Coronavirus surge in Spanish nursing homes fuels debate on mandatory vaccination for carers

In Spain, vaccination against Covid-19 is voluntary. The population’s response to the vaccine rollout has been very strong: 59.1% is fully vaccinated, according to figures released by the Spanish Health Ministry on Thursday.

But the fifth coronavirus wave has led to a spike in coronavirus cases in care homes. In just two weeks, the number of infections has risen eightfold. Between July 5 and 11, there were 123 nursing home residents with the virus. Between July 19 and 25 that number had risen to 1,029, according to the latest data from the public social services agency Imserso.

All of the over-80s in Spain are fully vaccinated, meaning they are protected from developing a serious case of Covid-19 – but not from contracting the virus and spreading it. Most of the current cases in care homes are minor or asymptomatic but experts warn there is still a risk of complications, given elderly people have weaker immune systems. Another problem is that care home residents who contract the virus have to be quarantined, which can have an impact on their health especially if they are suffering from cognitive impairment.

The surge in cases in care homes has sparked concern within the central government and the regions, which are in charge of the vaccination drive and containing the pandemic in their territories. At least five regions are calling for it to be mandatory for all workers who care for vulnerable people – such as health workers and nursing home staff – to be vaccinated against Covid-19, as is the case in France.

The Spanish Health Ministry opposes the idea of mandatory vaccination, but is in favor of toughening control measures at care homes. Together with the regions, it is studying how this can be done. One suggestion is to carry out coronavirus tests on the workers of these centers twice a week or move them to positions where they are not in contact with elderly people.

Galicia is the region that has taken the strongest stance in favor of mandatory inoculations. The regional parliament approved a law that would have allowed health authorities to introduce mandatory vaccination to control all infectious diseases – not just the coronavirus – in high-risk situations for public health. This law, however, was suspended by the Constitutional Court. The premier of Galicia, Alberto Núñez Feijoó, still supports introducing the measure for certain sectors. “In certain conditions in which a person’s work is directly related to vulnerable people, to the sick, I believe that general public health must take priority over an individual’s decision to get vaccinated or not,” he said.

People who don’t want to get vaccinated should not be working in direct contact with people in situations of risk

Ramiro González, head of provincial authority Diputación de Álava

The southern region of Andalusia also supports the mandatory vaccination of health professionals and care home workers, a demand that is also backed by associations from the sector. Murcia is also considering whether a similar measure can be introduced under the law. Sources from the Canary Islands government said the region is looking at making vaccination mandatory for certain public workers.

Ramiro González, head of the provincial authority Diputación de Álava, in Spain’s Basque Country, is also in favor of mandatory vaccination for care home workers. “People who don’t want to get vaccinated should not be working in direct contact with people in risk situations, for example, elderly people in senior residences,” he said at a press conference on Tuesday. In the Basque provinces of Bizkaia and Álava, between 5% and 6% of care home workers have refused the vaccine.

The premier of Cantabria, Miguel Ángel Revilla, went one step further and called on vaccines to be mandatory for the whole population – not just certain workers – at last week’s regional summit.

While sources from the Spanish Health Ministry say “a very large majority” of health workers have been vaccinated, they admit a higher percentage of workers at care homes have refused the vaccine, although there are no official statistics.

Although transmission rates are falling, Spain continues to report thousands of new coronavirus cases every day. The latest Health Ministry report, released Thursday, recorded 21,387 new contagions and added 87 fatalities to the official death toll, which now stands at 81,931.

English version by Melissa Kitson.