• The French Hospital Federation and the president of the PS group in the National Assembly called on the government to make the vaccine compulsory for all.

  • A measure unprecedented in the history of medicine by its magnitude which could raise questions at the level of medical ethics, but also at the democratic level.

  • For many health professionals, convincing rather than coercing remains the solution so as not to accentuate the population's mistrust of health authorities.

In a few days, we will no longer be able to travel far, have a beer on the terrace, sit at a restaurant table, make a canvas or see the Mona Lisa without a valid health pass. The measures have already convinced a large number of people to go for the vaccine, but for some it is not enough.

On Sunday, the French Hospital Federation (FHF) called on the government to make the Covid-19 vaccine mandatory for all.

For its president, Frédéric Valletoux, interviewed in the columns of the

JDD

, "we no longer have the luxury of taking half-measures".

A proposal supported by Valérie Rabault, president of the PS group in the National Assembly, who again pleaded Tuesday for "compulsory vaccination for all adults".

However, it is perhaps not out of “luxury” that the French state has not gone further in these measures aimed at containing the new epidemic peak which is hitting France.

Because compulsory vaccination for all would raise many questions.

Does France currently have the logistical means to vaccinate everyone?

Regarding vaccine doses, if most poor countries in the world lack them, this is not a priori the case for France. "Production adapts to need and laboratories produce according to orders", assures Alice Desbiolles, public health doctor and epidemiologist. Everything would obviously depend on the allotted time set by the government, but in absolute terms, "it does not seem impossible from a logistical point of view to vaccinate all French people", she believes.

While hospitals are currently suffering from a lack of staff to handle hospitalized Covid patients, there are on the other hand enough people to inoculate vaccines.

“Between doctors, nurses and pharmacists, there are around 200,000 people in France capable of vaccinating,” underlines Michaël Rochoy, general practitioner, epidemiology researcher and member of the “On the side of science” collective.

Can the government legally make vaccination compulsory for all?

There is already a list of compulsory vaccines for children. In addition, article L. 3111-4 of the Public Health Code (CSP) makes vaccination against hepatitis B compulsory for health personnel. However, to impose vaccination against the coronavirus on everyone, regardless of age or profession, would be unprecedented in the history of medicine in its scale. We therefore have little perspective on this kind of situation. The government could come up against the code of medical ethics. "Article 36 says that for any treatment, test or medical act, the patient's consent must be obtained," recalls Alice Desbiolles. We must respect his will even if his decision is considered by the doctor to be harmful for him. "

From a societal point of view, it is also difficult to rule out questions of a legislative and democratic nature that a strict vaccination obligation would pose. "One can wonder to what extent a power can force its citizens to pass an examination, a medical test, take a drug? And to what extent can there be government interference in our health? “Asks the public health doctor. Because if a democratic government "must offer a framework favorable to individuals to allow them to remain in good health, the final decision rests with the individuals according to their perception of the risk and their aspiration", she recalls.

Finally, there is the question of the control of the immune status of a person by people who are not authorized to have access to this type of information.

This question about medical confidentiality is already raised with the current health pass, the control of which is the responsibility of companies welcoming the public.

What advantages and disadvantages could have the vaccination obligation for all?

For Thierry Amouroux, spokesperson for the National Union of Nursing Professionals (SNPI), it is absolutely essential that everyone be vaccinated. “We know that whatever the vaccine or the variant, it protects you against serious forms. We have hardly seen vaccinated patients in intensive care units for several months, ”he says. For him, a government injunction can actually have effects on vaccination coverage: "We have seen people rush to Doctolib to be vaccinated following the announcements of Emmanuel Macron".

But this is only a short term effect.

"There are still people who were vaccinated against their will and who will continue to believe that their hand was forced", presumes Thierry Amouroux.

Same analysis for Alice Desbiolles: “An obligation to vaccinate is not trivial and will surely leave traces.

It is a decision which could damage the confidence of a part of the population towards the institutions and the rulers.

"

How to avoid coming to the vaccination obligation for all?

For Alice Desbiolles as for Thierry Amouroux, one of the fundamental problems to be solved is mistrust of the vaccine. Both recommend “convincing rather than coercing”. "People must understand the interest in themselves and their loved ones, and this requires field work to dialogue, reassure, explain," said the spokesperson for SNPI. The latter regrets on this subject that people without a health pass cannot go to the hospital, to accompany a loved one or to seek treatment (except in an emergency). “This prevents us from convincing these people,” he argues.

Although she is in favor of vaccination, for Alice Desbiolles, compulsory vaccination is perhaps not the only solution. “I am thinking of strengthening local hospitals, hospital capacities, and the territorial network to have access to care with nursing homes. Always keep in mind the right proportion of the response to the threat. "

The expert finally judges that the current health pass is already a vaccination obligation that does not speak its name.

“There aren't many people who will have the energy, the inclination and the luxury in terms of time and money to do a PCR test every 48 hours.

We can always invent more threats, more constraints, more devices, to pay fines, but if this already conditions the freedom of movement, leisure and in certain professions to work, I do not see who can resist such device.

"

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  • Health

  • epidemic

  • Anti-covid vaccine

  • Covid 19

  • Coronavirus