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HEALTH

Why Belgians, Italians, Spanish, and Swiss are coming to France for monkeypox vaccine

Hundreds of Europeans have crossed borders for the monkeypox vaccine, sparking calls to address a gaping inequality in access to doses between nations.

Why Belgians, Italians, Spanish, and Swiss are coming to France for monkeypox vaccine
A pharmacist administers a dose of Imvanex, a vaccine to protect against Monkeypox, at a pharmacy in Lille, northern France (Photo by FRANCOIS LO PRESTI / AFP)

The current outbreak began in Europe in May, when the virus began spreading rapidly outside areas in Africa where it has long been endemic.

The virus, which is rarely fatal but can cause extremely painful lesions, has overwhelmingly affected men who have sex with men, some of whom have sought to swiftly get vaccinated.

However some countries have had much larger and quicker rollouts of the only approved vaccine for monkeypox, a smallpox jab produced by Danish firm Bavarian Nordic and marketed in Europe as Imvanex.

Belgium, for example, has just 3,000 doses, which are only available to LGBT sex workers, men who have sex with men with sexually transmitted infections or HIV, and some rare contact cases.

But neighbouring France has far more doses. While the exact number is unknown, more than 53,000 doses have already been administered in the country.

READ MORE: France opens monkeypox vaccinedrome

During the European summer many Belgians have popped over the border to get a jab.

Pharmacist Virginie Ceyssac said that 30 to 40 percent of those who had been vaccinated at her Aprium pharmacy in the northern French city of Lille were Belgians.

‘Very warm’ welcome

Samy Soussi of the Brussels-based HIV association ExAequo said that “thanks to word of mouth, we knew that it was possible for Belgians to be vaccinated in France”.

ExAequo even contacted Lille’s vaccination centre to organise carpooling for Belgians to attend a jab rollout day on August 6.

“444 Belgians were vaccinated that morning,” Soussi said, adding they were given a “very warm” welcome.

Around 90 percent of those vaccinated on the day were from Belgium, Lille’s town hall told AFP.

The Hauts-de-France region’s health agency said that its vaccination centres are asked to “respond favourably to requests from Belgian border residents, provided that it does not affect access to vaccinations for the French”.

In France’s capital, vaccinations have also been available for people from outside the country.

“Foreign tourists have taken advantage of their trip to get vaccinated,” said Checkpoint Paris, a sexual health centre dedicated to LGBT people.

However on France’s southern borders, Italians and Spaniards have been very much in the minority for vaccinations, according to local HIV organisations.

Switzerland meanwhile has had zero vaccine doses of its own, though the government bowed to growing criticism by announcing on Wednesday that it would buy 100,000 doses.

Lacking any local doses, “some people have gone to France to get vaccinated without any problems, but others have been refused,” said Alexandra Calmy, head of the HIV unit at Geneva University Hospitals.

Thomas, a 32-year-old in the Swiss town of Montreux, told AFP he spent a fortnight trying to get a vaccination appointment in France.

He eventually managed get an appointment in the eastern French city of Besancon.

“I’ve taken a day off work, I’m going to rent a car and drive,” he said.

‘Expensive and unfair’

A vaccination centre in the French Alpine town of Chambery in the Savoie department refused to give him an appointment.

“We only take people who live in Savoie,” local doctor Silvere Biavat told AFP.

The centre has been “overwhelmed with calls from Swiss people” and has had to turn them away due to a lack of resources, he added.

The French health ministry’s DGS directorate said it was up to vaccination sites whether they administer doses to foreigners.

After being denied an appointment in France, Sergio, a 41-year-old who lives in Geneva, looked farther afield. First he tried in his native Portugal, then in the United States, before finally getting an appointment in London.

“I paid almost 600 euros for a last-minute flight from Geneva to London,” he said.

“It’s expensive and it’s unfair because not everyone can do this… but everyone is afraid” of monkeypox, he said.

The inequality in access has spurred organisations and healthcare professionals across Europe to call for new diplomatic agreements for doses to be shared with countries in need.

