Heckled by Emmanuel Macron’s remarks on the unvaccinated, the debate on the vaccination pass ended at dawn Thursday morning with a vote largely in favor of the text. However, in the discussions at the Palais-Bourbon and on the TV (or radio) sets, it is on another device to fight against the coronavirus epidemic that we came back with insistence: the vaccination obligation. “My conviction is that when it comes to controlling vaccines, the development of the epidemic, we should be able to ask this question and I am rather in favor of it,” said Wednesday morning the former Prime Minister Edouard Philippe on France 2. So, is the vaccination obligation the next step in the fight against Covid-19? And would it be the effective solution?
The problem of defining the vaccinee
In any case, the idea is gaining ground in Europe. In Austria, the unvaccinated will have to pay a fine of 600 euros from February 1, while Italy is preparing to force those over 50 to have a complete vaccination course. But while France is in the midst of its recall campaign, the vaccination obligation raises questions. “We have to define what it is to be vaccinated. Did someone start their regimen with the first dose? Two doses? Or who made his recall? What do we do with vaccinated two doses, but who did not do the third? “Asks Michaël Rochoy, general practitioner.
The one who is also a researcher in epidemiology also evoke the many people “who have Covid-19 and cancel their vaccination, since their contamination will give them immunity”. Establishing a vaccination obligation would require taking into account the different profiles of vaccinees, to define who the Health Insurance should contact as a priority. “We can imagine that it is variable geometry, as in Italy” with an age limit, sketches Laurent Chambaud, director of the School of Advanced Studies in Public Health.
The “Go to” policy
The question of the target population is central, since France already has more than 90% of its eligible population vaccinated at two doses, and that there are “between 5 and 10% of irreducible”, according to Laurent Chambaud. We are approaching a glass ceiling on vaccination and the public health specialist is “not sure that compulsory vaccination changes anything”, stressing that “France has chosen the social obligation” to be vaccinated via the health pass then vaccination. An “effective” strategy given the high vaccination rate, while Austria has only 72% of its population vaccinated. In addition, putting a fine for non-vaccination, the only possible “punishment”, could “create an inequality” according to Michaël Rochoy, who fears a “right not to be vaccinated for the rich”. Doctors find it difficult to imagine a threat from employment, ineffective for retirees and the unemployed.
Going from pass control to access any place of culture with a fine for recalcitrant cases, Jean Castex, successor of the founder of Horizons in Matignon, is not frankly for, and has let Jean-Jacques know it. Bourdin this Thursday morning, on RMC. “The objective is to vaccinate, not to bring in money,” said the Gersois, who also considers the pass “more effective”, especially with regard to controls. But on the side of devices going towards more constraints, it would not be the first time since the start of the epidemic that the executive has said “no” to better say “yes” afterwards..
Nevertheless, the two experts interviewed by 20 Minutes stress the importance of continuing to progress, of grabbing the last percentages. Thus, Olivier Véran announced Wednesday evening 66,000 more first-time vaccines in one day, a record over the last three months. For this, Laurent Chambaud insists on the notion of “going towards”. It is estimated that about 20% of the unvaccinated are elderly, who cannot easily reach a vaccination center or do not have access to information. “It is important to raise the awareness of local authorities and associations” which can identify people outside the system, the elderly or in a situation of great poverty, he believes.
Vaccination obligation vs political reality
“The vaccine is not the only element of the strategy to fight against the epidemic, we must remember the importance of barrier gestures”, insists Laurant Chambaud. But in the midst of the presidential pre-campaign, the hour is overbidding and the vaccination obligation has even been part of the arguments against the vaccination pass. The reflection around a vaccine obligation thus comes up against the political reality of the moment, in particular in the Overseas Territories, where the scandal of chlordecone has just found its culmination and where the boss of the hospital of Pointe-à-Pitre has had to be exfiltrated by the police. “If we make a vaccination obligation, it must be national. But this is a question that must be discussed democratically, which is currently complicated, ”warns Michaël Rochoy.
The general practitioner who is also a member of the collective Du Côté de la Science even suggests submitting the question to a referendum. Laurent Chambaud prefers, for his part, to forget such a proposal in the short term. “What seems important to me is how the public health issues will be present in the campaign? “Not sure that all the candidates are keen on a peaceful and in-depth debate on the subject.