ANALYSIS: What lies behind the slowing of vaccination rates in France?

ANALYSIS: What lies behind the slowing of vaccination rates in France?
France hopes to vaccinate 40 million people by the end of the summer. Photo: Olivier MORIN / AFP.
Around 200,000 people received a first dose of the Covid-19 vaccine every day in France last week, half as many as a month ago. What’s the reason for the fall off, and should we be worried?

After a slow start, France’s vaccination campaign finally seemed to be hitting its stride earlier this month – daily injection rates were regularly hitting 600,000 or 700,000 and all adults, plus children over 12, are now eligible for the jab.

But although overall daily injection rates remain high, recent weeks have seen sharp drop-off in first injections and a return to unfilled appointments at vaccine centres across the country.

On Thursday June 24th, the French health ministry reported 236,000 daily first doses, compared to 455,000 on Thursday June 3rd. Total vaccinations remained more stable at around 700,000 as large numbers of people received their second dose.

This takes the number of people who have received a first dose up to 33 million, or 48.8 percent of the French population. 20 million people are now fully vaccinated (29.8 percent of the population).

“It’s still not sufficient,” Prime Minister Jean Castex said on Thursday, during a visit to the Landes department where authorities are anxiously monitoring the spread of the Delta variant of Covid.

READ ALSO Is France facing a wave of cases of the Delta variant of Covid?

Addressing young people in particular, Castex added: “Be afraid of the virus; above all, don’t be afraid of the vaccine.”

So what’s causing the drop-off and exactly how worried should France be?

Complacency

With cases in France plummeting to around 2,000 per day, the government has relaxed many restrictions ahead of schedule and a general air of optimism prevails.

Children over 12 can now be vaccinated in France. Photo: GEOFFROY VAN DER HASSELT / AFP.

Jocelyn Raude, an associate professor in social psychology at the Ecole des Hautes Etudes en Santé Publique (EHESP), says that a sense of optimism has led to complacency.

“When there is a rise in cases and deaths, people are better at respecting public health rules… The fall in circulation explains the lower rate of vaccination,” Raude told The Local.

“It’s now the people who are most scared of getting vaccinated [who are left]. They are weighing up the risks and benefits.”

With the health situation visibly improving, and restrictions being lifted, many people no longer believe the added protection provided by the vaccine is worth risking potential side-effects.

In the large Saint-Quentin vaccination centre outside of Paris, only 30 percent of available appointments are taken up, and weekly injections have fallen by half, meaning the operation could be moved to a smaller location, according to BFMTV

France is not the only country whose vaccination campaign is beginning to lose momentum. In the United States, daily jabs fell by almost half in May after peaking in April.

It was “completely expected” the vaccination campaign would eventually slow down, according to Raude. “When we look at medical innovations, the uptake follows an S-shaped curve.” At the beginning, there is a burst of enthusiasm, and then things begin to plateau as you are left with people who are less motivated.

“We’ve reached a ceiling with about 20 percent of over 75s who are not vaccinated and don’t wish to be, and 25 percent of over 65s,” said Raude.

“I think we will have around 30 percent of over-50s, and 40-50 percent in the youngest groups [who will not be vaccinated]. If we are able to vaccinate half of under-45s, that will be good.”

Holidays

France is approaching the months of les grandes vacances – the summer holidays in July and August that traditionally see many businesses shut up shop and even government agencies work at a much slower pace.

Local health authorities in Paris have already announced that some vaccine centres will close over the summer, anticipating that many people will be away from the city.

To attempt the counter the ‘holiday mood’ that could be leading some to put off their vaccines, the government recently changed the guidelines so that the second dose could be given any time between three and seven weeks after the first, in the hope that this would encourage people to get vaccinated before going on holiday.

Meanwhile some holiday areas are preparing to increase their offer. “It is certainly conceivable to receive your second or even your first injection at your holiday destination,” Dr Sylvie Quelet of Nouvelle Aquitaine’s regional health authority told The Local. “The coastal departments, and particularly Landes, have changed the distribution of their centres to move them closer to the coast.”

Despite these preparations, the government is still advising people to receive both jabs in the same vaccination centre whenever possible.

Anti-vaxxers?

Much was made at the beginning of the year about vaccine hesitancy in France, and whether the slow roll-out was a result of a population vehemently opposed to vaccines. But Françoise Salvadori, a biologist and co-author of Antivax, a history of the anti-vaccination movement in France, believes this is not the reason for the current slowdown.

“I don’t think we’ve arrived at a glass ceiling like other countries, such as the US and Israel,” she told The Local. “In France we still have a lot of room for growth.”

According to Salvadori, staunch anti-vaxxers make up no more than 15 percent of the French population, a relatively small proportion of those who are yet to take an appointment, although conspiracy theories remain a danger, and not just in France.

“Among young people, there is an unfounded rumour that it makes you sterile, which is spreading a lot on TikTok,” Salvadori added.

Antoine Flahault, Director of the Institute for Global Health at the University of Geneva, agrees, although he estimates the hardcore anti-vaxxers much lower, at around three percent of the population.

“There is a small section that’s anti-vax, and they will never be convinced,” he told The Local. “Then there’s another category who have expressed doubts, and we need to convince these people.

“And the third category is those who are difficult to reach, or more excluded from society.”

Elderly people who struggle with technology and cannot book an appointment online, migrants, people who are illiterate, or have a disability and struggle to understand the public health messaging… these are all groups which the authorities will need to work harder to reach, according to the epidemiologist.

Authorities are also worried about the low uptake among healthcare professionals – 37 percent of hospital workers and 45 percent of care home workers are yet to receive an injection, according to LCI, which has led to calls to make the vaccine obligatory for health workers.

Getting the message across

A more targeted approach is required, according to Raude: “We need to go from a mass campaign to something more individualised; go looking for people who aren’t yet vaccinated, through their GPs.”

While authorities have already begun to adopt this strategy, it has not been enough to arrest the decline in vaccinations. “I don’t think it’s working very well, for a lack of will or organisation,” said Salvadori.

“Communication has been inadequate since the beginning, but now it’s becoming a serious problem,” added the biologist.

A long way from herd immunity

Flahault estimates that 80 percent of the population will need to receive their jab in order to be confident of avoiding another wave of infections. “For the measles vaccine, we reached 95 percent coverage. We are capable of vaccinating an entire population,” he said.

Public opinion has already come a long way since the beginning of the year, when polls showed that up to 60 percent of French people could refuse the vaccine. According to the most recent survey from national health agency Santé Publique France, 76 percent of adults said they had either received a jab already, or planned to do so.

“It’s a sprint against the variants,” Salvadori said. “We could maybe achieve 80 percent coverage in the Autumn, but that’s a long way away and gives the [delta] variant time to multiply.


Member comments

Become a Member to leave a comment.Or login here.