As coronavirus incidence rises in Spain and regions consider Covid passports, demand for vaccination spikes

Spain’s vaccination drive against Covid-19 is picking up speed once again. With nearly 80% of the population fully immunized, Spain has one of the highest vaccination coverages in Europe, but there is still room for improvement. The vaccination rate began falling in July, but since the end of October, the numbers have started to rise once again.

Last week, Spain administered 72,036 first vaccine doses, 25% more than the last seven days. In the previous three weeks, this figure came in at 57,500, 57,875 and 60,849, respectively. The uptick in vaccination numbers has coincided with a rise in coronavirus cases. On October 25, the 14-day incidence rate stood at 46 cases per 100,000 inhabitants. Now that figure has shot up to 149 cases, according to the latest figures released Thursday by the Spanish Health Ministry. Of Spain’s 17 regions, Navarre has the highest incidence rate, with 428 cases per 100,000, followed by the Basque Country (332 cases) and Aragón (245 cases).

In a bid to curb the contagions, Spanish regions – which are in charge of their healthcare systems, the Covid-19 vaccinations drive and coronavirus restrictions – have recently started to discuss making the European Union’s Digital COVID Certificate a condition for entry in different venues, including bars and restaurants. This so-called Covid passport can be accessed in Spain via each region’s healthcare system, and certifies whether the bearer has been vaccinated against Covid-19, has recently recovered from an infection, or has been tested for the virus.

The regions that have announced plans to introduce or extend the use of the Covid passport have seen a particularly sharp rise in vaccination rates. The Basque Country, for example, administered 3,797 first doses last week, compared to 1,562 the previous seven days, and in Navarre, this figure jumped from 628 to 1,018. Navarre, however, is still waiting for court authorization to introduce the measure, while in the Basque Country, the courts ruled against it.

In Madrid, which is also planning to introduce the measure but has not yet requested court approval, health workers administered 19,346 first shots last week, up from 10,531 the previous seven days. And in Castilla-La Mancha, the number of first doses more than doubled to 3,962, even though the regional government has no intention of introducing the Covid passport.

I don’t know if they will end up asking for the Covid certificate in bars, but I prefer to have it just in case

Eduardo, 55, after being vaccinated

For Azahara Martínez, an 18-year-old in Madrid, the Covid pass was the main reason she decided to get vaccinated on Tuesday. “I have a class trip to Navarre. They ask for the certificate at bars there,” she said, outside the vaccination center at the WiZink Center arena. As already mentioned, in Navarre this measure has not been introduced yet, but is pending court approval.

Her friend and classmate Ivi Antoniuk made the same decision: “I would not have gotten vaccinated if this trip hadn’t come up. I was waiting for a better [vaccine] to be made and for things to be a bit better.”

Martínez’s mother, María del Mar Voz, however, was certain she wouldn’t be getting the shot. “It makes me a little afraid,” she said outside the vaccination center, where the line “was much bigger than in previous weeks,” according to one of the workers.

“I don’t know if they will end up asking for the certificate in bars, but I prefer to have it just in case,” said Eduardo after having his first shot at the WiZink Center. The 55-year-old, who preferred not to give his surname, could have been vaccinated months ago, but didn’t do it out of “laziness.” “I didn’t see the need,” he said.

Sara Molina, 21, was also among those who got vaccinated at the WiZink Center on Tuesday. In her case, she made the decision due to the rise in infections. “I had coronavirus in July. I should have gotten a dose in 60 days, but I had been putting it off,” she explained. “My father and brother are at risk and I don’t want anything to happen to them because of my mistake.” But she had another reason too: “My partner lives in Ireland. If I want to see her, I have to have the certificate.”

Experts agree that the spike in infections, as well as the plans to introduce the Covid passport, could be driving more people to get vaccinated. “It’s a very slow rise and just rising one point [in vaccination coverage] is a huge effort, but we have to continue making an effort to vaccinate,” said Salvador Peiró, an epidemiologist at the Foundation for the Promotion of Health and Biomedical Research (Fisabio) in the Valencia region. “The rise in incidence has definitely influenced some to get vaccinated. Those who want to enter nightclubs and see that they are asking for the Covid passport are getting scared and are also coming in to be immunized.”

Amós García, the president of the Spanish Vaccinology Association, agreed. “It makes sense that there has been a small uptick in first doses due to the increase in the incidence rate and also the talk about new restrictive measures that could bring people to get vaccinated,” he explained, adding that there is also “certain pressure in work environments and people are resentful of those who are unvaccinated.”

The boost in the vaccination drive also comes ahead of the Christmas vacations and the upcoming long weekend – December 6 and 8 are national holidays in Spain. This is a time when families come together and many make trips abroad to see loved ones. Yassine Lamtaraf, a 31-year-old warehouse worker, for instance, also decided to get vaccinated on Tuesday, despite his unfounded beliefs that the vaccines “leave people disabled” and “unable to have sexual relations.” “I have a pregnant wife in Morocco and to enter they ask for the certificate,” he explained. “I am risking myself to visit her.”

Lamtaraf was at the WiZink Center with friend and work colleague Rabei Akrikezi, who also expressed reservations about the vaccine, even though it has been approved by the European Medicines Agency and has been proven to reduce the risk of serious illness and death. “You see comments on Facebook saying that this or that could happen to you with the vaccine… It makes you pause. If I could travel to Morocco [without the certificate], I would have waited at least a few years to get it, to see how it affects you in the long term. Hopefully, we are the ones who are confused and they [public health authorities] are right.” According to the Spanish Health Ministry, the 60-80 population is 25 times more at risk of dying from Covid-19 if they are unvaccinated, compared to the fully immunized in the same age group.

Booster shots

While more first doses were administered last week, the uptick is mostly due to the demand for booster shots. These doses have been going to the immunosuppressed, the over-70 population, nursing home residents and recipients of the single-dose Janssen. According to the Health Ministry, nearly four million people have had a booster shot. More than 55% of the over-70s have had the booster, while nearly 16% of Janssen recipients have received a second dose.

But Peiró believes the rate is still too slow. “The booster shots increase protection quite a lot. For the elderly, they are almost imperative. And we should be going faster than we are. We are vaccinating more slowly,” he said.

On Tuesday, the Public Health Commission also approved giving booster shots to the over-60 population, as well as healthcare workers and nursing home staff. Meanwhile, the president of the European Commission, Ursula von der Leyen, said on Wednesday that these doses should be given to all adults, with priority given to the over-40s.

García, however, believes this is not the pressing issue. “We have to consolidate the additional doses in the established groups and extend it where there is room for improvement in the general vaccination drive. We have to identify where there are low [vaccination] coverages because there could be multiple sources: it could be young people with a low perception of risk, lazy people, people who are scared, marginalized or have difficulty accessing the health system,” he explained.

There are many reasons why people have not been vaccinated. For Antonio José Cid, 22, for example, his reason was nothing to do with being hesitant of the vaccine. “I preferred to get vaccinated here, not in Cuba, where I was living until not long ago. I was very clear that I wanted to get vaccinated, but here in Spain.”