From vaccine nationalism to vaccine tribalism

As the global COVID-19 pandemic passes the one-year mark, new hope has arrived in the form of various vaccines to thwart the spread of the virus and allow nations to reopen their societies and economies.

And as predicted, many nations have sought to secure the vaccine for themselves in order to reduce the amount of time they must remain under restrictive protective measures and gain back some of the economic ground lost over the past year. As a result, we witnessed the emergence of vaccine nationalism as governments jumped into line to sign agreements with vaccine manufacturers to supply their own populations ahead of others.

Even before many of the vaccinations were approved, the United States, United Kingdom, European Union and others contracted for millions of doses with the UK and US taking more risk up front, which has been rewarded with vaccination rates in the 40% to 50% range and growing, while the EU remains mired at 23%. Others such as Israel, Serbia and the United Arab Emirates have vaulted even ahead of the US and UK, reaching levels near herd immunity by May of this year.

Amid the acrimony between the EU and manufacturers over lower than contracted deliveries, governments have had to make hard choices about which groups to prioritise for the first batches of vaccines.

But even as these vaccines have begun to be administered to people across the globe, a new phenomenon has emerged – vaccine tribalism.

In EU member states Greece, Italy and Spain, foreign residents, including EU citizens, are unable to make vaccine appointments since these nations require a national social security number in order to get the vaccine – and foreign residents are finding themselves unable to get this number. Legal foreign residents as old as 72 years old are still being denied the vaccine due to this technical gap and after months of the issue being raised, these problems remain unsolved. Meanwhile much younger citizen residents of these countries are getting the vaccine, undermining the logic of a risk-based approach to the rollout.

While the reasons for these non-citizen residents being barred from getting the vaccine are administrative, the lack of any workable solution is creating the perception that the reason may instead be vaccine tribalism.

In other places, it is more clearly a case of vaccine tribalism. In Kuwait, where 70% of the population are foreign residents who are relied on to run much of the country, they are not able yet to receive the vaccine. The same applies to large numbers of Palestinians in occupied territories who are unable to get the vaccine from the occupying power, Israel. This phenomenon of vaccine tribalism is similar to what we see in crises elsewhere when societies become more tribal when faced with the scarcity of a resource.

Meanwhile in places like the US, Russia and Serbia, people from abroad are flying in to receive the vaccine.

For Europe, this phenomenon has a corrosive effect on EU solidarity, the cornerstone principal of the free movement of people within the Union and the right to be treated on an equal footing with nationals of the host country.

At the same time, the slow rollout of the EU vaccine scheme is putting member state governments under fire for not ‘going it alone’ and enabling them to re-open their societies faster. All of these dynamics are providing fresh fuel for those who seek to create and widen divisions within the EU, hatching new EU sceptics along the way.

And it’s not just legal residents of the EU that have trouble accessing health care. Medicins du Monde, which runs street clinics in a number of EU countries, provides basic health care to those who can’t access care. According to their data, 20% of those that they see are in fact EU citizens who fall afoul of byzantine administrative procedures or can’t afford co-payments.

In addition, underneath all of Europe’s rhetoric of universal access to healthcare is that in many EU countries, undocumented migrants have no entitlement to care. In 2018, nine member states required payment even for emergency care.

There are, of course, consequences for this. Beyond emergency care, migrants or people with irregular paperwork can’t get care for chronic conditions, meaning their health worsens – causing unnecessary suffering and costing local communities even more in the long run.

Even if countries have made the political decision to provide vaccines to everyone on their territory regardless of a person’s administrative status, so long as administrative barriers remain in place, many will not receive the vaccine or be able to access other forms of health care.

To tackle COVID-19, we need to ensure that everyone has access to vaccination because the virus does not check passports as it spreads in our communities. Given concerns about vaccine hesitancy making it a greater challenge to reach herd immunity, effectively leaving out any number of inhabitants willing to take the vaccine is a recipe for prolonging the pandemic and the human cost that goes with it.

Article 35 of the EU Charter of Fundamental Rights states that “everyone has the right of access to preventative care and the right to benefit from medical treatment under the conditions established by national practices and laws.” There is no stronger case for breaking down the barriers to health care than the COVID vaccine campaign. This means changing the very national practices that exclude people from services that support their health and well-being.