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                    反疫苗主义者终于承认:强制接种真的有效

                    反疫苗主义者终于承认:强制接种真的有效

                    Vivienne Walt, David M. Mayer, Ian Mount, Bernhard Warner 2021年08月28日
                    强制性措施显著提高了新冠疫苗的接种率。

                    在法国人结束夏季假期,无精打采地回到家时,街上的游行示威活动和政治内部斗争通常会达到高潮。但今年,这种惯例发生了改变:人们发现,总统埃马纽埃尔?马克龙的引发多数人不满的新冠疫苗强制接种,取得了惊人的成功。

                    在欧洲各地,一系列强制性程度各不相同的疫苗接种措施显著提升了疫苗的接种率,欧盟(European Union)也因此在这方面进一步领先于美国(此前,疫苗接种率最高的地区是美国的华盛顿州)。目前,欧盟有63.6%的人口至少接种了一剂疫苗,美国则仅有60.4%,而这一差距还在继续扩大。

                    强制性措施显著提高了新冠疫苗的接种率,而接种率的提高正在对公共健康和经济产生深远的影响。

                    在美国,每百万人中死于新冠肺炎的七天滚动平均值为3.02,几乎达到了欧盟0.77人的四倍。

                    在深受新冠肺炎疫情影响的旅游业,据彭博社(Bloomberg)报道,欧洲航空公司的运力已经恢复到2019年水平的三分之二左右。廉价航空公司瑞安航空(Ryanair)表示,公司预计将在本季度再度开始盈利,并在冬季开设250条新航线。而在美国,今年夏季激增至疫情前水平80%的客运量目前已经消退。美国西南航空公司(Southwest Airlines)称,在上季度实现盈利后,公司可能会再度开始亏损。

                    欧洲现在的情况明确地说明了强制接种新冠疫苗能够发挥怎样的效用,为别国提供了值得学习的经验。

                    类似措施的尝试却遭到了美国的共和党州长们的阻挠,上周一项民意调查表明,美国与欧洲的情况相似——超三分之二的美国人支持强制接种新冠疫苗,而共和党人的做派只代表了少数人的观点。

                    法国

                    7月12日,法国总统马克龙再次充分展现了他傲慢的“万事通”形象,其在电视直播讲话表示,民众要么接种新冠疫苗,要么面临严重后果。

                    他提出了“一刀切”式疫苗接种新规定,没有商量余地:自8月9日起,任何18岁以上的人想去电影院、体育比赛或博物馆,去餐馆吃饭,甚至去商场购物,都必须在门口出示二维码,证明自己已经完全接种疫苗;从9月15日起,法国所有的医护工作者都必须完全接种疫苗。

                    马克龙强调,违反规定者将被停薪停职。

                    现在,法国购物中心外的顾客会排队等待,拿出手机出示自己的疫苗接种证明。8月22日,《财富》杂志驻巴黎记者因二维码太过模糊无法扫描,她险些错过一次约会。

                    法国的右翼和极左翼反对派团体都把“健康通行证”作为竞选议题,抨击将于明年4月面临连任竞选的马克龙。每周的示威活动都在指责马克龙政府践踏了他们珍视的宪法权利。8月21日,一名抗议者在反对强制接种疫苗示威活动的海报上写道:“你们正在扼杀我们的自由。”

                    法国独立医生联盟(National Union of Independent Doctors)的负责人杰罗姆?马蒂在接受《财富》杂志采访时说:“法国现在出现了非常政治化的反疫苗、反健康通行证运动。”

                    马蒂认为,如果马克龙在实施疫苗强制接种措施之前与工会和卫生专业人士进行会面,结果应该会“更有效”。当然,目前的影响也已经很显著了。“重症监护室中的绝大多数新冠肺炎患者都没有接种疫苗。疫苗的接种速度已经显著加快。”

                    自马克龙于7月12日发表声明以来,有1000多万法国人接种了疫苗。法国卫生部(French Health Ministry)的数据表明,截至8月23日,法国有超过4100万人全面接种了新冠疫苗,占总人口的61%以上。这一数据远远超过了美国的接种水平——美国仅有51.3%的人口完全接种了疫苗。

