Vaccines

They have traveled miles and crossed borders: the monkeypox vaccination campaign has taken an unexpected turn in Europe where hundreds of people are going abroad in search of a dose, for lack of rapid access to the vaccine in their country.

In France, “Belgians, Swiss, Italians and even Spaniards” were thus able to be vaccinated once morest monkeypox, the Directorate General of Health told AFP.

In Paris, “foreign tourists took advantage of their trip to get vaccinated,” says Checkpoint Paris, a sexual health center. But the phenomenon mainly concerns the border regions.

In the north of France, in Lille, the vaccination sites thus saw the arrival in the middle of summer of many Belgians. “In proportion, we had to vaccinate 30 to 40% of Belgians”, assesses Virginie Ceyssac, pharmacist at the Aprium, one of the five pharmacies experimenting with vaccination in pharmacies in France.

Belgium, which currently only has 3,000 doses, vaccinates only a very limited public: homosexual or transgender sex workers, homosexual men who have had two STIs (sexually transmitted infections) in the past year or who have HIV, and rare contact cases.

Faced with this situation, Belgians excluded from these categories but belonging to populations considered to be at risk have decided to go to France.

Because the disease, if it is rarely fatal, is often very painful and the patients must put themselves up to three weeks in total isolation.

– “Word of mouth” –

“Thanks to word of mouth, we knew that it was possible to be vaccinated in France by being Belgian.

And since the border is not so far, people have started to go to Lille or to villages close to the border,” reports Samy Soussi, from the Brussels association for the fight once morest HIV Ex Aequo.

The Belgian structure contacted the Lille vaccination center, which held a “punch operation” on Saturday August 6, in order to organize the arrival of Belgians thanks to carpooling.

“We were 444 Belgians to be vaccinated that morning”, says Samy Soussi, who describes a “very warm” welcome from French caregivers. On this vaccination day, around 90% of those vaccinated came from Belgium, the town hall of Lille told AFP.

The Hauts-de-France regional health agency (ARS) speaks of “several hundred” Belgians vaccinated since the start of the campaign due to the principles of “European solidarity” and public health issues – – the French from the North “frequent the same festive events” as the Belgian public.

The agency specifies that the centers are even “asked to respond favorably to requests from Belgian border residents, provided that this does not affect access to vaccination for the French”.

However, the situation in Hauts-de-France remains marginal. In the south of France, the vaccination of Italians and Spaniards is very small, indicate the associations for the fight once morest HIV.

– Five hundred kilometers by car –

And near the Swiss border, the situation is heterogeneous. As Switzerland does not yet have access to vaccination once morest monkeypox, “some have gone to be vaccinated in France without problems, but others have been refused vaccination”, explains Alexandra Calmy, infectious disease specialist responsible for the disease. HIV unit of Geneva hospitals.

Although cross-border care networks exist – during the Covid epidemic, French patients were received in intensive care units in Switzerland – the Swiss do not have simplified access to vaccination in France.

Thomas, 32, who lives in Montreux, told AFP that he had been looking for a date in France for two weeks. He finally found it, in Besançon (Doubs). “I took a day off, I’m going to rent a car and drive 500 km”.

Located one hour from Geneva, the vaccination center of Chambéry (Savoie) had refused him an appointment. “We only take people who live in Savoie or who are followed here”, explains to AFP Silvère Biavat, doctor of the structure.

The site was “overwhelmed with calls from Swiss”, and had to refuse, for lack of means, these foreign residents, he explains. “The doses are distributed by the ARS in a departmental way, the doses are therefore planned according to the population who lives in the department”.

Asked, the general directorate of health explains that “vaccination sites are responsible for the way they manage their patients”, and can therefore accept, or not, to open vaccination to foreign residents.

– “Very unfair” –

Faced with refusals from neighboring French centers, Sergio, 41, from Geneva, looked even further: in Portugal, where he is from, in the United States, before finally finding an appointment in London.

“For a last-minute Geneva-London flight, I paid almost 600 euros,” he explains. “It’s expensive and it’s unfair because not everyone can do it (…), but everyone is afraid” of this disease.

Faced with this unequal situation, the associations and caregivers interviewed by AFP, in France and in Europe, are calling for the establishment of diplomatic agreements to allow in particular the loan of doses to countries in need.

“In a globalized world, in a Europe without borders, it does not make sense that countries like France, Germany and the Netherlands have a large number of vaccines”, while countries like the Spain, the country most affected by the epidemic, has only 17,000 doses, estimates Toni Poveda, director of the Spanish association for the fight once morest HIV Cesida.

“Epidemics don’t pay much attention to borders. What we want is to have a concerted response at European level, within the WHO and not just the European Union because we must include Switzerland”, continues Marc Dixneuf, director of the French association AIDES.

“Until now, we had not been faced with this difficulty: Switzerland or Belgium were states that responded to the HIV and Covid epidemics,” he explains. “But here we are faced with very strong inequalities, both between French regions (…) and at European level”.

The French authorities ensure that the subject is currently being discussed in the competent European bodies. They specify that they are in contact with Belgium and Switzerland to discuss “cross-border monkeypox vaccination” and its financing.