Occupational physicians will be able to administer the vaccine against Covid-19 from Thursday, February 25. For the moment, only people aged 50 to 64 inclusive and suffering from co-morbidities (unstabilised diabetes, cardiovascular or respiratory pathologies, immunosuppression, cancer under treatment, kidney disease, obesity, etc.) will be eligible for the moment. The vaccination will be done on a voluntary basis, which means that a person refusing the vaccine can in no way be judged. “Unfit” at his workstation.
The vaccine that will be offered in this context will be that of AstraZeneca. It should be administered in two doses, with a gap of nine to twelve weeks. This vaccination will only concern a limited number of people because initially, companies will only be able to obtain a vial of ten doses. From March 1, they will be able to obtain 2 to 3 additional bottles.
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This vaccine should be stored at a temperature of 2 to 8 degrees. It can only be kept for 6 hours at room temperature. It is up to occupational physicians to ensure that they have the storage capacity or to schedule ten appointments in a row, so as not to lose a dose.
No individual notice
The press release from the Ministry of Labor announcing the opening of this vaccination channel specifies that occupational physicians will act “In strict compliance with the ethical rules related to medical confidentiality and the confidentiality of vaccinations vis-à-vis the employer”. This is indeed the problem posed by vaccination in the workplace.
To ensure this confidentiality, occupational physicians will not be able to summon individual employees. They can simply distribute the information to all staff. Employees who volunteer, and who meet the criteria, can make an appointment with their company’s doctor or the inter-company occupational health services on which they depend.
Confidential medical information
“The risk that an employer will be informed by this means of a chronic health problem of one of his employees remains low”, Judge Frédéric Guzy, Managing Director of Entreprise et personnel, an association providing companies with expertise in human resources management issues. “The medical files which are in the hands of occupational physicians remain confidential”, he recalls.
The risk that colleagues will be informed of the state of health of an employee can arise if several meetings follow one another too closely. It’s up to the doctors to make sure that doesn’t happen.
Concerned occupational physicians
For occupational physicians, in any case, this participation in the national vaccination effort will not be an entirely new role. They already contribute to influenza vaccination campaigns and can offer employees any vaccination “Related to occupational risks”, as indicated in a circular from 1998.
This possibility of vaccinating was especially requested by very large companies. They have been consulted by the government, as have the inter-company health services. The prospect of having to pay for this vaccination does, however, raise some reservations among occupational physicians: “We do not wish to become substitutes for general practitioners”, regrets for example the doctor Dominique Huez, vice president of the association Health and occupational medicine.
He wants to defend his specialty, at a time when the government is in the process, he judges, “To dismantle it”. A bill currently aims to change the role of occupational health services. It must give them greater responsibility in terms of prevention and public health and entrust part of their tasks to general practitioners.
Shortage of occupational physicians announced
For Doctor Dominique Huez, this is an evolution that ignores the role of occupational physicians. “If we are requisitioned to vaccinate against Covid-19, as was the case during the H1N1 flu epidemic, we will let it go. But our job is first of all to take care of health at work ”, he judges.
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The reform, however, is made necessary by the fact that the number of occupational physicians is tending to decrease. “By 2025, half of those who work in France today must retire”, notes Frédéric Guzy.
For employees who are candidates for vaccination, falling within the set framework, it will always be possible to choose to be vaccinated elsewhere. But going through their company’s health department can save them time, at a time when it is difficult to get an appointment.