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ANALYSIS: Why are French health workers so reluctant to get the Covid vaccine?

For many people in France, getting an appointment for the Covid vaccine would be a dream come true, but while health professionals all have access to a vaccine, only one third of them have so far got the jab. So why are France's health workers so reluctant?

ANALYSIS: Why are French health workers so reluctant to get the Covid vaccine?
A French nurse sets a Covid vaccine on an elderly person. Pascal GUYOT / AFP

France’s healthworkers have been able to get a vaccine since February 8th, but by the start of March only 30 percent of them had done so.

On Monday, emergency workers in the Bouches-du-Rhône département announced they would pause vaccination of firefighters and rescue workers with the AstraZeneca vaccine after one employee had an adverse reaction – this despite the health ministry deciding against suspending the AstraZeneca programme, saying the benefits of vaccination outweighed the risks.

“If you have not yet been vaccinated, do it quickly,” French Health Minister Olivier Véran wrote in a public letter addressed to the country’s health workers on March 5th.

Only 30 percent of them had by then received the Covid injection, according to the letter, despite it being available to health workers since February 8th. The number rose to 40 percent when looking solely at those involved in care of the elderly. 

“It’s not enough,” Véran said.

“Your vaccination is an act of protection. To protect yourselves . . . (and)  also your patients and the community.”

President Emmanuel Macron, dreading the economic, social and political consequences of a third nationwide lockdown, has gambled that the Covid vaccine would be the game changer required to avoid it.

But if hospitals cannot cope with the number of Covid cases – and already hospitals in the capital are cancelling surgical procedures – a third nationwide lockdown will be unavoidable.

On Tuesday, the National Academy of Medicine recommended making the Covid vaccine compulsory for health workers, who they said represented 34 percent of all Covid cases that originated inside the hospital or in other medical establishments.

So why won’t they get vaccinated?

“Conspiracy theories have massively affected the health care community,” Célestin-Alexis Agbessi, an emergency doctor at the Bichat Claude-Bernard Hospital in the north of Paris, told The Local.

A Covid reference hospital, Bichat is again on the brink of becoming overwhelmed with patients. Still, many nurses and other medical staff remained reluctant to get vaccinated, according to Agbessi.

“They don’t want to get vaccinated,” he said. “It’s not just here, it’s like that across France.”

France as a whole has been one of the most vaccine-sceptic countries in the world for the last 10 years.

A series of pharmaceutical scandals and public health policy errors sent the country’s confidence in vaccines plunging from around around 2009. Distrust in immunisation was one of the main reasons the government quickly discarded the idea of making the Covid-19 vaccination compulsory, fearing it could bolster anti-vaccine sentiments.

Sixty percent of the population said they doubted whether to get vaccinated against Covid in January. That number has since dropped, but remains relatively high compared to peer countries – even in the world of medicine and science. 

“We have a tendency to think that everyone in the health world agrees with the health authorities’ advice. That’s not the case,” Jeremy Ward, a sociologist who specialises in vaccine controversies, told Le Journal du Dimanche (JDD).

Nurses and care workers are the most reluctant to get the Covid injection, according to a Santé Publique France report published in February. While 89 percent of doctors said they intended to get vaccinated against Covid-19, only 44 percent of care workers (aides-soignants) and 68 percent of nurses said the same.

Graphic: Santé Publique France

“I’m waiting to get more information,” Marie France Boudret, a nurse at an elderly care home north of Paris, told the TV channel France 24 earlier this month.

Boudret wanted to “see how it goes” before getting injected herself, saying she worried about unknown long-term side effects.

This a commonly expressed opinion among vaccine-reluctant health workers. Of those doubting whether to get the vaccine, 66.2 percent said it was due to lack of information, according to a study by the GERES, a French research group focusing on health personnel. Nearly as many, 62.2 percent, said they worried about unidentified side effects.

Women are generally more hesitant to get vaccinated than men, according to several studies.

“We don’t have enough of a perspective yet,” Elodie Daulcle, a nurse in Paris, told JDD. “I ask myself: how is it possible that we discovered (the Covid vaccine) this quickly? Where is the scam?”

READ ALSO: Lockdowns and vaccine scepticism – how France and Italy are struggling to get Covid under control

AstraZeneca 

Healthworkers in France currently receive the AstraZeneca vaccine, while over 75s get Pfizer.

AstraZeneca was initially only licenced in France for under 65s, after the medical regulator said there was not enough data on its effectiveness for over 65s.

President Macron himself fuelled these doubts when he called AstraZeneca “quasi-ineffective” for over 65s, although the regulator has since licenced it for all under 75s after new test data.

READ ALSO: Why have three quarters of France’s AstraZeneca vaccines not been used?

But AstraZeneca remains unpopular among many health workers, who maintain that their high exposure to the virus merits access to what they perceive to be the “best” vaccine.

“(AstraZeneca) is suitable for the general population, but not for overexposed care workers,” Thierry Amouroux, a nurse and SNPI union spokesperson, told JDD.

“It’s a bit like the surgical mask: it protects everyone very well, but we need an FFP2,” he said, referring to the highest-grade protective face masks hospital staff in France wear.

‘From hero to zero’

Agbessi, the hospital doctor at Bichat, called this a “paradox”: vaccine-reluctant nurses and health care staff who rejected the AstraZeneca vaccine “are doing everything to get the Moderna and Pfizer,” he said.

One of the reasons had nothing to do with conspiracy theories, but was simply due to the fact that AstraZeneca has produced serious – albeit temporary and not dangerous – side effects in some people, particularly those who have already had the virus.

