A way to reduce the transmission of the flu to vulnerable people or a not-so-effective lever? The outbreak of the epidemic and its strong impact on hospitals has relaunched in France the sensitive question of a possible vaccination obligation for caregivers.
For the Minister of Health Yannick Neuder, we must “ask the question of whether there is a vaccination obligation for caregivers”, faced with the repercussions of a more severe flu this season, in order to prepare for fall 2026 , as he declared on Friday on France Info.
The obligation to be vaccinated against influenza had been in the law since 2005, but was suspended by decree in 2006, the Superior Council of Public Hygiene judging that it “would risk altering the support of professionals”.
Since then, the anti-Covid vaccination required of caregivers under penalty of suspension during the pandemic, from fall 2021 to spring 2023, has created great tensions.
Strongly recommended by the authorities, vaccination against influenza remains in the minority among health professionals in France. If the current proportion is not known, it was around 22 to 25% in previous seasons, a third of the objective of at least 75% set by the World Health Organization.
At Assistance Publique-Hôpitaux de Paris, only 19% of caregivers are vaccinated this season against the flu, according to general director Nicolas Revel. Head of emergencies at Delafontaine hospital (Seine-Saint-Denis), Mathias Wargon was moved to not count “even 10%” in his teams, saying he had “already heard nurses say: + If it were important, it would be obligatory.”
Four vaccines are currently compulsory for hospital or nursing home staff: diphtheria, tetanus, poliomyelitis and hepatitis B.
During a trip to the Cochin hospital in Paris a week ago, Mr. Neuder had already estimated that “the question will arise” of a possible return of compulsory vaccination of caregivers against the flu.
If we must first ensure that each establishment promotes “all conditions of access to vaccination” for caregivers, “we must have no taboo”, according to this cardiologist, who instructed the High Authority for Health to “take stock”.
– “In Pasteur’s country” –
-In the summer of 2023, this health authority considered that the “low coverage legitimately raises the question of compulsory vaccination” for caregivers against the flu, but did not recommend it.
To justify her position, she mentioned “the inconsistent effectiveness of influenza vaccination over the years” (from 40 to 75%, editor’s note), and considered large-scale studies necessary to “verify and quantify the impact of the implementation of ‘a vaccination obligation for health professionals on the burden of nosocomial influenza’.
“We are not here in a pandemic emergency. Can we not demand scientific proof?”, launched Tuesday on X the epidemiologist Antoine Flahault, from the University of Geneva, for whom the obligation to vaccinate caregivers is “not possible in the absence of scientific proof of reduction in the risk of influenza” transmitted in a hospital environment.
Conversely, the Academy of Medicine has been advocating for years for annual vaccinations against influenza and Covid compulsory for caregivers, considering that, “far from an attack on individual freedom”, they “do the honor of their profession.
And for a long time, in France as in other countries, doctors have generally been more vaccinated than nurses, who are themselves more vaccinated than nursing assistants.
“This ‘professional gradient’ is regularly analyzed solely with a view to better scientific training for doctors, but it is much more complex,” sociologist Hugo Touzet, who participated in a study on ” the human and social aspects of vaccination in France since Covid-19″.
Thus, “the deterioration of the working conditions of nurses in hospitals – when they do not feel recognized, poorly paid – can generate distrust towards health authorities and/or their hierarchy, which can affect their perception or their adherence to vaccines,” he explained.
“Beyond an obligation, (…) what is very important is that we take up the question of vaccination in our country”, according to the boss of the AP-HP. For the Minister of Health, in “Pasteur’s country”, there is still “need for educational measures”.
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