July 27, 2021

who can decide to make vaccination compulsory in France?

The spread of the Delta variant on French territory raises fears of a new epidemic wave. The question of making vaccination compulsory for caregivers, effective against this mutation, is therefore on the table.

At the end of last week, Prime Minister Jean Castex opened the possibility of compulsory vaccination for caregivers, and why not “more widely”, while the Delta variant continues to spread over the territory, raising fears of a new epidemic wave .

Several times ruled out, this possibility of compulsory vaccination for all French people therefore seems to be on the table again, although the Minister of Health Olivier Véran tempered the ardor on the subject this Friday, ensuring that the government does not “force not the French to be vaccinated “. But if the government ultimately chose to go down this path, who would decide?

The Minister of Health on the initiative

As provided for in article L3111-1 of the Public Health Code, the establishment of a vaccination obligation goes through the Minister of Health: “The vaccination policy is drawn up by the Minister in charge of health who sets the conditions of immunization, sets out the necessary recommendations and makes public the schedule of vaccinations after opinion of the High Authority of Health “.

Such a vaccination obligation in France would not be a first: currently, 11 vaccines are thus compulsory for children under 2 years old, against diphtheria, tetanus and polio, whooping cough, measles, mumps, rubella, hepatitis B, meningococcus C, pneumococcus and Haemophilus influenzae, list the Ministry of Health.

This passage from 3 to 11 compulsory vaccines in 2017 was thus carried out, “following the proposal by Agnès Buzyn, Minister of Solidarity and Health to make 8 additional vaccines compulsory”, explains the government website.

To note that Article L3131-1 of the Public Health Code, amended by a law of May 31, 2021 relating to the management of the exit from a health crisis, provides that “in the event of a serious health threat calling for emergency measures, in particular in the event of a threat of epidemic, the minister responsible for Health may, by reasoned decree, in the interest of public health and for the sole purpose of preventing and limiting the consequences of this threat on the health of the population, prescribe any regulatory or individual measure relating to the organization and functioning of the health system “.

Among these measures, vaccination could be planned.

“Effective vaccination eliminates a widespread, severe and often fatal disease”

The list of compulsory vaccines was established because of the dangerousness of certain diseases circulating in France, with “the sole objective of the health of all”, declares the Ministry of Health. “From the moment when these diseases are preventable by a simple and effective gesture, there are always too many serious cases and deaths due to insufficient vaccination coverage”, we can read on a page dedicated to the vaccination of children.

“It is a question of individual and collective protection: the vaccination of the child makes it possible to protect it, and to protect it for a long time. Vaccination also and above all acts as a shield, in particular for the most fragile people around us such as the very young infants, too young to be vaccinated, pregnant women, the elderly and the immunocompromised “.

Seized in 2019 to reject the obligation of 11 vaccines, the Council of State considered that this obligation “does not violate the right to physical integrity and respect for private life, given the seriousness of the diseases, the effectiveness of these vaccines and the need to make them compulsory in order to achieve satisfactory vaccination coverage for the entire population “. They “present a favorable ratio between benefits and risks”, it is written in the decision.

In the case of Covid-19, the Academy of Medicine called at the end of May for the implementation of the vaccination obligation in France because it “is necessary in all cases where an effective vaccination makes it possible to eliminate a disease widespread, severe and often fatal “.

With a vaccine efficacy rate of 90 to 95% against severe forms of Covid-19, “the vaccines currently approved in France against SARS-CoV-2 meet the conditions which allow compulsory vaccination against to a formidable epidemic “.

A “gradual” establishment

If the government made this choice, it could not be effective immediately, if only for questions of organization and management of vaccination.

The Academy of Medicine thus underlines that in “practice, the application of such an obligation can only be established gradually” with for example the establishment in a first phase of a vaccination pass, and the ‘obligation intended for certain more risky professions.

Currently, it is compulsory vaccination for caregivers that is being discussed. “It’s a serious possibility,” government spokesman Gabriel Attal said on Monday morning on France Inter. “If it is decided to do so, it is possible that the text will be presented before the end of July. There may be a measure adopted, and an obligation which comes into force a little later”, but “we must also leave the time for people who are not vaccinated to do so if they were to be concerned by an obligation “.

Salome Vincendon BFMTV reporter