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4 January 2021updated 28 Jul 2021 1:31pm

Hesitancy and poor planning: why France’s Covid-19 vaccination campaign is so slow

 Emmanuel Macron’s cautious approach has backfired.

By Ido Vock

As European leaders struggle to address the slow pace of the EU’s Covid-19 vaccination campaign, the French government in particular is coming under attack for its failures to manage the country’s high levels of vaccine hesitancy.

Just four in ten French people say they intend to receive a coronavirus vaccine, the lowest figure of 15 countries surveyed by Ipsos last week. By contrast, 78 per cent of Brazilians, 77 per cent of Brits, and 60 per cent of Japanese say they will get immunised. French TV reported on one care home where just 70 of 250 residents had given their consent. One resident said: “We don’t know what’s in their vaccine.”

Such hesitancy already seems to be affecting France’s rollout out of the Pfizer/BioNTech vaccine, which began on 27 December as part of the EU’s joint procurement programme. Only 500 people had been vaccinated in the first week of the campaign, according to official figures, compared to around 200,000 in Germany, which has received the same number of doses per capita as France and started administering doses at the same time.

The glacial pace of France’s vaccination programme is causing growing political consternation at home and mockery abroad. There have been calls from across the political spectrum and the medical establishment for a rapid acceleration of the programme’s pace. On 31 December, the National Academy of Medicine called for the rollout to be “simplified and accelerated”, while the head of the Grand Est region termed the vaccine programme “a state scandal”.

The government is on the back foot, first insisting that the slow rollout is part of a well-thought-out plan, with the higher education minister, Frédérique Vidal, tweeting that “France is not late.” President Emmanuel Macron was later reported to be furious at the slow pace, and the government has now set a target of one million doses to be administered by the end of the month.

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[See also: Why Germany’s long-admired Covid-19 response is in trouble]

The delay is in part due to France’s decision to prioritise elderly people over medical staff, said Eric Billy, a member of On the Side of Science, a grouping of health professionals sometimes critical of the government’s approach to the pandemic. “Some elderly people do not have their whole wits around them, and so obtaining consent from them can be more time-consuming,” Billy said.

Even though the French government would have known since early December that the Pfizer vaccine was likely to be approved for use in the EU – when the UK gave it the go-ahead – it appears to have badly misjudged how to target the rollout according to the vaccine’s particular logistical demands. Knowing that transporting the Pfizer vaccine, which must be stored at -70°C, to care homes was likely to prove complicated, it could have chosen to first vaccinate hospital workers. This would be a simpler task, as they are already at the hospitals where vaccines are stored and their consent is more easily obtained, Billy said. On 2 January, the government began vaccinating healthcare professionals over 50, partly in response to the criticism.

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Vaccine hesitancy and delays caused by the consent requirement could continue to pose a significant bottleneck in the French rollout, according to Billy. The country is relying on GPs to administer doses and choosing not, for the time being, to immunise via large-scale vaccination centres. Experts believe that as more people receive their doses, it will inspire faith among those who have not, creating a snowball effect that is likely to turn vaccination into a social norm.

The government’s vaccination coordinator, the biologist Alain Fischer, has claimed that the current slow pace “gives us the opportunity to do things well in terms of security, effectiveness, organisation and ethics”. Yet this line is likely due – in part – to awareness that appearing to hasten the process could further dent trust. Pharmaceutical controversies, such as the Mediator scandal of 2010, have contributed to a uniquely French distrust of medicine, including vaccines, according to France Info.

The government also plans to set up a “citizens’ collective” of 35 people chosen at random to determine how worries about the vaccine can be addressed.

The far right, the most obvious home for vaccine sceptics, is caught in a rut, with some of its members pandering to anti-vaxxers and others choosing to criticise the slow pace of vaccinations. 

In the face of a much more ambitious rollout from France’s neighbours, including Germany and the UK, and the possibility of a third national lockdown, calls are mounting for Emmanuel Macron’s government to rapidly take further measures to accelerate the vaccine’s distribution.

[See also: Sweden’s Covid-19 failures have exposed the myths of the lockdown sceptics]