There are two effects that are needed to lower the actual temperature. One is the fact that temperature is the average kinetic energy, implying that some nuclei at this temperature would actually have much higher energy than 0.1 MeV, while others would be much lower. It is the nuclei in the high-energy tail of the velocity distribution that account for most of the fusion reactions. The other effect is quantum tunnelling. The nuclei do not actually have to have enough energy to overcome the Coulomb barrier completely. If they have nearly enough energy, they can tunnel through the remaining barrier. For these reasons fuel at lower temperatures will still undergo fusion events, at a lower rate.