                    路透社(Reuters)的新冠肺炎疫情数据汇总表明,按照目前的疫苗接种速度,法国可能在9月下旬达到70%的全面接种率。这与法国年初启动疫苗接种计划时,复杂纷乱的使用计划和严重短缺的疫苗剂量相比有了显著提高。。

                    与其他国家一样,法国也在遭受德尔塔变种病毒引发的第四波新冠肺炎疫情,每天约有93人死亡,远超7月下旬每天约24人的死亡人数。法国政府表示,几乎所有的重症病例都未曾接种新冠疫苗。

                    法国未接种新冠疫苗的人数正在迅速减少。在位于巴黎近郊塞纳圣但尼地区的法国红十字会(French Red Cross)接受《财富》杂志采访时,负责人罗杰?方丹在称,疫苗接种的新规定带来了立竿见影的效果。方丹所在的组织也管理着流动的新冠疫苗接种点。

                    他说:“总统发表讲话的那一刻起就出现了显著的变化。过去的一个月中,我们的疫苗接种量超过了1万剂。”塞纳圣但尼是法国最贫穷的地区,这里的疫情曾经一度十分严峻,医院人满为患。

                    一名游客在巴黎里沃利街的一个临时检测点接受新冠病毒检测。

                    图片来源:Kiran Ridley—Getty Images

                    德国

                    德国正在开始采用与法国类似的措施。

                    8月23日,德国的16个州均出台了一项统一规定,人们如果想进入餐馆、健身房等室内空间活动,就必须证明自己已经接种疫苗、曾经感染新冠肺炎并且已经完全康复或者并未感染新冠病毒。从10月11日起,未接种过疫苗的人群要想接受此前一直免费的新冠病毒快速检测,必须支付相关费用。

                    德国实施这类措施,主要是为了推动还在犹豫的人群尽快接种新冠疫苗。在6月初达到一天接种140万剂的峰值后,德国的疫苗接种率正在显著放缓,现在每天的接种量约为32万剂。政府的官方数据表明,德国现在只有59%的人口完全接种了疫苗,64.1%的人口至少接种了一剂。

                    但德国的疫苗接种率数据存在一定的不确定性。

                    本月早些时候,德国政府的顶级生物医学顾问罗伯特?科赫研究所(Robert Koch Institute)表示,政府很可能低估了接种疫苗的人数,特别是18至59岁的人群。

                    德国政府认为,这一群体中有59%的人接种了第一剂疫苗。而罗伯特?科赫研究所的报告表明,这一比例应为79%。该报告指出,数据误差的出现,很大程度上是由于地方的医生没有在政府的中央系统中报告疫苗接种情况,并错误地将单剂的强生(Johnson & Johnson)疫苗记录为第二剂。

                    意大利

                    8月6日起,意大利人需要拥有由该国卫生部(Ministry of Health)的“绿色通行证”,才能做他们最珍视的事情:在米其林星级餐厅或路边小餐馆的室内用餐、去健身房、参观佛罗伦萨的乌菲齐美术馆(Uffizi Gallery)或该国任何其他博物馆,或去体育馆观看足球比赛。

                    这张“绿色通行证”代表持证人已经接种了疫苗、最近的新冠病毒检测结果呈阴性,或已从新冠肺炎中彻底康复。藐视这一规定的企业和消费者将被处以高额罚款。

                    在该规定正式推出前,就有一个小但有声望的群体提出了抗议。部分人坚决表示要在Tripadvisor上为遵守该规定的餐馆留下一星评论,其他人则呼吁抵制该规定。一位著名的“绿色通行证”反对者谴责说,这种因为餐馆遵守法规而惩罚餐馆的行为是“疯狂的”。