At least 149 health workers had by February 11th reported suffering from high fever following the injection, according to the National Agency of Medical Security (ANSM). Having to stay from home for several days due to high fever is something many want to avoid during a health crisis.

This was the reason Agbessi himself had not yet been injected – he tested positive for Covid in mid January and would have to await June to get his first and only AstraZeneca jab.

But short term side effects can only explain some of the reluctance, and the main reason seems to be a widespread, simmering distrust in health authorities that predates the pandemic, but grew in the months since. 

“I think many of them had a hard time understanding why they weren’t put first in the line for the vaccine,” Agbessi said, referring to the government’s strict priority list of vulnerable groups, which prioritised the oldest and most vulnerable first, although health workers were quickly added to the list.

“I’m caricaturing a bit, they went from hero to zero,” Agbessi said.

For months, people in France took to their balconies to applaud the healthcare heroes who were sacrificing themselves for the greater good. But back then France lacked protective gear and its stocks of face masks had run dry. Health workers later called out the way they had been treated, reiterating longstanding demands of increased salaries and better working conditions

READ ALSO: How do nurses’ salaries in France compare to the rest of Europe?

An increasing number of people have over the past few days spoken out in favour of making the vaccine compulsory to all health professionals. Several vaccines are already mandatory for this group: diphtheria, hepatitis B, tuberculosis, tetanus and poliomyelitis. The flu vaccine was compulsory until 2006.

For now, the government has chosen “dialogue and conviction,” said Véran, who is himself a doctor and received the AstraZeneca vaccine live on TV in an attempt to boost confidence.

After a visit to a vaccination centre in Pas-de-Calais, Véran said he was “convinced that the adherence rate among health professionals towards the vaccine will catch up with the general rate”.

He could be right: the trend seems to be a rise in the number of health professionals willing to get vaccinated. Back in December 2020, only 20 percent of care workers said they intended to get the Covid injection, less than half of the 44 percent registered a month later.

Ward, the sociologist, said making the Covid vaccine compulsory risked making matters worse.

“Making the vaccine compulsory is a solution that can only be used when you have tried everything else,” he said.

Member comments

  1. I can not see why health workers are not allowed to choose which injectable they want. Forcing anyone to take this unknown vaccine is against human rights. Several countries have for now stopped astra because of blood cloths, this might be coincidence or something fishy going on. I wonder about who exactly got the blood cloths, I pressume this were not the very old. When people are passed their life expectancy you think ‘that’s life, nobody lives forever’, when this are younger people it becomes another matter, especially after a vaccine with emergency approvement. Coincidence? cover up? mad countries who stopped vaccinations with astra? Time will tell……

  2. “A series of pharmaceutical scandals and public health policy errors sent the country’s confidence in vaccines”
    I wish the article extrapolated on this. It’s disappointing that the reasons for the French in particular to be skeptical of vaccines in general still have not been elucidated in this article.

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COVID-19

France scraps compulsory self-isolation after positive Covid test

France's public health body has outlined how Covid-19 rules will change on February 1st, including an end to compulsory self-isolation after a positive test result.

France scraps compulsory self-isolation after positive Covid test

Starting on February 1st, Covid rules will relax in France as the country ends compulsory isolation for those who test positive for the virus.

However, those travelling from China to France will still be required to agree to a random screening upon arrival and to isolate in the case of a positive Covid-19 test result. Travellers aged 11 and over coming from China must also provide a negative test result (less tan 48 hours) prior to boarding and those aged six and over must agree to wear a mask on board flights. These regulations – which was set to last until January 31st – is set to remain in place until February 15th.

The French public health body (The Direction générale de la santé or DGS)  announced the change on Saturday in a decree published in the “Journal Officiel” outlining the various ways the body will loosen previous coronavirus restrictions.

READ MORE: What Covid rules and recommendations remain for visiting France?

Those who were in contact with someone who tested positive – ie a contact cases – will also no longer be required to take a test, though the public health body stressed that both testing after contact and isolating after receiving a positive test remain recommended.

Previously, even asymptomatic people who had been in contact with someone who tested positive for Covid-19 were required to test on the second day after being notified that they were a “contact-case”.

These changes will take effect on February 1st.

READ MORE: What changes in France in February 2023?

The DGS also said that website SI-DEP, which records test results, will remain in operation until June 30th, however starting in February it will only collect personal data with the express permission of the patient.

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Additionally, the French government announced that sick leave procedures for people with Covid-19 will return to normal on February 1st – this means that those who test positive for Covid-19 will have the three-day wait period before daily sick benefits are required to be paid, as is usually the case. Previously, people with Covid-19 could expect daily sick benefits to begin at the start of their sick leave period (arrêt maladie in French).  

READ MORE: How sick leave pay in France compares to other countries in Europe

Covid tests are still available on walk-in basis from most pharmacies are are free to people who are fully vaccinated and registered in the French health system. Unvaccinated people, or visitors to France, have to pay up to a maximum of €22 for an antigen test of €49 for a PCR test. 

If you recently tested positive for Covid-19 in France – or you suspect you may have contracted Covid-19 – you can find some information for how to proceed here.

In explaining the changes that will begin in February, the French public health body also noted a drop in Covid-19 infections in the past month. As of January 30th, approximately 3,800 people in France had tested positive in the previous 24 hours for the coronavirus – which represents a decrease from the averages of 20,000 new cases per day about one month ago.

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