Reader question: How will foreigners in Spain with private health insurance be contacted for Covid-19 vaccine?

We've had a number of readers writing in asking how foreign pensioners who aren't registered on Spain's public health will be notified when it's their time to get the Covid-19 vaccine. Here's what we know so far.

Reader question: How will foreigners in Spain with private health insurance be contacted for Covid-19 vaccine?
Photos: Frederick FLORIN/AFP

The background

With Spain’s Covid-19 vaccine campaign almost into its third month, some of the challenges of vaccinating millions of people as quickly as possible are being exposed.

One of those cracks in the system is foreign pensioners who are not registered with the public health system, instead receiving medical care in Spain through private health insurance.

Firstly, be assured that the Spanish government has emphasised that no distinction will be made between citizens and non-citizens and has pledged to vaccinate everyone in the country, regardless of their legal status and that includes those not registered with the social security system, including ‘illegal' immigrants and the homeless.

“All those living in Spain will be able to receive the vaccination against the virus as the campaign unrolls. Vaccination is universal, it includes all people,” insisted a Health Ministry spokesman.

But Spain’s vaccine supplies are only in the hands of the public health system and not private health suppliers, which leads to the question, how will Spain’s Health Department know of my existence and contact me if I’m not on public health records?

The stats

The first thing to remember is that you’re not alone.

Spain’s National Statistics Institute reported at the start of 2021 that there were 5.4 million foreign residents in Spain, but according to Spain’s Social Security and Migrations Ministry only 2.07 million of them are affiliated to the country’s social security system.

However, these 3 million 'invisible' foreigners also have their access to public health services guaranteed since Spain’s former Minister of Health María Luisa Carcedo approved Royal Decree 7/2018 on universal access to the National Health System.

READ ALSO: What over-70s in Spain need to know about their Covid-19 vaccines

The problem

As soon as Spain’s vaccine campaign plan was drafted, another former Spanish Health Minister, Salvador Illa, ‘passed the buck’ to the regional authorities in terms of how they should handle their Covid-19 vaccine strategy, including how to go about vaccinating foreigners and anyone under the radar.

So as with so many other big matters in Spain, decisions aren’t centralised and what one region might do to call up and contact those who aren’t registered on the regional public health system, another comunidad autónoma might do differently.

The same problem arose during 2020’s flu vaccine campaign, as private clinics and pharmacies didn’t have access to supplies because they were entirely in the hands of Spain’s public health centres. Many foreigners in Spain who weren't on the system didn't get the flu jab. 

So far Spain’s Health Ministry has recognised the difficulties in reaching outside-the-system groups, but not necessarily foreign pensioners not using public healthcare.

“Some groups with access barriers to the health system would be more difficult to reach out to (for example, people without residency documents or the homeless).”

The latest advice

“The line that the Spanish government has given us is that the private insurance companies, which are called mutuas, are currently coordinating with the regional health authorities on how the vaccine is going to be rolled out to those with private health insurance,” Martyn Standing, from the Department of Health in Alicante's British Consulate, said during the latest Facebook Q&A by the British Embassy in Spain.

“If you need to get an update on this, we would suggest you contact your private health insurance company because they are currently working with public authorities and should be able to give you an update on when you’ll receive your vaccination.”

Potential solutions

“They’re registered at the town hall and pay their municipal tax but don’t figure in local healthcare records,” Paloma Hoffmann-Vevia, former president of the association of foreign residents of Benissa (Alicante) and a former lawyer at the European Commission told national broadcaster RTVE.

“They don’t have access to the Spanish public health system for a number of reasons, from having had private insurance in their home country to other reasons that aren’t allowing them to use the S1 form to gain access to the public health card”.

One of the most outspoken voices relating to the plight of German, English, Irish, Swedish and other ‘invisible’ foreign pensioners in Spain says there’s an easy solution.

“Manage the vaccine rollout through the census (town hall/padrón) and not through the records of local health centres,” she told RTVE.

“With a joint effort between the town halls and the health centres, this whole collective would be covered.”

“In small places I believe this is how it is being done already. It’ll be harder in locations with bigger populations but volunteer groups can be set up who help to coordinate and close the gap between both sides and do the correct tracking and tracing of this population group.”

