As France's bid to vaccinate 5- to 11-year-olds against Covid-19 hits the one-month mark, progress remains ploddingly slow, light years behind many EU neighbours. As the Omicron wave rages through France with average confirmed cases exceeding 300,000 a day, Prime Minister Jean Castex on Thursday euphemised that the jab campaign had begun "gently" and pledged to loosen the strict logistics holding it back. FRANCE 24 takes a look at France's lagging effort to vaccinate kids and explores why.
Saturday marks one month since France began vaccinating its general population of 5- to 11-year-olds on December 22, a week after it allowed vulnerable kids access to Pfizer-BioNtech's paediatric doses. Figures vary slightly depending on the official source, but uptake by all accounts has been anecdotal so far.
As of Wednesday, according to the Santé Publique France health authority, 1.8 percent of France's population of some 5.8 million eligible 5- to 11-year-olds had received a first dose and 0.4 percent were completely vaccinated. The French health ministry's figures puzzlingly are slightly better, with some 175,000 children, or 3 percent, having lifted a sleeve, it said Tuesday.
Most of France's closest European Union neighbours, meanwhile, are inoculating kids against Covid-19 at pace. Twenty-six percent of Italy's 3.6 million 5- to 11-year-olds have received a dose and 6.45 percent two doses. Spain had given one dose to 45 percent of its 3.4 million children by Tuesday; regionally, Galicia leads the way with more than 80 percent receiving the first jab. Portugal has vaccinated half of its more than 600,000 eligible youngsters. Even in more vaccine-sceptical Germany, more than 15 percent of the age group have received a dose and 6.5 percent both jabs. And in just two weeks since its push began, Ireland has vaccinated more than 10 percent of its 480,000 kids.
So why is France so far behind? It isn't as if the country's children have gone untouched by the pandemic. Some 19,000 school classes were closed due to the pandemic as of Friday, despite a controversial school health protocol engineered to keep them open. Nearly 6 percent of all French primary schoolchildren tested positive for Covid-19 over the last week alone.
Hospital admissions of children with Covid-19 are at an all-time high in France, outstripping last summer's previous high by 600 percent. While deaths among children with Covid-19 are mercifully rare, nine children under 10 with Covid-19 have died in the first three weeks of 2022, as many as during all of 2021.
But among French 6- to 10-year-olds, Covid-19 has also been linked with more than 300 cases of Multi-system inflammatory syndrome (Mis-C), a rare but serious illness that sends a majority of its patients to intensive care. The vaccine is known to provide overwhelming protection against Mis-C.
An abundance of caution and a later start
Some European Union countries took up the torch with enthusiasm once the bloc's drug regulator, European Medicines Agency (EMA), gave its go-ahead on November 25. Austria had begun even before that green light, Denmark started on November 27, Portugal's own health authority gave approval on December 7 and Italy, Greece and Spain quickly followed.
Historically vaccine-sceptic France, meanwhile, tapped three separate health and ethics authorities for their own reviews, conditioning its go-ahead for vaccinating all 5- to 11-year-olds on their approval. The last of the bodies waited for data on 8 million vaccinated American children before finally giving its thumbs up on December 22, nearly a full month after the EMA decision.
When France finally opened its campaign, the government did so with a relative lack of fanfare, certainly compared to neighbouring Spain. Eight days earlier, Spanish President Pedro Sanchez tweeted a public-service ad with kids hugging each other and their grandparents. "It's time to vaccinate boys and girls from 5 to 11 years old," he wrote. "We continue to move forward to protect the population and recover the spaces the pandemic had stolen from us; to ensure minors and the people around them are safer."
Bad timing
When inoculations began just 48 hours before Christmas Eve, the country was deep into a two-week school holiday. On Wednesday, France's Scientific Council – the panel of scientists that advises the government on Covid-19 matters (or tries to) – cited that "hardly favourable timing" as one reason for 5- to 11-year-olds' "very weak" vaccination coverage today.
The Council also flagged another timing flaw: As schools reopened after the break, with Omicron spreading like wildfire, a "very large number of children were contaminated" with many more classmates becoming contact cases (sometimes repeatedly). A Covid-19 infection rules out a vaccination appointment for months, while contact cases are asked to postpone the jab to be sure.
In shrugging off a Christmas Day plea by health professionals to postpone the school reopening for a week in order to better secure schools and promote vaccination for schoolchildren, the government inadvertently may have contributed to slowing the campaign altogether.
Vaccine-skittish parents
Did the slow-burn approval process allay sceptical parents' fears or somehow serve their suspicions?
Two polls conducted in December – between the EU regulator's green light and France's OK – showed parents widely against vaccinating children against Covid-19. A poll by the Elabe firm found 68 percent of parents of 5- to 11-year-olds opposed to the jab (with 47 percent "very opposed"), compared to just 31 percent in favour. Another poll for the National Institute of Health and Medical Research (Inserm) found comparable results with the parents it surveyed (58 percent against, 28 percent in favour).
Both studies found parents to be more skittish than the general French population about vaccinating 5- to 11-year-olds. As a whole, France was evenly split on the matter – 51 percent against to 48 percent for – on the Elabe poll.