                    这种抗议的声音进一步分裂了意大利的反疫苗运动。

                    但慢慢的,意大利有关绿色通行证的争议开始消退。餐馆老板和酒吧老板都表示,8月的经营情况很不错,早上买卡布奇诺或午餐后买特浓咖啡的长队几乎同过去一样。卫生官员指出,绿色通行证推出后的疫苗接种率稳步上升,特别是在年轻人群中。离新学年开始还有几周,超60%的意大利16至19岁青少年至少接种了一剂疫苗,这让公共卫生官员和教育工作者深受鼓舞。

                    从8月的第一个星期五(夏季假期的高峰期)开始,意大利人需要出示“绿色通行证”,证明自己已经接种过疫苗,或最新一次新冠病毒检测结果为阴性。

                    图片来源:Giuliano Berti—Bloomberg via Getty Images

                    西班牙

                    欧洲大部分国家都在努力提高疫苗接种率,但西班牙一直是一个异类。

                    在经历了极其严峻的第一波疫情并采取了世界上最严格的疫情封锁措施后,马德里一直拒绝施加其他严格的限制措施或强制规定。近期,西班牙最高法院支持地方法院推翻了安达卢西亚的一项要求——进入夜总会需持疫苗护照或新冠病毒核酸检测阴性证明,以及另一项卡斯蒂利亚-拉曼查地区的养老院工作人员定期接受新冠病毒检测的要求。

                    但西班牙人并没有像法国等国家的人们那样,对接种疫苗持犹豫态度。西班牙的疫苗接种率在欧盟大国中处于领先地位,67.3%的人口完全接种了疫苗,76.3%的人至少接种了一剂。20至29岁的人口中,有70.5%至少接种了一剂。

                    世界卫生组织(World Health Organization)前主任、西班牙巴斯克地区的卫生部长拉斐尔?本戈亚称:“西班牙政府没必要推动疫苗接种。新冠疫苗一问世,就有调查表明90%的西班牙人想要接种疫苗。”

                    本戈亚指出,西班牙其他疫苗的采用率很高。这让人们与医生可以进行疫苗相关的对话,而西班牙的单一支付人公共卫生系统,能够将民众与初级卫生保健团队联系起来。

                    马德里自治大学(Autonomous University of Madrid)的流行病学家费尔南多?罗德里格斯?阿塔莱霍说:“在过去的30年里,西班牙的疫苗管理一直是由初级卫生保健护士进行的,该群体一直将其视作自己的主要工作任务之一。”(财富中文网)

                    译者:张翯

                    在法国人结束夏季假期,无精打采地回到家时,街上的游行示威活动和政治内部斗争通常会达到高潮。但今年,这种惯例发生了改变:人们发现,总统埃马纽埃尔?马克龙的引发多数人不满的新冠疫苗强制接种,取得了惊人的成功。

                    在欧洲各地,一系列强制性程度各不相同的疫苗接种措施显著提升了疫苗的接种率,欧盟(European Union)也因此在这方面进一步领先于美国(此前,疫苗接种率最高的地区是美国的华盛顿州)。目前,欧盟有63.6%的人口至少接种了一剂疫苗,美国则仅有60.4%,而这一差距还在继续扩大。

                    强制性措施显著提高了新冠疫苗的接种率,而接种率的提高正在对公共健康和经济产生深远的影响。

                    在美国,每百万人中死于新冠肺炎的七天滚动平均值为3.02,几乎达到了欧盟0.77人的四倍。

                    在深受新冠肺炎疫情影响的旅游业,据彭博社(Bloomberg)报道,欧洲航空公司的运力已经恢复到2019年水平的三分之二左右。廉价航空公司瑞安航空(Ryanair)表示,公司预计将在本季度再度开始盈利,并在冬季开设250条新航线。而在美国,今年夏季激增至疫情前水平80%的客运量目前已经消退。美国西南航空公司(Southwest Airlines)称,在上季度实现盈利后,公司可能会再度开始亏损。

                    欧洲现在的情况明确地说明了强制接种新冠疫苗能够发挥怎样的效用,为别国提供了值得学习的经验。

                    类似措施的尝试却遭到了美国的共和党州长们的阻挠,上周一项民意调查表明,美国与欧洲的情况相似——超三分之二的美国人支持强制接种新冠疫苗,而共和党人的做派只代表了少数人的观点。

