In the last few days have been riots in several cities of Europe after mandatories measures against COVID-19. As a Medical Doctor and foreigner living in Czechia for two years, I can see the strong reluctance of a large proportion of the people to the COVID vaccine from a different angle.
In the local news, you can see the journalist asking farmers and domestic workers “why are you not taking the vaccine?” I see this as an intent to ridicule their answer. What a farmer or a domestic worker, randomly selected, poorly reflects the lack of understanding of the real problem.

I work in research on the prevention of cardiometabolic risk factors, and I came from a country (Venezuela) with a large primary health care system, that works very far from ideal, but it works. Arriving in Czechia, I proposed to my team and fellows that we should evaluate different strategies to increase the control of hypertension in the country, and I regularly asked “why a  well-organized country with all the resources only had a rate of control of 30%? why not 50% or 70%? Which are the main barriers related?” When I proposed to work with community health care workers as a strategy to increase the rate of control, the face of the people was like they were seeing an Alien. “We don’t have community health care workers here”, they said.
Then, designing another project about type 2 diabetes prevention, I suggested to a diabetologist to work in collaboration with the general practitioners to detect people with high risk for type 2 diabetes and implement the diabetes prevention program, again, the face “what the hell are you talking about?” was present.

When I asked about the registry of patients with hypertension and diabetes, and how they are locally distributed, the face appeared again. The ideas that I have do not fit into the current health care system. When I had the “brilliant idea” to attend to my general practitioner for preventive screening, it was out of his mind, why I was attending without pain, that my insurance is not going to pay for that.

Other comments that created the face of “I’m speaking with an Alien” were when I asked about the vaccination of children at the schools, the active search of cases, the story of nurses walking on the street vaccinating people house by house. All these components, which are a critical part of a primary health care system, are missing.
If on one hand you don’t have a primary health care system, and all the actions and education that implies, and on the other hand you constantly receive a message that «you are free to decide wherever» there will have a vulnerable scenario if something goes wrong and is needed the primary health care system. In this scenario, appeared COVID-19 and their need to get the people vaccinated very fast.

If a government is trying to establish preventive measures against the COVID-19, which requires the be implemented based on a primary health care system that currently has a lot of weaknesses, is creating a castle in muddy ground. Understanding this, you can see that asking a farmer or a domestic worker “what they don’t want the vaccine?” is futile.

We have so many things to learn from this pandemic, in case of this reflection, about the relevance to having a strong primary health care system in every country, a system that by good and recurrent actions increase the level of health literacy of the population and makes them less vulnerable to fake news.