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Has Spain almost reached Covid-19 herd immunity?

Covid-19 infections are at their lowest levels since last autumn and almost 88 percent of the population over 12 has been vaccinated, so could Spain be on the verge of reaching herd immunity as health experts suggest?

People sit at a bar in Madrid
Has Spain reached herd immunity? Photo: Gabriel BOUYS / AFP

Medical journal The Lancet has published an article suggesting that herd immunity in Spain may soon become a reality.

“Experts are beginning to believe the country is on the cusp of reaching something that barely seemed possible even weeks ago—herd immunity,” reads the article. 

Spain was one of the first countries in Europe to be hit hard by the Covid-19 pandemic, with 45,000 deaths during the first wave and a recent study by Northeastern and Boston universities published in Nature magazine suggesting only 1 in 100 infections were detected during those first months. 

But as The Lancet points out, “since the first lockdown, however, the country has largely fared better than many of its European neighbours”.

So why is that Spain has overtaken other countries in the race towards herd immunity?

What the Spanish government says

When asked on Thursday if Spain could achieve herd immunity, Health Minister Carolina Darias said: “With 90 percent of the population [who have been given at least the first vaccine dose], we are at a tremendously optimal level” to reach herd immunity.

In August, Spain revised its vaccination target from 70 to 90 percent following the emergence of Delta as a more transmissible variant, a vaccination goal which it is not far from reaching with almost 80 percent of the total population now fully vaccinated. 

Spanish health authorities have determined the herd immunity threshold based on two factors: the effectiveness of vaccines and the R number (the average number of people that one person with Covid-19 will infect). 

READ ALSO: ’70 percent vaccinated isn’t enough’ – Why Spain is revising its target for Covid herd immunity

Darias stressed that apart from “better vaccination levels”, “Spain has low levels of infection risk compared to other countries”. 

This provides “ideal conditions to have the virus cornered”, Spain’s Health Minister concluded.

READ ALSO – Getting a Covid-19 booster shot in Spain: What you need to know

What the experts believe

“We still don’t know the exact proportion of the population that needs to be immune to reach herd immunity for SARS-CoV-2, as we need to better understand the duration and protection of transmission generated from both vaccination and previous COVID-19 infection”, Jesús Rodríguez Baño, head of infectious diseases at the Virgen de la Macarena Hospital in Seville, told The Lancet.

“However, the situation in Spain might provide some clues: after leaving behind most of the control measures in the population, the infection rate (and particularly the hospital admission rate) has been going down, and this is the opposite of what happened with previous waves.

“The only plausible explanation is the very high rate of vaccination in the country,” Baño concluded.

The current epidemiological situation in Spain  

Although so far this autumn Covid infections have stayed low, cases have been rising slightly during the last two weeks.

On Thursday November 4th, the country’s health ministry reported that the fortnightly infection rate was above 50 cases per 100,000 for the first time in weeks, putting it back in the medium risk category.  

However, hospitalisations remain low (1,799 people across the country, 400 of whom are in ICU) and Covid-19 deaths in the past week in Spain number 52. 

Covid-19 cases across Europe during the last seven days. Source: Our World in Data

Covid-19 cases are still down two-thirds from levels seen in September 2020. Experts are now waiting to see whether the arrival of the cold autumn weather will have an impact on infections and hospitalisations.

READ ALSO: Why are Spanish homes so cold?

Baño believes that winter 2021–22 in Spain will be very different from what we experienced in 2020. “However, we must be prudent in our predictions. The third booster dose is already being administered in high-risk groups here in Spain, and we must still see whether a third dose (or a yearly dose) is needed for everyone. Also, new variants might cause problems.”

How Spain compares with other European countries

Although the vaccination programme in Spain started slowly, the percentage of the population over 12 who are now fully vaccinated is over 80 percent, which is much higher than countries such the UK, France, Germany and Italy.

In terms of hospitalisations Spain has seen one of the biggest percentage decreases in Europe, down 62 percent, just behind Malta which saw an 83.8 percentage decrease. Incidentally, Malta is one of only two European countries which has a larger percentage of the population fully vaccinated than Spain.

Cases have also been rising more rapidly across other European countries. The UK for example currently has an infection rate much higher than Spain’s at 407 cases per 100,000 in the last seven days. Recently the UK has seen daily case rates of 50,000.