                    法国

                    7月12日,法国总统马克龙再次充分展现了他傲慢的“万事通”形象,其在电视直播讲话表示,民众要么接种新冠疫苗,要么面临严重后果。

                    他提出了“一刀切”式疫苗接种新规定,没有商量余地:自8月9日起,任何18岁以上的人想去电影院、体育比赛或博物馆,去餐馆吃饭,甚至去商场购物,都必须在门口出示二维码,证明自己已经完全接种疫苗;从9月15日起,法国所有的医护工作者都必须完全接种疫苗。

                    马克龙强调,违反规定者将被停薪停职。

                    现在,法国购物中心外的顾客会排队等待,拿出手机出示自己的疫苗接种证明。8月22日,《财富》杂志驻巴黎记者因二维码太过模糊无法扫描,她险些错过一次约会。

                    法国的右翼和极左翼反对派团体都把“健康通行证”作为竞选议题,抨击将于明年4月面临连任竞选的马克龙。每周的示威活动都在指责马克龙政府践踏了他们珍视的宪法权利。8月21日,一名抗议者在反对强制接种疫苗示威活动的海报上写道:“你们正在扼杀我们的自由。”

                    法国独立医生联盟(National Union of Independent Doctors)的负责人杰罗姆?马蒂在接受《财富》杂志采访时说:“法国现在出现了非常政治化的反疫苗、反健康通行证运动。”

                    马蒂认为,如果马克龙在实施疫苗强制接种措施之前与工会和卫生专业人士进行会面,结果应该会“更有效”。当然,目前的影响也已经很显著了。“重症监护室中的绝大多数新冠肺炎患者都没有接种疫苗。疫苗的接种速度已经显著加快。”

                    自马克龙于7月12日发表声明以来,有1000多万法国人接种了疫苗。法国卫生部(French Health Ministry)的数据表明,截至8月23日,法国有超过4100万人全面接种了新冠疫苗,占总人口的61%以上。这一数据远远超过了美国的接种水平——美国仅有51.3%的人口完全接种了疫苗。

                    路透社(Reuters)的新冠肺炎疫情数据汇总表明,按照目前的疫苗接种速度,法国可能在9月下旬达到70%的全面接种率。这与法国年初启动疫苗接种计划时,复杂纷乱的使用计划和严重短缺的疫苗剂量相比有了显著提高。。

                    与其他国家一样,法国也在遭受德尔塔变种病毒引发的第四波新冠肺炎疫情,每天约有93人死亡,远超7月下旬每天约24人的死亡人数。法国政府表示,几乎所有的重症病例都未曾接种新冠疫苗。

                    法国未接种新冠疫苗的人数正在迅速减少。在位于巴黎近郊塞纳圣但尼地区的法国红十字会(French Red Cross)接受《财富》杂志采访时,负责人罗杰?方丹在称,疫苗接种的新规定带来了立竿见影的效果。方丹所在的组织也管理着流动的新冠疫苗接种点。

                    他说:“总统发表讲话的那一刻起就出现了显著的变化。过去的一个月中,我们的疫苗接种量超过了1万剂。”塞纳圣但尼是法国最贫穷的地区,这里的疫情曾经一度十分严峻,医院人满为患。

                    一名游客在巴黎里沃利街的一个临时检测点接受新冠病毒检测。

                    德国

                    德国正在开始采用与法国类似的措施。

                    8月23日,德国的16个州均出台了一项统一规定,人们如果想进入餐馆、健身房等室内空间活动,就必须证明自己已经接种疫苗、曾经感染新冠肺炎并且已经完全康复或者并未感染新冠病毒。从10月11日起,未接种过疫苗的人群要想接受此前一直免费的新冠病毒快速检测,必须支付相关费用。

                    德国实施这类措施,主要是为了推动还在犹豫的人群尽快接种新冠疫苗。在6月初达到一天接种140万剂的峰值后,德国的疫苗接种率正在显著放缓,现在每天的接种量约为32万剂。政府的官方数据表明,德国现在只有59%的人口完全接种了疫苗,64.1%的人口至少接种了一剂。

