Reader question: How can people who cannot be vaccinated use France’s vaccine pass?

With a vaccine pass required for a range of everyday activities in France including visiting bars, cinemas or going on long-distance train trips, what is the situation for those who cannot be vaccinated for medical reasons?

A doctor fills a syring with an anti-Covid vaccine.
A doctor fills a syring with an anti-Covid vaccine. In France, some people can obtain a medical exemption to vaccination and continue using the health pass. (Photo: Fred Tanneau/AFP)

Question: I have a serious medical problem that means I cannot be vaccinated, does that mean I have to accept having a severely restricted lifestyle in France for the foreseeable future?

The French government has been clear since it introduced the health passport that one of the goals is to push people into getting the vaccine, by making life more complicated for the unvaccinated.

This will become stricter when France’s health pass becomes a vaccine pass, with no option for the unvaccinated to get tested instead.

The general principle is that activities like working (with the exception of certain professions), commuting or visiting shops do not need a health or vaccine pass, but for anything fun like getting dinner and drinks with friends, going to the theatre or cinema or getting a train to another part of France, the pass is required. 

But what about those who might want to be vaccinated but cannot for medical reasons?

The Decree that enshrined the health passport into law back in the summer does contain provision for those who cannot be vaccinated.

It is possible to obtain a certificate from your doctor declaring your status as unvaccinated for medical reasons – but only if you fit one of the conditions outlined in the decree.

Those who fit these criteria can obtain an attestation de contre-indication from their doctor.

The decree introducing the vaccine pass adds some detail to this.

Individual doctors can issue an attestation de contre-indication if the patient fits one of the listed criteria below. The patient then sends the attestation to Assurance Maladie, who check the conditions and then issue a QR code that can be scanned into the Tous Anti Covid app and uses as a vaccine pass in order the access bars, cafés etc. 

The conditions outlined by the decree to qualify for this are;

  • A documented history of allergy to one of the components of the vaccines
  • Anaphylaxis of at least grade 2 after the first dose injection
  • A documented history of capillary leakage problems
  • History of pediatric multi-systemic inflammatory syndrome after suffering from Covid
  • A recommendation following a multi-disciplinary medical consultation not to administer a second dose following a severe reaction to the first dose eg myocarditis, Guillan-Barré syndrome

There are also some conditions that have a temporary medical contra-indication

  • Treatment with anti-SARS-CoV-2 monoclonal antibodies
  • Myocarditis or pericarditis that occurred prior to vaccination and is still evolving

For people with severely compromised immune systems, such as cancer patients, the general advice is to get vaccinated, and many have been given an extra dose of the vaccine – in addition to the booster – to ensure adequate protection.

Pregnant women are advised to get the vaccination since there is increasing evidence that pregnant women are more likely to develop the most severe forms of the virus – pregnant cabinet minister Olivia Gregoire was  vaccinated live on TV by her colleague Olivier Véran in order to highlight the need for mothers-to-be to get vaccinated.

This article is not intended as a substitute for medical advice – if you are in any doubt about whether you should get vaccinated, or have concerns about side effects, you should of course consult your doctor.

Member comments

  1. Hi — I’m in the US, traveling to Paris in early September. On Aug. 10, I emailed the signed form, passport, CDC vaccination certification, etc. to the email address provided in your article and by my hotel in Paris in order to get uploaded into the health pass system. I immediately received a computer generated response saying my email and attachments had been received, but nothing since. Anyone with anything to share on them actually getting back with the health pass QR code and all that? Thanks. Jeff

    1. I don’t believe they’re processing health pass QR codes via email anymore. Your best bet is to visit a pharmacy upon arrival, and have them convert your CDC-issued vaccine card into a QR code, which you can then upload into the TousAntiCovid app. The entire process took less than five minutes for us at our local pharmacy in Nice, FR.

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Vaccine pass for visitors in France – your questions answered

France now has in place a vaccine pass that is required for entry into a wide range of everyday venues including bars, cafés, tourist sites and long-distance trains - but this can be complicated for visitors or people vaccinated outside France.

Vaccine pass for visitors in France - your questions answered
Bars and cafés are among the French venues that require a vaccine pass. Photo: Sameer Al Doumy/AFP

Since January 24th, France has put in place a vaccine pass which is required to enter a wide range of venues including bars, cafés, restaurants, gyms, leisure centres, cinemas, theatres, museums, large events and long-distance trains.

In short, if you intend to spend time in France, you are going to need one if you want to do anything fun.

Previously a health pass was in place, which allowed for either proof of vaccination or a recent negative test, but from January 24th negative tests are no longer accepted for anyone aged 16 and older.

You can find more details on how the pass works HERE, but there are some issues which particularly affect tourists, visitors or people vaccinated outside France.

Do I need a vaccine pass to enter France?

No. When the French government talks about the vaccine pass, they mean the domestic pass required to access everyday activities in France.

Depending on where you are travelling from, you may need to show proof of vaccination at the border, but this can be a vaccination certificate from your home country.

Once you’re in France, however, you will most likely need the pass. 

How do I get a vaccine pass?

The vaccine pass isn’t a physical document, it just means that you need to show proof of either vaccination, recent recovery from Covid or a medical exemption in order to enter certain venues (more on those below).

Importantly, however, these documents must have a French QR code so that staff in venues can scan them.

Most people use the TousAntiCovid app, which is available on all smartphones and has an option in English, but you can show paper certificates if you prefer.

If you are travelling from an EU or Schengen zone country you can use your own country’s domestic health/vaccine pass, since all QR codes are compatible within the bloc.

I had a health pass when I came to France in the summer, is the vaccine pass the same thing?