But is the difference in case numbers because of Spain almost reaching herd immunity and its vaccination rates being higher or is it the fact that the UK opened up all businesses and removed all legally binding COVID restrictions in July, 2021, including the need to wear masks indoors?

Spain meanwhile kept up many of its restrictions such as mask-wearing indoors, capacity limits in bars and restaurants, and nightlife venues only reopened in many regions last month.

READ ALSO: What Covid-19 restrictions are in place in Spain’s regions in November?

Denmark similarly lifted all Covid-19 restrictions in September 2021 and since then, cases have risen from around 300 per day in late September to more than 700 per day in late October.

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Spain rules out EU’s advice on compulsory Covid-19 vaccination 

Spain’s Health Ministry said Thursday there will be no mandatory vaccination in the country following the European Commission’s advice to Member States to “think about it” and Germany’s announcement that it will make vaccines compulsory in February.

Spain rules out EU's advice on compulsory Covid-19 vaccination 
A Spanish man being vaccinated poses with a custom-made T-shirt showing Spain's chief epidimiologist Fernando Simón striking a 'Dirty Harry/Clint Eastwood' pose over the words "What part of keep a two-metre distance don't you understand?' Photo: José Jordan

Spain’s Health Minister Carolina Darias on Thursday told journalists Covid-19 vaccines will continue to be voluntary in Spain given the “very high awareness of the population” with regard to the benefits of vaccination.

This follows the words of European Commission chief Ursula von der Leyen on Thursday, urging Member States to “think about mandatory vaccination” as more cases of the Omicron variant are detected across Europe. 

READ ALSO: Is Spain proving facts rather than force can convince the unvaccinated?

“I can understand that countries with low vaccine coverage are contemplating this and that Von der Leyen is considering opening up a debate, but in our country the situation is absolutely different,” Darias said at the press conference following her meeting with Spain’s Interterritorial Health Council.

According to the national health minister,  this was also “the general belief” of regional health leaders of each of Spain’s 17 autonomous communities she had just been in discussion with over Christmas Covid measures. 

READ MORE: Spain rules out new restrictions against Omicron variant

Almost 80 percent of Spain’s total population is fully vaccinated against Covid-19, a figure which is around 10 percent higher if looking at those who are eligible for the vaccine (over 12s). 

It has the highest vaccination rate among Europe’s most populous countries.

Germany announced tough new restrictions on Thursday in a bid to contain its fourth wave of Covid-19 aimed largely at the country’s unvaccinated people, with outgoing Chancellor Angela Merkel speaking in favour of compulsory vaccinations, which the German parliament is due to vote on soon.

Austria has also already said it will make Covid-19 vaccines compulsory next February, Belgium is also considering it and Greece on Tuesday said it will make vaccination obligatory for those over 60.

But for Spain, strict Covid-19 vaccination rules have never been on the table, having said from the start that getting the Covid-19 jabs was voluntary. 

There’s also a huge legal implication to imposing such a rule which Spanish courts are unlikely to look on favourably. 

Stricter Covid restrictions and the country’s two states of alarm, the first resulting in a full national lockdown from March to May 2020, have both been deemed unconstitutional by Spain’s Constitutional Court. 

READ ALSO: Could Spain lock down its unvaccinated or make Covid vaccines compulsory?

The Covid-19 health pass to access indoor public spaces was also until recently consistently rejected by regional high courts for breaching fundamental rights, although judges have changed their stance favouring this Covid certificate over old Covid-19 restrictions that affect the whole population.

MAP: Which regions in Spain now require a Covid health pass for daily affairs?

“In Spain what we have to do is to continue vaccinating as we have done until now” Darias added. 

“Spaniards understand that vaccines are not only a right, they are an obligation because we protect others with them”.

What Spanish health authorities are still considering is whether to vaccinate their 5 to 11 year olds after the go-ahead from the European Medicines Agency, with regions such as Madrid claiming they will start vaccinating their young children in December despite there being no official confirmation from Spain’s Vaccine Committee yet.

READ MORE: Will Spain soon vaccinate its children under 12?

Spain’s infection rate continues to rise day by day, jumping 17 points up to 234 cases per 100,000 people on Thursday. There are now also five confirmed cases of the Omicron variant in the country, one through community transmission.

Hospital bed occupancy with Covid patients has also risen slightly nationwide to 3.3 percent, as has ICU Covid occupancy which now stands at 8.4 percent, but the Spanish government insists these figures are “almost three times lower” than during previous waves of the coronavirus pandemic.