Belgium powers ahead in EU’s vaccination race – POLITICO

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These days, Belgians are focused on winning only one thing: Euro 2020. 

But in the meantime, the country of 11 million is winning the race to get as many arms jabbed as possible.

As of Saturday, three-quarters of Belgians over 18 had gotten at least one shot, with 42 percent fully vaccinated. And with vaccinations proceeding at a steady clip, the country leads all other EU countries except Malta, according to POLITICO’s chart of vaccination progress.

The rapid rollout contrasts with Belgium’s wrenching experience trying to control the virus at the beginning of the pandemic and in the second wave last fall. And the vaccination campaign itself had a bumpy start because of delays in vaccine deliveries, as was the case in other EU countries.

But Belgium turned all that around in the spring, especially in the northern Dutch-speaking region of Flanders, with a world-beating rollout. That wasn’t a surprise to some experts who had said early on the long run would look much better.

Steven Van Gucht, a virologist serving as the Belgian government’s COVID-19 spokesperson, was among them. In a follow-up interview with POLITICO in mid-May, he said it was “Flemish confidence in receiving a jab” that was making the difference.

As of Saturday, 79 percent of adults in Flanders received at least one dose. That figure rises to around 95 percent for citizens over 65, with some towns hitting up to 100 percent. 

As in other Western countries, the debate is now shifting from vaccine deliveries to vaccine willingness. And what’s helping in Flanders is a tradition of openly communicating about vaccines, said Karolien Poels of the University of Antwerp, who monitors vaccination willingness and advises the Belgian government on their communication.

“The government left the decision up to citizens, and didn’t push back too hard against initial vaccine hesitancy,” Poels said. “Respecting certain doubts and leaving people a choice can help get citizens who are hesitant at first over the line.”

Belgium’s success is also tied to the country’s decision to take a straightforward approach that made “vaccination as easy as possible,” said Wouter Beke, health minister for the Flemish region.

“Instead of an open invitation, citizens get a time and a date,” he said. “We set up a whole range of new vaccination centers so that everyone could get a jab within a radius of 10 kilometers. And we got doctors, pharmacists and civil society involved to convince those who had initial doubts.”

Logistics was key for this to work, added Beke, who also serves as mayor of Leopoldsburg, a small town that used to house a garrison and now has a military base.

“Wars have been lost and won over logistics,” Beke said. “This vaccination campaign was the biggest logistical operation since the Second World War. So we made sure we were prepared when going into battle.”

Too many cooks in the kitchen?

One particularly Belgian challenge was implementing a policy with nine ministers in charge of health. In fact, the division of health competences between the different Belgian governments was one of the reasons the country initially struggled with the pandemic.

But during the vaccination campaign, a spirit of cooperation arose. The five different ministers in charge of vaccination, for example, shared best practices and learned from each other, Beke said. Given that many other countries are struggling with similar challenges, he added, they could do more to learn from Belgium’s experience.

“We constantly exchange our experiences within Belgium, from invitations to call centers to deliveries,” he said. “That pushes us to achieve a higher performance level.”

“A lot of the differences within Europe, just like in the U.S., have to do with social factors and other variables, but it’s also the way you approach this vaccination campaign,” he added. “What works and what doesn’t?”

Another example where the EU could have done better, in his view, is the differing regulations in the EU about the Oxford/AstraZeneca jab, which he says resulted from the European Medicines Agency’s failure to give clearer advice. After its qualified green light in March, he said, “half of the EU countries continued using it, a quarter stopped using it and another quarter applied restrictions.”

“That’s not really ideal,” he said, referring to the lack of EU unity. In two key respects, he explained, the bloc could have managed this challenge better: Having more exchange of best practices, and making sure everyone is on the same page.

Brussels’ outreach

That’s not to say the Belgian example is perfect. Some communities continue to struggle in convincing citizens to accept the jab.

One of those is the French-speaking southern region of Wallonia, which is more influenced by French public opinion — historically more skeptical regarding vaccines. There, the share of adults with at least one shot is 72 percent, well below Flanders, as of Saturday.

The problem is even more entrenched in Brussels, which has so far only vaccinated 54 percent of its adult population with at least one jab.

The international character of the city, home to the EU institutions and NATO as well as 182 nationalities, is a huge challenge, said Inge Neven, the COVID-19 crisis manager for Brussels. 

“Some don’t have a doctor or the necessary digital skills, and some are in a difficult socio-economic situation,” she said. “More than one out of ten citizens either don’t get their invitation or don’t understand it. That makes the vaccination campaign more challenging.”

In response, Brussels has set up outreach programs, deploying mobile teams to reach groups such as the homeless and undocumented migrants. There are also teams at weekly markets and municipal halls, ready to set up an appointment when they manage to convince someone to get their jab. 

The city has also approached local community leaders to spread the message. “Certain African cultures have particular concerns about the impact of the vaccine on fertility, as do the Roma community,” said Neven.

Brussels’ aim is to have 70 percent of adults vaccinated with one shot by mid-July, which Neven describes as “ambitious,” especially compared to other major cities.

“They often don’t hit more than 60 percent,” Neven pointed out.

That’s not the only reason for concern. Despite the broader success of the campaign, public health officials say it’s too soon to rule out the possibility of another COVID-19 resurgence in Belgium. The country remains particularly vulnerable because its population is so international and itinerant. For example, people working at the EU institutions are likely to travel elsewhere in the summer and then to Brussels, bringing with them the risk of new variants.

Virologists are especially vigilant about the rise of the Delta variant and warn that infections might go back up again. The highly infectious strain is already making inroads across Europe, prompting Belgium to decide on Saturday to ban travelers from the U.K. from entering the country.

“We’re not out of the woods yet,” Beke admitted. “But there’s only one answer to that threat: Getting as many people as possible vaccinated.”

Jillian Deutsch contributed reporting.

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.





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