Leading French doctors have been asked whether the country should extend the vaccination campaign to the entire population earlier than planned, as thousands of doses of the AstraZeneca jab are going unused.
It comes as a vaccination centre in Nice - which had been scheduled to stay open all weekend to vaccinate people aged 55 and over - closed at lunchtime on Saturday, due to a lack of booked appointments for the AstraZeneca vaccine.
Benoit Huber, prefect director of the Alpes-Maritimes, said: “We only had 58 people who showed up this morning, out of 4,000 doses available.”
The early closure can be partly explained by late communication that the centre was operational, but is also said to be linked to the public’s fears over the very rare thrombosis side-effects of the AstraZeneca jab.
President Emmanuel Macron has also admitted “difficulties convincing people on AstraZeneca”, even as he celebrated the country having almost administered 18 million doses of the vaccine (April 20).
During a weekly vaccine meeting at the Elysée, Mr Macron said: “We have had difficulties convincing people on AstraZeneca; we must think about communication and our ability to convince. If we want [our vaccination campaign] to continue to improve and last, it is true that we must improve take-up [of the AstraZeneca vaccine].”
But he said: “Last week, we saw 2.5 million doses injected, the highest ever seen in one week.”
The government has always said it is aiming to have given 20 million first jabs in France by mid-May, and judging by the current numbers, it appears to be on target.
At the time of writing, France has given 12,766,311 first doses; 4,679,521 second doses; and 19,877,325 doses of vaccines in total.
But with more deliveries of the AstraZeneca jab expected next week, and existing doses continuing to build up, some have suggested that France should open the vaccination campaign to every adult who wants it, regardless of age or health condition.
On April 18, vaccination in France opened to certain professionals aged 55 and over - such as teachers and law enforcement.
On Saturday April 24, AstraZeneca appointments will also open for people aged 55 and over in other public professions, such as refuse collectors, bus drivers, delivery drivers, funeral workers, security staff and retail workers.
‘Vulnerable population first’
The idea to extend vaccination across the entire population - by offering “spare” AstraZeneca jabs to anyone who wants one - has been met with reticence from some doctors.
Dr Martin Blachier, epidemiologist and public health doctor, told La Dépêche: “First of all, right now we do not have the necessary doses to vaccinate the entire population.
“We have seen that even in countries that have no stock limits, it is practically impossible to vaccinate the entire population. Several studies have been done, and it seems that a glass ceiling exists, around 70%, of people who accept vaccination, which is very difficult to exceed.
“Obviously, this ceiling depends on age, but even among those that we might consider high risk, so those over 65, the threshold of 70-75% of vaccination coverage is difficult to exceed.”
Dr Blachier said instead that it was more important to vaccinate the entire vulnerable population.
He said: “Even 5-10% of this category not being vaccinated represents too many patients, who could be hospitalised, when compared to our intensive care capacity.
“The real question on vaccination is how can we vaccinate 100% of people who are vulnerable, and not how can we vaccinate the entire French population. It’s more important to vaccinate 100% of the vulnerable population than 70% of the entire population.”
‘Vaccination by age not so important’
But Professor Pascal Crépey, expert epidemiologist, said that with some vaccines, vaccinating by age group was not as necessary as one might think.
He said: “Several studies are starting to show that when we have a vaccine that protects at 80%, such as the mRNA vaccines, vaccinating in order of age is much less important...to make a strong impact on the epidemic.”
Professor Crépey explained that this could mean that vaccination strategies could change, and open up to younger people more quickly.
He said: “It becomes pertinent to vaccinate - as well as people who are vulnerable - people who are at risk due to their work, because they are in contact with a lot of people, and at risk of infecting a lot of people.
“At the beginning, there will be a strong demand from the most motivated people, and then the rhythm will slow down. It is therefore important [for the country] not to slow down, and extending the vaccination recommendations will allow us to maintain a sustained vaccination rhythm.”
Despite the excess vaccination doses sitting unused in fridges across France, currently there are no definite government plans to extend vaccination to the entire country.
Christelle Akkaoui, ministerial health advisor to Work Minister Elisabeth Borne, said: “The priority criteria are still age and underlying conditions. We do not plan to extend the age criteria at this stage.”