Maureen Payne, President of Age Concern in Costa Blanca Sur, told The Local Spain that “some private health insurers were offering a document to their customers in Spain that allowed them to get a temporary SIP (health card) through their local public health centre, which then would allow them to get the vaccine,” adding that British consular services were best positioned to advise on this depending on the person's location and circumstances.

This, as reported by Clínica Benissa (a private health centre in Alicante province where this scheme has been tried and tested) is dependent on what each municipality chooses to do.

Here at The Local we’ll continue to push for answers relating to this particular group’s situation and share with you all the latest information on the vaccine rollout for other foreign groups in Spain.

You can find out more about the vaccine for foreigners who aren’t on the public health system by clicking on the article below.

Reader question: How do I get a Covid vaccine if I'm not in Spain's public health system?


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Vaccine scramble: How Spaniards want Covid jabs more than other Europeans

Whilst the EU warns that unused doses due to vaccine scepticism are piling up, Spaniards of all ages want to achieve immunity against Covid-19 as soon as possible, the data shows. 

Vaccine scramble: How Spaniards want Covid jabs more than other Europeans
People queue to get the vaccine in Barcelona. Photo: Lluis Gené/AFP

In Spain, where the Covid-19 rollout has gone from one of the slowest in the EU to currently one of the fastest, pretty much everyone wants to get vaccinated. 

With priority groups almost fully immunised, Spain is still beating daily records with 600,000 to 700,000 doses administered every day. 

The spike in cases among the country’s young population has led several regions to bring forward jabs for teens and twenty-somethings ahead of people in their thirties.

Despite the apparent lack of concern for the pandemic witnessed  in packed squares and streets over the past weeks, young people who have been able to take advantage of the vaccine offer have headed en masse to the vaccination centres. 

When an Asturian youth called Ana Santos told a local newspaper that “after the elderly, it should be our turn to get vaccinated as it’s not as if people in their forties go out, is it?”, her comments went down like a tonne of bricks among this age group, who demanded it was their turn to reach full immunisation first. 

Vaccine scepticism hasn’t been a problem for Spain as it has been for other countries, with President of the European Commission Ursula von der Leyen launching a warning recently that vaccine supplies are piling up, even though Brussels has reached its target of providing enough doses to fully vaccinate 70 percent of EU adults.

“If we look at the statistics, more and more doses remain unused,” von der Leyen told journalists in Strasbourg.

“This is linked to the fact that there is a greater distribution of vaccines, but in part also due to doubts about vaccination,” adding that it was crucial to reach the most sceptical parts of the population” in the face of the “worrying” presence of the Delta variant.

“Traditionally in Spain, we have had much less resistance or rejection towards vaccines, that’s always been the case,” vaccine expert at the Spanish Association of Pediatrics (AEP) Ángel Hernández-Merino told 20minutos. 

“In any vaccination programme, it’s vital to count on the population being willing to accept the vaccination”.

A June 2021 Eurobarometer study found that 49 percent of people in Spain want to get vaccinated “as soon as possible”, the highest rate in the entire EU (32 percent EU average). 

Whereas an average of 9 percent of EU citizens don’t ever want to get vaccinated, the rate in Spain is 4 percent.  Around 63 percent of Spaniards told Eurobarometer that they couldn’t understand why people are hesitant to get vaccinated and 71 percent said Covid vaccines are the only way for the pandemic to end. 

In Belgium, around a third of the population doesn’t want to get vaccinated.

In other countries where in the earlier stages of the Covid vaccination campaign it seemed  that available doses were easily used up it’s now becoming evident that sprinting through the age groups doesn’t guarantee that everyone is being vaccinated. 

Germany, the UK and the US, all seen as examples to Spain of how to quickly immunise a population, have all seen their campaigns slow down due to hesitancy and the summer holidays.

Spain’s Health Ministry doesn’t give data on how many people have rejected the vaccine and why, but stats do show that already more than half of the population (57.5 percent) have at least one dose and 43.3 percent are fully vaccinated. 

The Spanish government has stuck to its objective of vaccinating 70 percent of the country’s 47 million people before the end of August, even though it did fall short of its June target by more than half a million doses. 

Rather than vaccine scepticism, what’s been holding up Spain’s inoculation campaign have been doubts over the administration of second AstraZeneca vaccines and the decision to keep a reserve in case the country experienced delivery setbacks as it has in the past, with 2.9 million doses in storage reported in late June.