France is overhauling its Covid-19 immunisation campaign after a cautious, phased strategy aimed at placating the world's most vaccine-sceptical population fell flat in its first week.
The country has only vaccinated some 350 people against Covid-19 to date – compared with the UK's 1 million and Germany's 238,000 – although the government has received 500,000 doses of the BioNTech/Pfizer vaccine and will get a similar amount each week in January.
The situation is piling pressure on president Emmanuel Macron and risks sparking another political fight over how the government has managed the Covid-19 pandemic. Opposition politicians have already criticised the government over how it bungled mask supplies and struggled to roll out mass testing last year.
Axel Kahn, a prominent French geneticist, at the weekend called the slow start to the vaccination campaign "a disaster" and blamed excessive government bureaucracy, while the National Academy of Medicine, a doctors' organisation, said there was "no more time to waste" given that about 300 people were dying of the virus in France each day.
The country's Covid-19 death toll is nearly 65,000 people so far. Despite two national lockdowns and ongoing restrictions, it has the highest case count in western Europe, according to Johns Hopkins data.
A reportedly angry Mr Macron has told his government that “things must change quickly and strongly and they will”, according to a Journal du Dimanche report on Sunday.
Changes to strategy
The government announced changes to its vaccine rollout strategy late last week, bringing forward the timetable for administering doses to healthcare workers aged 50 and older from the end of February to now. It also reversed an earlier decision to rely largely on family doctors to deliver the programme, with health minister Olivier Véran promising to open mass vaccination centres “before February”.
France had initially planned to focus first on vaccinating elderly people in care homes, who face the highest risk of death from coronavirus. But that posed logistical challenges, with care homes lacking the facilities to keep the BioNTech/Pfizer vaccine at the necessary ultra-low temperatures. Seniors were also to have a consultation with a doctor and a waiting period of at least five days before being vaccinated.
France had set a goal to vaccinate 1 million people by the end of February and up to 20 million in the first half of the year. The government and external advisers advocated a phased approach to allow regulators time to review additional vaccines and build public confidence.
Academic studies and polls have shown the French to be the most wary about vaccines of any country in the world, and especially worried about side effects. A 2018 Gallup-Wellcome Trust study showed one in three in France disagreed that vaccines were safe, the highest percentage in the 140 countries surveyed.
Philippe Juvin, who heads the emergency department at the Georges Pompidou hospital in Paris and is also mayor of a Paris suburb, criticised the government's strategy. "The changes announced are still very insufficient: we need to open the vaccination to a broader population now," he told the Financial Times at the weekend.
“Going slowly doesn’t build confidence – on the contrary, it supports the idea that there is something to worry about. All these excuses hide fundamental problems of preparation.”
Mr Juvin pointed to Germany, where some 400 vaccination centres were planned, and said France needed similar facilities as soon as possible. "Germany ordered specialised freezers in November and secured additional doses outside of the EU's joint purchasing agreement. Where are ours?"
Government defence
Government spokesman Gabriel Attal said on Sunday it was unfair to judge the vaccine campaign after only a week and that the government stood by the choice to start with older people in care homes.
The cautious approach appears to be backfiring. Only 40 per cent of French people polled by Ipsos last week said they planned to be vaccinated, down from 54 per cent in October and 59 per cent in August.
Vaccine wariness took root in France about 2009 after the H1N1 flu pandemic in 2009 was seen to have been badly handled, said Jocelyn Raude, a sociologist at EHESP, the French school of public health.
“The government is terrified of the anti-vaccine movement and has been scarred by the memory of the H1N1 failure,” he said. As a result, public messaging to date on the Covid-19 vaccine had focused too much on potential risks and unknowns and not enough on the vaccine’s benefits.
“There is a desire to be transparent and reassuring but they’ve gone too far with the precautions,” added Mr Raude.
Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, said she was "somewhat sympathetic" to France's approach given the "hypercritical" environment there.
“We should remember that how this is handled will be remembered by the public for better or worse. That should not at all be taken lightly in an effort to go as fast as possible.” – Copyright The Financial Times Limited 2021