                    但德国的疫苗接种率数据存在一定的不确定性。

                    本月早些时候,德国政府的顶级生物医学顾问罗伯特?科赫研究所(Robert Koch Institute)表示,政府很可能低估了接种疫苗的人数,特别是18至59岁的人群。

                    德国政府认为,这一群体中有59%的人接种了第一剂疫苗。而罗伯特?科赫研究所的报告表明,这一比例应为79%。该报告指出,数据误差的出现,很大程度上是由于地方的医生没有在政府的中央系统中报告疫苗接种情况,并错误地将单剂的强生(Johnson & Johnson)疫苗记录为第二剂。

                    意大利

                    8月6日起,意大利人需要拥有由该国卫生部(Ministry of Health)的“绿色通行证”,才能做他们最珍视的事情:在米其林星级餐厅或路边小餐馆的室内用餐、去健身房、参观佛罗伦萨的乌菲齐美术馆(Uffizi Gallery)或该国任何其他博物馆,或去体育馆观看足球比赛。

                    这张“绿色通行证”代表持证人已经接种了疫苗、最近的新冠病毒检测结果呈阴性,或已从新冠肺炎中彻底康复。藐视这一规定的企业和消费者将被处以高额罚款。

                    在该规定正式推出前,就有一个小但有声望的群体提出了抗议。部分人坚决表示要在Tripadvisor上为遵守该规定的餐馆留下一星评论,其他人则呼吁抵制该规定。一位著名的“绿色通行证”反对者谴责说,这种因为餐馆遵守法规而惩罚餐馆的行为是“疯狂的”。

                    这种抗议的声音进一步分裂了意大利的反疫苗运动。

                    但慢慢的,意大利有关绿色通行证的争议开始消退。餐馆老板和酒吧老板都表示,8月的经营情况很不错,早上买卡布奇诺或午餐后买特浓咖啡的长队几乎同过去一样。卫生官员指出,绿色通行证推出后的疫苗接种率稳步上升,特别是在年轻人群中。离新学年开始还有几周,超60%的意大利16至19岁青少年至少接种了一剂疫苗,这让公共卫生官员和教育工作者深受鼓舞。

                    从8月的第一个星期五(夏季假期的高峰期)开始,意大利人需要出示“绿色通行证”,证明自己已经接种过疫苗,或最新一次新冠病毒检测结果为阴性。

                    西班牙

                    欧洲大部分国家都在努力提高疫苗接种率,但西班牙一直是一个异类。

                    在经历了极其严峻的第一波疫情并采取了世界上最严格的疫情封锁措施后,马德里一直拒绝施加其他严格的限制措施或强制规定。近期,西班牙最高法院支持地方法院推翻了安达卢西亚的一项要求——进入夜总会需持疫苗护照或新冠病毒核酸检测阴性证明,以及另一项卡斯蒂利亚-拉曼查地区的养老院工作人员定期接受新冠病毒检测的要求。

                    但西班牙人并没有像法国等国家的人们那样,对接种疫苗持犹豫态度。西班牙的疫苗接种率在欧盟大国中处于领先地位,67.3%的人口完全接种了疫苗,76.3%的人至少接种了一剂。20至29岁的人口中,有70.5%至少接种了一剂。

                    世界卫生组织(World Health Organization)前主任、西班牙巴斯克地区的卫生部长拉斐尔?本戈亚称:“西班牙政府没必要推动疫苗接种。新冠疫苗一问世,就有调查表明90%的西班牙人想要接种疫苗。”

                    本戈亚指出,西班牙其他疫苗的采用率很高。这让人们与医生可以进行疫苗相关的对话,而西班牙的单一支付人公共卫生系统,能够将民众与初级卫生保健团队联系起来。

                    马德里自治大学(Autonomous University of Madrid)的流行病学家费尔南多?罗德里格斯?阿塔莱霍说:“在过去的30年里,西班牙的疫苗管理一直是由初级卫生保健护士进行的,该群体一直将其视作自己的主要工作任务之一。”(财富中文网)

                    译者:张翯

                    This week marks the beginning of France’s so-called rentrée, when the French slouch home after their sacred (and long) summer break, and when street protests and political infighting typically hit a high point. But this year, there is a twist to the usual pattern: The biggest complaint against President Emmanuel Macron—his hard-line COVID-19 vaccine mandates—is falling flat, as most French seem to have concluded that the tough approach is a stunning success.

