Article updated on February 15 with new statistics
France has repeatedly said that it is aiming to vaccinate every eligible adult “who wants it” by summer. But as new variants spread and health pressure stays high, will this really be possible? We explore.
On February 2, President Emmanuel Macron said that “all the adults who want it” will be vaccinated by the end of the summer.
Health Minister Olivier Véran even said that the country would have the capacity to vaccinate 70 million people by August 2021, “if all of the ordered vaccines are approved by world and European health authorities”.
Yet, France has received strong criticism for the slow rollout of its vaccination campaign. The country has so far vaccinated 2,249,685 with the first dose, and 633 771 with the second dose (from the latest figures to February 15).
In contrast, the UK has vaccinated 15,062,189 with the first dose - more than six times as many as France - and 537,715 with the second.
Germany is also far ahead when it comes to the second dose, having vaccinated 2,736,109 people with the first dose so far, and 1,410,239 people with the second.
A recent poll found that 68% of people in France doubt that all adults will be vaccinated by the end of the summer.
So are President Macron and Dr Véran’s promises realistic? Newspaper Le Monde has taken a closer look. We summarise and translate.
How many people does ‘all eligible people’ really mean?
This only applies to adults aged 18 and over, as there is no data on the efficacy of the vaccine in minors.
France has around 52 million inhabitants aged 18 and over, but not all of them will want the vaccine, as it is not mandatory.
The percentage of people in France who say they want the vaccine has risen considerably in recent months. In December 2020, health body Santé publique France estimated that 40% of the population would be in favour.
In January, further polls showed that this figure had risen to 56-58%.
Currently, the health ministry is working on the assumption that at least 60% of the adult population will seek a vaccination by the end of August. This is the equivalent of 31 million people.
In a statement, the ministry said that this figure could rise to 70%. It said: “We are anticipating several hypotheses, because we know that the number of people who want a vaccine is changing considerably.”
Are these numbers possible, despite vaccine delays?
According to the current vaccination calendar France is set to have received 78 million doses by the end of June - enough to vaccinate 41 million people. This is well within the targets set.
This figure depends on the future availability of vaccines that are not yet authorised for the European market - such as Janssen and CureVac. Should these be approved - and this so far appears likely - they are set to begin deliveries in April and May respectively.
The European Medicines Agency is set to greenlight the Janssen vaccine by March, said the executive director of Janssen Italy, the Italian branch of the US giant Johnson & Johnson.
CureVac, created by a German biotechnology lab, is set to have finished phase 3 of its clinical trials by spring.
France has already seen how much its figures depend on vaccine deliveries; in January, delays from the US lab Pfizer meant that 100,000 vaccine appointments were postponed. And in February, Moderna said that its deliveries would be 25% lower than planned, postponing its deliveries until March.
Dr Pierre Parneix, public health expert at the CHU Bordeaux hospital, and also part of the Pittet mission, a study which is evaluating the country’s management of the health crisis, told Le Monde: “Today, our strategy is simply a reflection of a lack of stock.
"We have stock for a week, so the organisation is under pressure. We have no [long-term] view; we cannot deploy massive vaccination strategies because we do not know exactly what we will have next week.”
Is France on track to hit its goals?
So far, France has vaccinated 3.3% of the total population, and 4.2% of the adult population. This puts France ahead of Belgium and the Netherlands, but behind the UK and Germany.
The different numbers mainly correspond to nations’ different strategies - such as the UK, which is working to administer as many first doses as possible while Germany has focused on administering the second dose almost as quickly as the first.
To achieve its objective of vaccinating 31 million people by August 31, France will need to vaccinate 330,000 people per day, six days a week.
This will require a significant increase in daily doses - by almost four times - as the current average is estimated to be at around 80,000 per day.
The health ministry is working to increase vaccination capacity by opening more centres and possibly introducing drive-through units.
In addition and in contrast to some other vaccines, the AstraZeneca vaccine does not require “super freezer” storage making it easier to transport - and to be administered - in towns, GPs, and pharmacies.
What is required for herd immunity?
Herd immunity is achieved when enough of the population is vaccinated to cause a total drop-off of the epidemic.
Samuel Alizon, director of research at medical research centre CNRS in Montpellier, has said that hypotheses for collective immunity against Covid vary from 40% at the most optimistic, to 80% at the most pessimistic.
As soon as the 40% threshold is reached - equivalent of 27 million people vaccinated - the epidemic risk will begin to recede.
But Professor Mircea Sofonea, infectious diseases specialist at the University of Montpellier, said: “This immunity at 40% cannot protect us against the resurgence of smaller epidemics, especially after travel periods such as during holidays where people mix.”
Whether France reaches its targets will also depend on how the vaccines respond to the spread of the virus and also new variants - which may mean that more people will need to be vaccinated to achieve the same level of immunity.
Similarly the vaccines are not designed to block Covid completely, but offer protection against severe forms of the illness.
Professor Sofonea said: “When we take this into account, we find that we will need one year to achieve a 40% immunity with real effectiveness, meaning no contagion.”
Will the new variants need three doses of the vaccine?
The vaccination strategy has become more complicated due to the arrival of global variants of the virus, including from the UK, Brazil, and South Africa.
Pfizer/BioNTech, Moderna, and AstraZeneca have all said that their vaccines are effective against the UK variant, which has been detected in France over the past few weeks.
However there are doubts over the effectiveness of the vaccines towards the other variants, especially that from AstraZeneca with the South African strain - although the World Health Organisation has recently continued to recommend it for all adults.
Mylène Ogliastro, vice-president of the French virology society la Société française de virologie, said: “The more the virus spreads, the more mutations there are, the more chances the virus will have against changes in the environment.
“We must develop the vaccine as best we can to stop the spread as much as we can.”
One such proposal includes the provision of a “third dose” of the vaccine, which could act as a booster and offer long-term protection.
Professor Sofonea said: “This could be the key to guaranteeing long-term protection, and we might finally see the end of the tunnel and return to our pre-pandemic lives.”