Logistical obstacles
"It is getting less and less difficult to find an appointment," the French health ministry enthused on Tuesday, when it said 175,000 5- to 11-year-olds had received one dose. But France took delivery of no fewer than 1.9 million paediatric doses in December with a million more due this month. Why the gap?
The Scientific Council on Wednesday rapped the inoculation campaign for "initial logistical problems", including too few vaccination centres offering paediatric doses, too few appointments available, doses located at too great a distance from the demand or appointments during school hours. Indeed, the statistics are clear: French kids who do get vaccinated do so on Saturdays and Wednesdays, when school is out.
For a month on social media, parents have traded stories of fruitless searches for child vaccination appointments, driving long distances to snag the only appointment they could find for their child or lamenting having to cancel a hard-won appointment after a last-minute infection at school. They favour the hashtag #pasvitemadose ("Not quick my dose"), spoofing the popular vaccine reservation website ViteMaDose. Twitter has also seen its share of general practitioners inviting parents to bring their kids for a jab in this or that outpost of France lest they have to dispose of perishable leftover doses.
In vaccine-skittish France, authorities inserted extra hoops into the procedure for vaccinating 5- to 11-year-olds, ostensibly to promote acceptance. Aside from unique restrictions on the types of health professionals who could inoculate children, vaccinators are required to propose a rapid blood test that involves piercing a child's finger to screen for previous infection. Kids found to have Covid-19 antibodies aren't offered a second dose.
The addition of fresh red tape hasn't helped, either. Suddenly on January 6, both parents needed to sign off on authorising their child's vaccination following a ruling by France's Council of State – a new challenge, particularly for divorced parents.
On Thursday, the French prime minister appeared to recognise one aspect of the logistics bogging the campaign down. "We must in particular make progress on the vaccination of children aged 5 to 11, which began gently," Castex said during Thursday's press conference. "Even though I know many parents are still hesitating, I want to tell them that the scientific authorities have been very clear on the benefits of that vaccine and we will facilitate it by authorising more locations and more professionals, including pharmacists and nurses, to provide the injections."
Some authorities slow to accept Covid-19 spread in children
And yet over the course of the pandemic in France, a vocal crowd of health and education professionals have consistently slammed the influential French Society of Paediatrics (SFP) and its professor president, Christèle Gras-Le Guen. In breaking with the prevailing wisdom of its counterparts abroad and downplaying Covid-19 transmission in kids, the SFP has skewed the risk-benefit analysis in the public imagination, they suggest.
As recently as November, Gras-Le Guen told the regional daily Ouest-France, "We haven't stopped saying it for 18 months: Under-12s are little affected by Covid-19 infection and non-contagious." She added that "under 12s wearing a mask at school makes no sense. I'll say it again: the contagion doesn't happen at school".
To the dismay of experts, the SFP has openly had the ear of Education Minister Jean-Michel Blanquer, who long echoed SFP doctrine that kids are primarily infected outside school and whom specialists charge with shirking his responsibility to mitigate viral spread in the classroom.
Just last week, teachers nationwide went on strike to demand high-quality face masks and the repeated relaxing of a school Covid-19 protocol singularly devised to keep schools open even as attendance is decimated by infection.
When the Scientific Council this week explicitly validated the role back-to-school played in the 460,000 positive cases registered nationally on Tuesday alone, some of the pandemic-wearied doctors couldn't hide their tongue-in-cheek glee.
"The rise appears to be explained by a resurgence of the epidemic in those under 15 and 30-44 year-olds, suggesting an important back-to-school effect: the virus is circulating intensely among the youngest and then spreads to the parents," the panel said.
To which Dr. Christian Lehmann, a member of the Du Côté de la Science (On the Side of Science) policy watchdog group tweeted, "Hello French Society of Paediatrics, you're going to laugh, but we have something to show you...."
Shaking hands, kissing babies (virtually, please)
Have we mentioned that 2022 is a presidential election year in France?
With 79 days to go until April's first round, the row over vaccinating kids has become the archetypal wedge issue – to be avoided by moderates or embraced by extremes, the louder the better.
As consensus builds against the Covid-19 school protocol, many candidates have gravitated to that separate, relatively safe topic to needle the incumbent Emmanuel Macron. When Greens candidate Yannick Jadot did go on the record in December sharing his "reservations" over vaccinating kids, he tamely concluded it should be up to parents to decide.
But on the far right – where a trio of hopefuls are polling around a combined 30 percent – it’s been open season on the airwaves over the 5- to 11-year-old jab.
Pundit-turned-politician Éric Zemmour has said he is "hostile", saying vaccinating kids against Covid-19 "beggars belief".
National Rally leader and 2017 presidential finalist Marine Le Pen told France Inter radio this week that she was opposed because "the risk-benefit for children is nil". She said, "They have almost no chance of being victims of a serious form, so vaccinating them is, in my opinion, a form of abuse."
Not to be outdone, Nicolas Dupont-Aignan has accused the government of putting kids in danger when, he contends, the risks outweigh the benefits. He made his opposition known on the lower-house National Assembly floor last week, calling the policy "horrifying".
In the glare of that election spotlight, France's bid to catch up on vaccinating kids may prove all but gentle.