                    Across Europe, a series of sticks of varying severity has led to a pronounced rise in vaccine uptake, pushing the European Union further ahead of the U.S. in a process Washington once led. Today, 63.6% of the EU population has had at least one shot, compared with 60.4% in the U.S., and that gap is growing.

                    This mandate-inspired uptick is having profound effects both in terms of health outcomes and the economy.

                    The seven-day rolling average of COVID deaths per million people is 3.02 in the U.S., almost four times the EU figure of 0.77. And in the COVID-sensitive travel sector, European regional airline capacity has risen to around two-thirds of 2019 levels, while discount carrier Ryanair has said it expects to post a profit this quarter and is opening 250 new routes for the winter, Bloomberg reports. In the U.S., however, a summer passenger surge to 80% of pre-pandemic levels has faded, and Southwest Airlines has said it may return to losses after a profit last quarter.

                    Europe now provides a clear example of how vaccine mandates can work—offering lessons for the U.S., where Republican governors have blocked attempts to impose similar rules. Much like in Europe, more than two-thirds of Americans now appear to support vaccine mandates, according to a poll out last week—leaving the Republicans to defend a minority opinion.

                    France

                    Macron’s reputation as an arrogant know-it-all was on full display on July 12, when he went on television and told people to get vaccinated, or face the consequences. His new rules were sweeping, and nonnegotiable. Since Aug.9, anyone over 18 wanting to go to a cinema, a sports match, or a museum, or eat in a restaurant or even shop in a mall, has had to show a QR code at the door to prove they are fully vaccinated; from Sept. 15, all health workers will need to be fully vaccinated, or, Macron vows, face losing their jobs.

                    Now, lines of customers outside shopping centers wait to show their vaccine proof, phones outstretched, and on August 22, Fortune’s Paris-based correspondent narrowly missed a tennis date when the security guard at the gym found her cell phone QR code too blurry to scan.

                    Both right-wing and far-left opposition groups have seized on the “health pass” as a campaign issue with which to bash Macron, who faces a reelection battle next April, for a second five-year presidential term. Weekly demonstrations have accused the government of trampling on their cherished constitutional rights. “You are killing our liberties,” read one poster in a demo on Saturday against the vaccine mandates.

                    “We have a movement that is anti-vax and anti–health pass that is very, very politicized,” Jér?me Marty, head of France’s National Union of Independent Doctors, tells Fortune. Marty believes it would have been “more effective” if Macron had met with labor unions and health professionals before imposing the vaccine mandates. Even so, he says the impact has been striking. “The great majority of those in ICUs are not vaccinated,” he says. “There has been a strong accelerate of vaccines.”

                    More than 10 million more French have rushed to be vaccinated since Macron’s declaration on July 12. As of August 23, more than 41 million people in France have been fully immunized—more than 61% of the population, according to the French Health Ministry. That’s far above the U.S., where 51.3% of people are fully vaccinated.

                    At this rate, France could hit 70% full vaccination by late September, according to Reuters’ COVID-19 tracker, a sharp increase from early this year, when the country struggled to launch its vaccine program with a labyrinthine vaccination program and severe shortage of doses.

                    Like other countries, France is suffering a fourth COVID-19 wave from the Delta variant, with about 93 deaths per day, up from about 24 daily deaths in late July. Virtually all severe cases have been among the unvaccinated, according to the government.

                    Those unvaccinated people are decreasing rapidly. Roger Fontaine, head of the French Red Cross in the Paris suburb of Seine-Saint-Denis, tells Fortune the new rules brought immediate results. “From the moment the President spoke we saw the change,” says Fontaine, whose organization runs mobile coronavirus vaccination units. “We exceeded 10,000 vaccines in the past month.” The area, the poorest district in France, was hard-hit by the pandemic, with hospitals strained to capacity.