“It is not logical that countries like France, Germany and the Netherlands have a great number of the vaccines” while countries like Spain — one of the world’s worst-hit countries — only has 17,000 doses, said Toni Poveda, director of the Spanish HIV organisation CESIDA.

Marc Dixneuf, head of French group AIDES, said that “epidemics don’t pay much attention to borders”.

“What we want is a concerted response at the European level, within the World Health Organization and not just European Union — because we have to include Switzerland,” he said.

French health authorities said they are in contact with Belgium and Switzerland to discuss cross-border monkeypox vaccinations, including financing.

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HEALTH

Children under five eligible for Covid-19 vaccinations in France

French health authorities have launched a campaign to vaccinate children under the age of five in certain high-risk groups against the Covid-19 virus.

Children under five eligible for Covid-19 vaccinations in France

According to reporting by Le Parisien, France’s public health body (the DGS) sent a message out to health professionals on Thursday night informing them that they had launched the campaign for children under the age of five in certain risk categories to be vaccinated against the virus.

The French medical regulator (HAS) had previously recommended that certain groups of children in certain high-risk groups – such as those with serious illnesses or those living with an immunocompromised parent – be vaccinated from the age of six months.

Previously those children could be vaccinated in hospitals and specialised centres, but starting on Monday, January 23rd, children under the age of five who are eligible for vaccination against Covid-19 will be able to be vaccinated by a doctor, midwife or nurse.

READ MORE: Paxlovid and vaccines: The latest Covid advice from the French government

The HAS released a list of conditions that would make children under the age of five eligible for vaccination, including;

  • Liver disease
  • Heart and respiratory diseases (including severe asthma requiring continuous treatment)
  • Neurological diseases
  • Primary or drug-induced immunodeficiency
  • Obesity
  • Diabetes
  • Hematologic malignancies
  • Sickle cell disease
  • Trisomy 2
  • Children who live in the same environment as an immunocompromised person

France’s decision to authorise vaccination for certain young children came after several other countries, such as the United States did so.

According to L’Obs, babies “under one year old accounted for 70 percent of hospitalisations for children aged 0-17 years old and 84 percent of critical care admissions.”

When authorising children under five for vaccinations, the HAS noted that so far “no deaths, cases of myocarditis or pericarditis have been reported in the various studies conducted.”

How to vaccinate your child 

First, you must verify whether your child under the age of five is eligible for the vaccine by checking the list of high-risk groups above.

Next, you should consult your child’s doctor, as a prescription will be necessary for them to be vaccinated. 

Both parents must agree to the child being vaccinated by filling out the authorisation form HERE, according to the DGS. 

The vaccination schedule will differ for children under the age of five. They will be given a lower dose of the vaccine – specifically the Pfizer-BioNTech shot – and it will be delivered in three total injections, rather than two. 

The interval between the first two will be three weeks, and the interval between the second and third jabs will be at least eight weeks.

Even if the child has had Covid, “all three doses should be given, to ensure optimal protection,” the DGS told medical professionals, according to Le Parisien. However, if the child becomes sick with Covid-19 during the vaccination schedule, it can be revised so that there is an interval of at least three months from infection and vaccination.

According to the HAS, citing data from a clinical trial conducted in the first half of 2022, three doses of the vaccine was 80.3 percent effective against symptomatic infections “in all age groups from 6 months to 4 years with no history of infection.”

What about kids over the age 5?

All children aged five to 11 have been eligible for Covid-19 vaccination since December 2021 in France (children aged 11 and over were already eligible). Despite this eligibility, only about five percent of children in this group have been vaccinated, giving France one of the lowest levels of vaccination for young children in Europe. 

While Covid-19 represents a greater risk for older children and adults, according to L’Obs, severe illness and death can also occur in children. 

READ MORE: Can anybody in France now get the latest Covid booster vaccine?

As of January 20th, the French government still required that children aged five to 11 have both parents or guardians (if both have legal parental authority) provide authorisation prior to vaccination against Covid-19.

Prior to being vaccinated, there will be a pre-vaccination medical interview (on-site) where the medical professional will ensure that the child does not have any conditions, answer any questions the child or parents may have, and finally provide a prescription for the vaccination.

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