Au compte-gouttes : France’s vaccine strategy

“Au compte-gouttes” means to dole out sparingly, and is the expression invariably used these days to convey the speed and scale of France’s vaccine rollout, which as of December 30 was 138 vaccinations. Woohoo!

Here’s how that compares to other countries in the EU:

Herd immunity from mass vaccination is currently the only feasible way to get out the Covid morass. The vaccine has been proven to be over 90% effective. Why is France waiting?

The official explanation

The official line is that the cautious pace is intentional, in order to get the consent and then vaccinate the most vulnerable, first at the EHPADs, followed by healthcare workers (but only those over 50 and with “risk factors”) as of mid-January.

This is what has been said by the Health minister, Olivier Veran, “Monsieur Vaccin” Alain Fischer and last night echoed by the government spokesperson, Gabriel Attal.

They all make a big point of emphasizing the complexity, as they are taking the vaccine to the EHPAD residents, not vice versa, implying that countries going faster (ie Germany) are frog-marching their elderly to giant vaccinodromes. Which is false.

(They also like to point to the dosage error that occurred in Germany. This affected a total of 8 people, with 4 needing hospitalization, out of 78 000 people vaccinated.)

Complex logistics are not a surprise

I’m not going to argue about complexity; the temperature constraints are well known. But it’s so well known that the question is why is it still being cited as a reason for the slowness?

Forget comparisons with the logistical-powerhouse next door: even tiny Romania has managed to vaccinate 20x more people than France so far.

But what really annoys me is implying that France is going above and beyond anywhere else to protect their elderly, when other countries are doing that too, just much faster and they are also allowing other groups to get vaccines, notably healthcare workers.

Healthcare workers are vulnerable too

Given the current facts:

• it’s the season of family gatherings from across the country;
• it’s the coldest time of the year and new studies confirm that cold, humid conditions are indeed ideal for Covid transmission;
• new cases are clearly on the upswing in 4 regions in the east half of France, even after factoring the ‘excessive testing’ done prior to Dec 24;
• we are stuck at a still-high plateau of hospital admissions and ICU occupancy;
• trained hospital and especially ICU staff is scarce in France, and they are exhausted after battling two waves in quick succession;
• There’s a 50% more infectious variant of Covid that’s been circulating in southeast England since at least September, and despite limited genetic sequencing capabilities in France, at least one confirmed case of this variant has already been found. Likely there are far more given the size of the expat communities on either side of the channel.

Doesn’t it seem prudent to assume there will be a third wave and that front-line hospital and emergency staff (even those young bucks under 50) are both vulnerable and essential and so should be among the first to get the vaccine too? Especially if they are in one of regions where the virus is circulating the fastest?

The conseil scientifique already warned the government on Dec 23.

Combatting vaccine-skepticism à la française

Also, the government is addressing France’s extreme vaccine-phobia (40% of the population willing to get the vaccine) with….paperwork!

First, there was an 45 page PDF to explain the campaign in EHPADs.

One of the key points is residents needed to first have a face to face interview at least 4 days before the hypothetical injection day in which to give their informed consent. Then another interview is required immediately before the jab, presumably to see if someone has changed their mind.

France is the only country with this consent process. The resulting forms will become yet another dossier.

In other words, rather than opting for a media campaign to win over the sceptics (nevermind provide a fast-track option for those who have no objections), the government has opted instead for CYA.

How they are overcoming vaccine-skepticism next door

Meanwhile, here’s what Italy—another vaccine-skeptical population, with only 60% are willing to be vaccinated— is doing:

Reasons for hope

This slowness, particularly relative to other EU countries, is alarming many infection and virus specialists in France.

The good news is the international vaccination numbers are readily available, and the media is picking up the outcry.

• The extremely articulate geneticist and president of League Against Cancer, Axel Kahn, gave a very passionate yet coherent argument yesterday in this interview.

• The most recent demand for picking up speed comes from the Académie de Médecine.

Emmanuel Macron is to give his traditional new year’s eve speech tonight. Let’s hope he announces a streamlined and more ambitious vaccination campaign!

Vivement la vaccination !