                    Germany

                    Germany is starting to adopt French-style rules.

                    On August 23, all of the country’s 16 states introduced a uniform rule forcing people to prove vaccination, recovery, or lack of infection if they want to enter restaurants, gyms, and indoor events. From Oct. 11, unvaccinated people will also have to pay for rapid coronavirus tests that have thus far been free.

                    These measures are, as in France, largely designed to push the undecided toward vaccination. Germany’s vaccination rate is undoubtedly slowing—after an early-June peak of 1.4 million doses being administered in one day, the daily figure is now around 320,000. According to the government’s official figures, only 59% of the population is now fully vaccinated, with 64.1% having received at least one dose.

                    However, there has recently been some uncertainty over how many Germans have already had the jab.

                    Earlier this month, the Robert Koch Institute (RKI)—the government’s top biomedicine adviser—said it was likely that the government had been undercounting the numbers of vaccinated people, particularly those in the 18 to 59 age group.

                    While the government believed 59% of this group had received a first dose, an RKI survey had the figure at 79%. It suggested the discrepancy was largely the result of local doctors not reporting vaccinations in the government’s centralized system, and incorrectly recording the single-dose J&J vaccine as a second shot, not a first.

                    Italy

                    Since Aug. 6, Italians have needed a special pass to do the things Italians hold most dear: dine indoors at a Michelin-starred restaurant or at a modest roadside trattoria, go to the gym, visit Florence’s Uffizi Gallery or any other museum in the country, or go to the stadium to watch a soccer match.

                    The “green pass,” as it’s called, is a nationwide certificate from the Ministry of Health declaring you’ve either been vaccinated, have recently tested negative for COVID-19, or that you’ve recently recovered from the virus. Businesses and patrons who try to flout the rules are hit with steep fines.

                    Even before it launched, a small but vocal group protested. Some vowed to leave one-star reviews on Tripadvisor for those restaurants that follow the rules. Others called for boycotts. If the howls of protest accomplished anything, it was to further divide Italy’s no-vax movement. “Madness,” is how one prominent “green pass” opponent condemned the movement to punish businesses for following the law.

                    Since then, the green pass controversy has mostly faded. Restaurateurs and bar owners are reporting a banner August, and the usual queues for the morning cappuccino or after-lunch espresso are as long as ever. More important, health officials saw a steady rise in vaccinations prior to the green pass launch, particularly among the young. More than 60% of Italian teens between 16 and 19 have now had at least one vaccine dose, encouraging public health officials and educators with a few weeks to go before the start of the new school year.

                    Spain

                    Spain has been an outlier in Europe’s push to increase vaccine uptake.

                    After facing a brutal first wave of the pandemic with one of the world’s most restrictive lockdowns, Madrid has been reluctant to impose heavy restrictions or mandates. In recent days, Spain’s Supreme Court has supported regional courts that overturned a requirement for vaccine passports or negative PCR tests to enter nightclubs in Andalusia, and another to require regular COVID testing for nursing home workers in Castilla-La Mancha.

                    At the same time, Spain has not suffered from the vaccine hesitancy seen in countries such as France. Spain leads large EU countries in vaccine uptake, with 67.3% of the population fully vaccinated and 76.3% with at least one dose. There has been high uptake among the young, with 70.5% of those ages 20 to 29 having received at least one dose.

                    “The governments haven’t had to push or pull. From the very beginning of [COVID] vaccines, surveys indicated 90% wanted it,” says Rafael Bengoa, a former WHO director and health minister of the Basque region.

                    Bengoa points to Spain’s high adoption levels for other vaccines, which expose people to vaccine conversations with their doctors, as well as the country’s national single-payer public health system, which connects each person with a primary health care team that can easily contact them.

                    “The administration of vaccines in Spain in the last 30 years has been carried out by primary care nurses, a group [who] have…looked at it as one of their main tasks,” says Fernando Rodríguez Artalejo, an epidemiologist at the Autonomous University of Madrid.

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