INTERVIEW. Agnès Buzyn plans to make 11 vaccines compulsory. A measure that will require a lot of teaching.
The new Minister of Health, Agnès Buzyn, wants to continue the work of the vaccine policy. In an interview given to Parisian, she spoke in favor of an extension of the vaccination obligation to 11 vaccines. A measure implemented “for a limited period, which could be 5 or 10 years,” she said.
To date, only 3 vaccines are compulsory for children under 18 months: diphtheria, tetanus and polio. The Minister wants to see vaccines against measles, meningococcus C or even pneumococcus become compulsory.
This position is in line with the recommendations made by the citizen consultation chaired by Prof. Alain Fischer, a specialist in pediatric immunology. Handed over at the end of November 2016, the report recommended extending the vaccination obligation in order to convince the French of the validity of vaccination, before lifting it completely.
Asked by Why actor, the doctor at Necker Hospital is delighted with such a rapid announcement from the Minister. But he recalls that this coercive measure must be accompanied by education.
Are you satisfied with the Minister of Health’s announcement?
Prof. Alain Fischer: Obviously, the answer is yes, but we must keep in mind that she has announced that she is considering the implementation of a temporary vaccination obligation. We are not yet at the stage of putting it into practice, especially since this decision must be approved by Parliament.
In addition, the Minister mentioned an obligation of 5 to 10 years, I think that it is a reasonable time to pass from the significant mistrust of the population to a satisfactory adhesion with regard to vaccination. And I am glad the minister kept the idea of a transitional measure.
Alain Fischer, specialist in pediatric immunology and president of the citizen consultation on vaccination
Will the children receive more vaccines?
Prof. Alain Fischer: No, they will receive exactly the same number of injections as the current recommendations provide. Because let us remember, the authorities are already recommending that a young child receive the 11 vaccines in question. Six of them are grouped together in the so-called hexavalent vaccine (1) produced at 2 then 4 months followed by a booster. Simultaneously, we have pneumococcus. Then at 2 years, meningococcus C and the trivalent measles-mumps-rubella (MMR) vaccine are added.
There is therefore no question of injecting more vaccines. On the other hand, we want all children to be immunized.
Is this achievable, given the many stockouts?
Prof. Alain Fischer: It is obvious that the establishment of this obligation has a whole series of corollaries. Very strict negotiation with the vaccine industry is one of them. But it is not easy, because there is a global tension on vaccines. But I believe that the authorities and the industrialists can work together to limit these tensions on the necessary vaccines. This is not a problem that can be solved with the wave of a magic wand, otherwise it would already be done. I do believe, however, that there is room for maneuver.
Could the implementation therefore take a long time?
Prof. Alain Fischer: It requires different steps. The first is legislative. At the same time, this time can be used to discuss with industry and ensure that vaccines are available.
It will also be necessary to conduct an information and educational campaign with regard to the population, but also to the children themselves in schools, in order to explain the merits of this measure. A campaign that will have to be repeated and persist beyond the implementation of the vaccination obligation. Caregivers must also be better trained so that they are better equipped to explain vaccination to their patients.
Another point that seems important to us, and of which the Minister did not speak, is the coverage of 100% of vaccines by Health Insurance. In addition to the reduction for families, this measure is a very strong signal given to the population.
Health professionals could also be affected by the obligation …
Prof. Alain Fischer: During the citizen consultation, we did not advocate the compulsory vaccination for influenza. But personally, I am in favor of it. There is an essential point concerning the vaccination of professionals: setting an example. If we are to be convincing, we must lead by example. It is obvious.
(1) This vaccine contains 6 strains: diphtheria, tetanus, polio, pertussis, Haemophilus ifluenzae type B and hepatitis B.
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