Scientists in France fear that the country could hit a ‘glass ceiling’ when it comes to vaccinations, and that the current strategy may not be sufficient to achieve the necessary collective immunity.
The current campaign, which focuses on ‘speed and effectiveness’ will leave 20-30% of the population by the wayside, according to the health advisory body Académie de médecine and medical researchers.
The Académie does not have a say on public health policy, but often issues recommendations.
It said that those who could be missed by the current campaign includes people who are wary of vaccination, people who struggled to get an appointment the first time around, those who live far from vaccination centres, or in remote locations.
With the government so far ruling out making vaccination mandatory even for vulnerable or high-risk groups, French behavioural scientist Eric Singler has advised a series of public ‘adverts’ to encourage these people to have a vaccination.
The government has also worked to open vaccination to under-18s, and to shorten the delay between doses, to enable faster coverage.
But the Académie has warned that once the campaign hits a 70% saturation point, “the dynamism of the campaign will hit obstacles such as those who are hesitant and opposed to vaccination”.
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President Emmanuel Macron has repeatedly said he would prefer to “convince rather than constrain”, and believes that the more people see that vaccination is helping the situation, the more they will take up the offer of a jab.
He said on June 3: “People are seeing the facts and want to get back to normal life. Adherence [to the vaccinations] is climbing."
Yet, on June 17, Health Minister Olivier Véran threatened to make vaccination obligatory for people who work in elderly care homes, if the level of staff vaccinated does not rise.
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Professor Henri Bergeron, director of research at national research centre the CNRS, and professor at Sciences Po Paris, told the HuffPost: “Communication and theories of behaviour have a very central place in the government’s strategy.”
But, he added that by letting the decision for vaccination rest with the individual, Mr Macron could “risk missing” some of the deeper objections to it.
He said: “The deciding factors that determine access to care and prevention are extremely varied, and cannot be reduced down to the need to convince simple 'refusers'.
“We have known for a long time, for example, that prevention and medication work better among the more well-off sections of society.”
Socio-economic situation
Statistics show that vaccination coverage in France is linked to the general quality of life of the given population.
At the end of May, a collective of carers called Nos Services Publics (Our Public Services) published an open letter accusing the state of “turning a blind eye” to disparities caused by the vaccination campaign.
It said: “The centralised organisation is creating strong inequalities in access to vaccination. The choice to focus on fast and massive coverage has left the question of the profile of people vaccinated by the wayside.”
Figures from l’Assurance Maladie from May 23, 2021 show that people under 55 in central Paris were twice as likely to be vaccinated than the same age group in the less well-off department of Seine-Saint-Denis.
And only 52% of diabetic people in that area had received a vaccination by the same date, versus the national average of 66%.
Jérémy Ward, sociologist and researcher at health and medical research agency l’Institut national de la santé et de la recherche médicale (Inserm), which creates a monthly report on the public’s vaccination intentions for regional health agencies the ARS, said: “We are focusing far too much on the challenges of communication”, rather than the profiles of people getting vaccinated.”
The last report, in June, highlighted the importance of socio-economic status in those getting vaccinated, and said that the most reticent are often people with low education levels, or the unemployed, who are not familiar with the healthcare system, and who have not been severely affected by Covid, such as those aged 25-34.
The study also shows that sometimes people who struggle to get a vaccine do so not because they are unconvinced, but because they worry about how much time and effort it will take.
Since February, the government has been working on a vaccination campaign aimed at these most-vulnerable sections of the population, called ‘Aller Vers (Go Towards)’, with mobile teams going into communities to encourage the most reluctant to be vaccinated.
The campaign is now entering a ‘more massive’ stage, the ministry of health has said.
The statement reads: “The first mobile teams were deployed in February. We are now in a more massive phase, and the campaign is being deployed in each region as a function of its needs.”
But one anonymous member of the campaign told the HuffPost that this may not be enough.
They said: “Between the very poor, who will benefit from ‘Aller Vers’, and the middle classes, who will go to vaccination centres, there are enormous numbers of people. They don’t have much money, and they are not well-informed, and will not go onto Doctolib.
“Right now these people are being completely ignored by the campaign. We talk a lot about ‘anti-vaxxers’ but not enough about these access conditions to vaccination for everyone.”
The ARS has so far only allocated 50,000 doses to Aller Vers, a small percentage compared to the numbers required for mass coverage.
Inserm researcher Mr Ward said: “To increase vaccination coverage, we have to go and find people. This means mobilisation of health workers on the ground, and also those outside the health sector, such as social associations, local figures, parishes and mosques.”
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