Belgium's Prime Minister shares 4 lessons on how the European country is outpacing the US in vaccination rates

• Peter Vanham is head of the International Media Council and Chairman's Communications at the World Economic Forum.
• He recently spoke with Belgian Prime Minister Alexander De Croo about the country's success in the COVID vaccine rollout.
• "We wanted people to be motivated by our fight against the pandemic," De Croo said of his administration's efforts.

"When in doubt, look at Belgium," probably said no one, ever. But when it comes to reaching herd immunity against COVID, the European country that is home to both the European Union and NATO - and of course, Jean-Claude Van Damme - may in fact have some lessons to share.

Back in the Fall and Winter, the country's COVID strategy still looked like it was headed nowhere. Its death rate per capita was higher than almost any other Western country, and its vaccination campaign by mid March was lagging all the major European countries, and of course that of the US.

By the end of June, however, that picture got turned on its head. Belgium has barely any COVID patients left in its ICU beds, and it recently surpassed the United States and all other major European countries in terms of COVID vaccination. How did that happen, and can America learn from the experience?

Belgium treated the vaccination campaign as a marathon, not a sprint.

"We knew we would take off slower than other countries," the Belgian Prime Minister Alexander De Croo told me in a phone interview. "But we wanted to build a scalable campaign that could accelerate as deliveries started to pick up."

And that's also what happened. Belgium chose to only build 150 vaccination centres for its 11.5 million people, says government scientific advisor Sam Proesmans. That increased the distance people needed to travel to get their shot, but it did make it easier to distribute, store and administer large amounts of vaccine as they got delivered.

The country also did not close itself off from the outside world when deliveries got delayed. Belgium in fact is home to both Pfizer and AstraZeneca facilities, where hundreds of millions of doses were made. Like the US, it could have introduced a "National Defence Act", to protect its supplies.

But, the Belgian Prime Minister said, doing so would go against international solidarity and the country's commitment to free trade. "There's a reason pharmaceutical companies produce in Belgium," said De Croo. "It's because we are an export country. We want to maintain that position."

It tried to get as close as possible to a 100% vaccination rate.

Where some other countries quickly opened up vaccination to the general population, Belgium tried to get all vulnerable populations 100% vaccinated, before proceeding to others.

This included convincing vaccine skeptics, who had underlying conditions but nevertheless did not want the vaccine. But with a "warm, but professional" approach by doctors, nurses, and community workers, in some target groups up to 93% of people have gotten their shot.

That is important, the government's scientific advisor Sam Proesmans told me, because it's the old and the sick that need protection from the virus most, as they have the highest risk of ending up in ICU or dying from it. Protecting them fully was therefore a first-order priority.

And, De Croo added, it helped to get those waiting in line next to be convinced also. "There's no better promotion for vaccinations than word-by-mouth," he said. "If those who got the vaccine had a good experience, those coming behind them will want to get it too."

It never paused or wasted any doses.

Very early on, Belgium's corona task force decided to be guided mainly by science and numbers, not by sentiment. "We wanted to make rational decisions, not emotional ones," Proesmans said.

That meant, for example, vaccination with AstraZeneca and Johnson & Johnson vaccines continued, even as reports emerged of rare associated side-effects, such as thrombosis. Halting the vaccination even a few days, the task force calculated, would result in many more deaths than those that could happen because of the alleged side-effect. So it stuck to its guns.

Similarly, the country wanted to minimize waste of any vaccines, as they were the country's most precious good. A digitally managed reserve list was created in case some people didn't show up for their appointment.

That reserve list, QVAX, was enabled through a novel approach: Seaters, a start-up focused on filling sports stadiums last minute if people did not show, used its software now to set up a similar process for the empty "seats" for vaccination. CEO of Seaters, Jean-Sébastien Gosuin, told me in an email that by June, more than 200,000 "fans" had been vaccinated this way.

It made the fight against COVID a positive story, not a negative one.

"We wanted people to be motivated by our fight against the pandemic," De Croo said. So by Easter, the government switched from "negative" stats such as ICU beds and infections, to "positive" ones such as vaccinations.

"The faster you get vaccinated, the faster we'll be able to end the lockdown and restrictions: that became the message", De Croo said. That focus on the carrot part of the "carrot-and-the-stick" worked.

For senior citizens, seeing their grandchildren and going out again became a motivating factor to get vaccinated; for younger people, knowing they could travel again or go to concerts was equally motivating.

In the end, it all added up to the current state and outlook: Almost 60% of Belgians got at least one shot of the COVID vaccine, and at the current rate, herd immunity is in sight over summer. Belgium may not be top of mind often, but when it comes to COVID vaccinations, it turns out it does hold some lessons for others.