential. You can mobilize staff from the closest health center to continue the vaccination.”

Amós García Rojas, the president of the Spanish Vaccinology Association, agrees. “The groups that must be vaccinated now are those most vulnerable and health workers. If there is an open vial left over, you have to have people ready from these groups so the vaccine doesn’t go to waste,” he says. “But you can’t take away doses from vulnerable people whose turn it is.”

In the meantime, the irregularities continue to mount, with hundreds of people already suspected of jumping the vaccine line. In Valencia province, the mayor of Rafelbunyol, Fran López, of the PSOE, said he agreed to be vaccinated at a local senior residence on the first day of the drive because he thought “he was helping to give a sense of trust, calm and security to citizens.”

In Alicante province, the mayor of La Nucía, Bernabé Cano of the conservative Popular Party (PP), and the local health councilor Manuel Alcalá, both made headlines for getting vaccinated in recent days. The provincial branch of the party justified the move, saying that both individuals fall into the health personnel category (Cano has a medical degree) and that their actions are not at all similar to the “lack of solidarity displayed by other mayors.”

And in Catalonia, the Catalan Health Institute has opened an investigation into three health workers from a vaccination team in Tarragona, who vaccinated their family members. “These actions call into question the logistics of the vaccination campaign,” warns Fernando Moraga-Llop, the vice-president of the Spanish Vaccinology Association.

But the most flagrant case to date is that of Manuel Villegas, the regional health chief of Murcia, which is governed by the PP. He and another 400 workers from the regional health department and the Murcia Health Service – including his wife – jumped the line to get vaccinated. Villegas justified the decision by arguing that once frontline health workers were vaccinated, the vaccine was offered to other health workers who requested it. But it wasn’t their turn. Under the Health Ministry’s protocol, only health workers who work in “health centers and care homes” should be vaccinated – which is not the case for the regional health department. And while Villegas is a doctor, he is not working at a medical center. In the wake of the controversy, Villegas resigned from his position on Wednesday.

And in Spain’s exclave city of Ceuta, on the northern coast of Africa, the local health chief Javier Guerrero said on Thursday that he will not resign after it emerged that he and 10 other people in his department recently got inoculated. Guerrero, who is a doctor, said that his case has nothing in common with the scandal surrounding Murcia’s health chief, who also has a medical degree.

“Responsibility and ethics”

In response to the growing irregularities, Illa called on Wednesday for “responsibility and ethics” in the vaccination process, adding that it was up to regional authorities to respond to instances of malpractice. The health minister explained that the priority groups were defined by health experts, with the over-80s next in line for the vaccine.

“We must all lead by example, especially those of us who hold public office. I think that says it all,” he said. Spain has administered more than one million doses of the vaccine and 15,642 people have received the two doses, meaning they are on their way to the full protection offered by the immunization.

But experts say that while some irregularities are obvious, other instances are less clear cut, such as the group of retired health workers who were vaccinated last week at the Clínico San Carlos hospital in Madrid, or the directors of two hospitals in the Basque Country who also received the vaccine, despite not being “frontline” workers, as stipulated in the Health Ministry’s protocol.

Another murky case is that of Iñaki Urdangarin, the brother-in-law of Spanish King Felipe VI, who is serving a five-year, 10-month prison sentence for his involvement in a corruption scandal known as the Nóos case. Urdangarin was vaccinated because he works three days a week as a volunteer at the Hogar Don Orione center for people with disabilities.

And the vaccination of soldiers set to leave Spain on international missions also falls in a grey area. In this case, the Health Ministry provided the Defense Ministry with enough doses to vaccinate 200 soldiers from the assault ship Castilla and another 600 from the minehunter Tajo.

As the vaccination drive continues, epidemiologists hope that the protocol can be improved so that there are no more problems with line jumping. “I think that the cases that have happened are the exception, not the rule,” says Toni Trilla, the head of preventive medicine at Clínic hospital in Barcelona. “Clear directives and prioritization are lacking. As well as supervision to ensure that nobody skips the rules of the game.”

English version by Melissa Kitson.