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Covid boosters and French health passes: what changes this week?

Booster doses will begin to become a mandatory element of the pass from Wednesday. We look at how they work to stimulate a refreshed immune response

The conditions under which people over 65 can access a French health pass will change on Wednesday (December 15) Pic: sylv1rob1 / Shutterstock

Booster vaccine doses will begin to become a compulsory part of the French health pass for over-65s in France from this week. 

From Wednesday (December 15), people in this age group who wish to “prolong the validity” of their health pass will have to make sure that they receive their booster dose within seven months of their second dose. 

If they fail to do so, their health passes will expire. 

The same applies to people who were initially injected with the single-dose Janssen jab. These individuals will have two months from the date of their first vaccine in which to get their booster. 

The French health pass is not required for entry into France from abroad, and is only needed for those already inside the country who wish to visit public spaces and services such as restaurants, cafés, bars, museums and long distance transport such as TGV trains.

Vaccinated people travelling France can continue to show their national vaccination certificates, and do not need to have had a booster dose in order to enter the country.

People vaccinated with Janssen become eligible for a booster one month after their first dose, while those who received other vaccines become eligible five months after their second dose.

This gives most vaccinated people an extra two months after they become eligible for the booster to organise and go to their appointment, and Janssen recipients an extra month.

On January 15, booster doses will gradually become an obligatory element of all adult health passes in France.

Each day around 400,000 people in France are receiving their booster dose, four times more than the number being administered one month ago.

Read more: Record 1.2m appointments made for boosters as rules change in France

The only vaccines being administered as booster doses in France are Pfizer-BioNTech and Moderna, although the latter is not being given to people under 30 due to a slightly increased risk of cardiac inflammation. 

Who is eligible for a booster dose? 

All adults who are resident in France can receive a booster vaccine dose as long as their other doses were received more than five months ago (or one month in the case of Janssen).

You are still entitled to the additional dose even if you have recently moved to France and are not yet fully integrated into the social security system. 

For example, if you have applied for your carte Vitale but not yet received it, you may have been issued with a temporary social security number which you can use to get vaccinated.

If you are concerned about proving that you are resident in France, you could take your visa, carte de séjour residence permit, proof of application for a carte de séjour and some recent utility bills with you.

Read more: Covid France: Can foreign residents get booster without carte Vitale?

What about non-residents? 

People who are not resident in France are not entitled to receive a booster dose in the country. 

However, if you are visiting from another country and have already received your booster, it is possible to integrate it into your health pass. 

People who received their vaccines in the UK, for example, will now see their third dose displayed in their NHS app Covid pass, whose QR code can be scanned into the French TousAntiCovid app to generate a health pass. 

Read more: UK-administered booster doses added to NHS app for travel

How much protection is offered by a booster dose?

As the name would suggest, the booster dose aims to ‘boost’ the number of antibodies in a person’s system, which begins to wane a certain amount of time after the second vaccine dose.

Between five and eight months after the second dose, the decline in antibody levels accelerates, which is why the booster is recommended around this time.

When a pathogen already known to the body is reintroduced through the booster, the immune system reacts by producing a surge of antibodies whose levels are estimated to be 10-12 times greater than in the weeks following the second dose. 

Jean-François Delfraissy, president of the official government advisory body on Covid, told the Senate on December 8 that the protection offered by two doses of an mRNA vaccine such as Pfizer and Moderna drops from 70-80% to 30% after five to six months. 

Read more: Third Covid dose vital, future doses may be needed, French senate told

Sandrine Sarrazin, Inserm researcher at Marseille’s Luminy science faculty, explained to 

Franceinfo that vaccination elicits a double-edged effect on our immune system. 

The injection of a vaccine causes the body to generate two different types of B cells, the white blood cells that create antibodies. 

“The first will produce antibodies immediately. The second, called the Memory B cell, will retain the blueprint of these antibodies and be stored in our bone marrow for later,” Dr Sarrazin said. 

By the third vaccine dose, the immune system will easily be able to recognise the Covid virus and the B cells will mobilise very quickly and produce a large amount of antibodies.

A recent study on booster efficacy carried out in Israel suggests that the third dose (or second in the case of Janssen) offers 93% protection against hospitalisation, 92% against serious illness and 81% against death.

It is, of course, also possible to generate this immune response by contracting Covid, but people then risk developing serious forms of the virus and/or long Covid symptoms.

How long does the booster protection last? 

It is not known for sure how long the booster dose immune response will last, but antibody levels are sure to decline gradually. 

However, if antibody numbers stabilise at a high enough level, the booster dose could continue to offer sufficient protection for several months. 

“Logically, the booster dose should be capable of providing an immunity which is much more durable than that offered by the first two doses,” said Claude-Agnès Reynaud, director of research and immunologist at the Institut Necker-Enfants malades.

“In my laboratory, we are following a cohort who had their third dose three months ago. Their antibody levels have declined but remain very satisfactory because they were coming down from a higher level,” added Olivier Schwartz, who leads the Virus and immunity department of the Institut Pasteur.

Will a fourth dose be necessary?

The potential for a fourth dose campaign depends on the protection which is offered by the third dose in the long term. 

Read more: Third Covid dose vital, future doses may be needed, French senate told

If it turns out that a variant such as Omicron resists the protection offered by the vaccine, a new vaccination programme using adapted doses may be necessary.

Pfizer-BioNTech has already stated that Omicron is “probably not sufficiently neutralised after two doses,” but that three doses offer better protection against it. Work is already underway to develop a “specific vaccine” against the new variant, which may be available from “March 2022.”

How can I book my vaccination appointment?

Eligible people can book their vaccination or booster appointment by: 

  • Calling the vaccination hotline on 0800 009 110 between 06:00 and 22:00 any day of the week

  • Calling your nearest vaccination centre using the list of numbers available on Santé.fr

  • Making an appointment with your GP or at your local pharmacy

  • Visiting the Doctolib platform

Related articles

Do over 65s need Covid booster jab to leave France from December 15?

Is it too late to get a French health pass if I get vaccinated now?

UK-France travel: Do I need three Covid jabs or three tests?

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