Will High Vaccination Rates Help Spain Weather Omicron?

MADRID — A month ago, Spain was riding high on its successes against Covid-19. The country’s caseload was among the lowest in Europe, and nearly 80 percent of the country had been vaccinated, leaving few eligible people to give a shot to.

Then came the Omicron variant, and success gave way to uncertainty.

Three cases of the variant have been detected so far in Spain, as the number of Covid-19 infections steadily rose all November. The appearance of the variant has now prompted local governments to swiftly roll out new measures they had been considering. Catalonia is introducing a Covid-19 “passport,” the first in Spain. The Basque region is preparing an emergency declaration with restrictions on bars and restaurants that look like a return to the past.

The new steps show how fragile the gains against the virus can be. But the country’s broad acceptance of vaccination may prove to be critical.

If the current vaccines offer good protection against the variant, then Spain could be largely shielded against a potential new wave. If fighting Omicron requires reformulating the vaccines, then Spaniards seem ready and willing to take another shot if their leaders recommend it.

“As far as vaccines go, in Spain there’s just a wide consensus among citizens — they follow the recommendations of the scientists,” said Salvador Illa, Spain’s former health minister who oversaw the country’s response during the pandemic’s first year.

Experts attribute Spain’s vaccine success, in part, to its widely trusted public health system, which spearheaded the effort. Politicians also played a big role, taking their doses with fanfare early on and avoiding politicized debate about the vaccine. Spaniards, for the most part, followed the health guidance of their leaders when it came to vaccines, masks and other precautions.

Delays in the European Union’s vaccine rollout initially left Spain well behind the United States and Britain. But as supply issues were resolved, the country rapidly caught up. Now, almost 90 percent of those eligible for the shot — anyone over 12 years old — have gotten it, with few Spaniards left to vaccinate.

Walk the streets of Spain and one encounters a different Europe from the norm on much of the continent. Masks are not only worn indoors, but are worn outdoors by residents in many cities where the government has not required them for months.

And while fights over the pandemic response have been common in Spain’s charged political landscape, almost none have concerned whether citizens should be vaccinated — territory where virtually no mainstream politician will venture.

Among the chief reasons for that consensus on vaccines, many said, was that Spain was hit hard by the pandemic early on. About 15,500 people perished from Covid-19 in April 2020 alone, putting Spain’s first wave in line with those of countries like Italy and New York. Spaniards were inundated with headlines of hospitals overwhelmed by intubated patients and makeshift morgues that received the bodies.

Rafael Vilasanjuan, the policy director at ISGlobal, a Barcelona public health think tank, said the experience left a deep collective will for vaccination.

“In the first wave, we were completely unprotected. There was nothing,” he said. “This was a big deal in Spain.”

Countries like Germany and Austria, where vaccine resistance has now become entrenched in some corners, also faced deadly waves of infections. But they came later in the pandemic. In Germany, 69 percent of its 83 million people are fully vaccinated, while in Austria, a country of about nine million, 67 percent are fully vaccinated.

Mr. Vilasanjuan said it was here that Spain’s demographics worked favorably toward vaccine acceptance: The country not only has many at-risk older adults — nearly 20 percent of the population — but Spanish youth live with their parents until they are 30, on average.

This led to many multigenerational households where young adults got vaccinations to protect older relatives.

“There’s been an intergenerational respect that has meant more people vaccinated,” Mr. Vilasanjuan said.

Another factor that may have set Spain apart from other countries: Its politicians largely avoided turning the scientific consensus on vaccines into an arena of debate.

To be sure, Spain remains a polarized nation. Nationalist showdowns and the emergence of a far-right political faction have riven the country in recent years, something that could have made it fertile ground for the mix of politics and vaccine resistance that was seen in the United States.

Yet while some fringe figures in Spain spoke out against vaccines as they were being released, politicians rarely followed. The biggest debates largely centered around the Spanish economy and whether pandemic lockdowns had gone too far.

“Public officials just never put any of this into doubt, and this has been key not just in vaccines, but getting people to keep their masks on,” said Dr. José M. Martín-Moreno, a professor of preventive medicine and public health in Valencia who also worked with the World Health Organization.

The general store run by Rebeca Torres and her family in the remote mountain village of Navarredonda de Gredos offers a window into Spanish attitudes in fighting Covid-19, where the consensus simply does not come up for debate.

As customers strolled inside on a recent snowy day, they didn’t need to put on masks before entering: They already had them on. Alongside rows of local breads and bottles of red wine were public health advertisements inviting people to get their third dose.

Ms. Torres said almost no one in town had even heard of anti-vaccine campaigners or their claims. She explained that she takes immunosuppressant drugs for multiple sclerosis and said she had spent years trusting science. She saw no need to stop now.

Maria Luisa Hernández, the pharmacist in the nearby village of Hoyos del Espino, said she believed it was Spain’s first wave of infections that jolted the population into readily accepting the vaccines when they were available.

She estimated that about 60 percent of the area’s population is elderly. The lockdowns closed public health clinics during the first weeks of the pandemic, and people were able to reach their doctors only by phone, with many older residents unable to navigate the complex system of online prescriptions.

Ms. Hernández, whose pharmacy remained open during the lockdown, ended up becoming the only health professional seeing the sick in person, leaving her to fill the role of doctor for many in the town. She and everyone she knows is vaccinated: No one wanted to return to the situation in 2020, she said.

Despite its vaccine success, Spain remains on guard, both because of the Omicron variant and a new wave of Covid-19 cases that began before the variant’s discovery. New infections have more than tripled in recent weeks, to about 190 cases per 100,000 people in the last 14-day period.

The numbers, however, are far lower than in other countries in Europe, like Germany, the Czech Republic and the Netherlands, which are now among the worst hit for infections.

Still, Francisca Hernández saw this as no reason to let down her guard.

The 77-year-old, who is not related to the pharmacist, lives in one of the multigenerational households typical of Spain. Her daughter moved in with her after losing her job. Her son, a cattle rancher, is constantly meeting up with other men as they move their livestock to pastures, then coming to see her.

She said she got her third shot last week. Everyone in her family will soon have theirs once her youngest grandchildren qualify.

“In my circle, there is no one who isn’t vaccinated,” she said. “We know this is the only solution.”

Roser Toll Pifarré contributed reporting from Barcelona.

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