In effect, yes. The health pass required either proof of vaccination, proof of recent recovery from Covid or proof of a recent negative Covid test and most people used the TousAntiCovid app to show this (although you can also show paper certificates).

The vaccine pass doesn’t allow presentation of a negative test result, but in most other respects is the same, so if you have proof of full vaccination, nothing changes for you. Apart, that is, from boosters . . .

Do I need a booster shot to use the vaccine pass?

Probably, yes.

It depends on when you were vaccinated, but over 18s who have not had a booster more than seven months after their second dose are no longer counted as fully vaccinated. 

From February 15th, this window shrinks to four months.

If you have had the booster, it doesn’t matter if the gap between second dose and booster was longer than four or seven months, this concerns only those who have not received a booster shot.

The booster requirement applies to all vaccine pass users, including visitors.

However boosters are not required for travel, so in brief you can enter France without a booster, but you won’t be able to do much once you’re here.

Full details on who needs a booster HERE.

Will my vaccination certificate/booster shot certificate work with the French pass?

It depends on where you were vaccinated.

If you were vaccinated in the EU, Schengen zone or UK then you can scan the QR code on your vaccination certificate straight into the French app. This is also the case if you previously had a health pass and need to add a booster shot in order to keep it valid.

If, however, you were vaccinated in the USA, Canada, Australia or any other non EU/UK/Schengen country then things are a little more complicated. Once in France, you will have to take your vaccination certificate to an approved pharmacy in order to get a QR code that can be used with the French app. Full details HERE.

A vaccination certificate from your home country will be accepted at the border.

I’m not vaccinated but I have recently recovered from Covid, can I use the pass?

The vaccine pass requires one of three things; proof of full Covid vaccination, proof of recent recovery from Covid or proof of a medical exemption (more on that below).

However, the proof of recent recovery must be in an accepted format.

You can find full details on that here, but again it depends on where you tested positive for Covid. If it was in the EU, UK or Schengen zone then you should be able to upload your positive Covid test to the French app. The test must be more than 11 days old, but less than six months old in order to be valid.

If you tested positive outside the EU, you may have a problem. Some countries provide positive tests in a format recognised by France but others – including the USA – do not.

You can find full details of compatible codes HERE.

I had Covid before I could get a booster, what should I do?

If you want to use proof of recent recovery from Covid instead of a booster shot, then it’s the same process as outlined above.

I can’t be vaccinated for medical reasons, what can I do?

France does provide an option for medical exemptions, but the process is so complicated as to be virtually inaccessible to people who are just visiting France.

READ ALSO How can people who cannot be vaccinated use France’s vaccine pass?

In order to use the medical exemption clause, you require a French certificat de contre-indication, and getting one of these is not easy.

First you must fit the criteria of listed medical conditions which constitute an acceptable reason not to be vaccinated – and that is a short list.

Then you need a certificate from a French doctor stating that you cannot be vaccinated, certificates from doctors outside France are not accepted.

Once you have the certificate you need to send it to Assurance Maladie – the French state health insurer – which validates the certificate and issues you with a QR code that can be used with the vaccine pass. French residents can use an online process to send their certificate to Assurance Maladie, but this requires a French social security number. 

Where can I go without a vaccine pass?

The theory behind the vaccine pass is that people can do the essentials of daily life without it, but anything fun requires the pass.

It is not required for shops, short-distance transport or city public transport such as the Paris Metro, most workplaces, parks, beaches and outdoor gyms or when buying food or drink to take out.

It is required for; ski lifts, bars, restaurants, cafés, cinemas, theatres, museums, galleries, tourist sites (including outdoor sites), gyms, leisure centres, sports grounds, concerts, nightclubs (when they reopen), large events like festivals or long-distance train travel.

Are there any exemptions?

There are a couple of exemptions where a negative Covid test, taken within the previous 24 hours, is accepted instead of a vaccine pass.

  • If you need to travel on a long-distance train and have “imperative reasons of a family or health nature” such as going to visit a dying relative – you would need to present some proof of this.
  • A vaccine pass is required to access non-emergency medical treatment or to visit a medical or social establishment (such as a nursing home). If you do not have a vaccine pass you can use a negative test instead. Emergency medical treatment does not require a vaccine pass or a Covid test.

What about children?

  • A vaccine pass is required for anyone aged 16 or above.
  • Children aged between 12 and 15 are required to use the health pass, in which a negative Covid test no more than 24 hours is accepted for those who are not fully vaccinated.
  • Under 12s do not require any type of pass.

The definition of fully vaccinated for children is the same as for adults; to be at least seven days after two doses of Pfizer, AstraZeneca or Moderna vaccines or 28 days after a Johnson & Johnson vaccine. Booster shots are not required for under 18s.

For children travelling from countries that have only recently started offering vaccinations to under 18s, or that only offer a single shot of Pfizer, AstraZeneca or Moderna, this creates a problem as the children are unvaccinated by the French definition and face daily Covid tests in order to keep the health pass.

Do all these venues really check the pass?

Staff at any of the listed vaccine pass venues are supposed to check the pass on entry, but as ever in life, compliance is not 100 percent.

The majority of places do check, especially in the cities, but it can be variable. We’ve also heard anecdotal accounts of staff accepting non-French vaccination certificates, especially the American CDC cards, but be aware that this is not official policy.

It’s probably best not to chance it on a train – guards can remove you from the train at the next stop if you are found to be travelling without a valid pass.

And if you’re tempted to use someone else’s pass in order to gain access to a bar/café etc then we would strongly advise against this – that is vaccine pass fraud and there are very stiff penalties in place for this, including jail time.

Do you have a question on vaccine passes that is not covered here? Email us on [email protected] and we will do our best to answer it.