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HEALTH

What is France’s plan for Covid vaccines for under-18s?

The Covid-19 vaccine programme is now open to all adults living in France, with the goal of offering a vaccine to everyone who wants one by the end of the summer - but what about under 18s?

What is France's plan for Covid vaccines for under-18s?
Photo: Mandel Ngan/AFP

In common with most countries, France is at present only vaccinating adults, but work is already being done on a plan for the under 18s.

Here’s what we know so far:

The current situation

At present, children aged 16 and 17 can receive a Covid vaccine in France if they have a serious underlying illness, such as cancer or transplant patients. Otherwise, vaccines are reserved for the over 18s.

READ ALSO Who is eligible for a Covid vaccine in France?

France, in common with most other countries, began by vaccinating the groups most at risk of developing the most severe forms of Covid, such as the elderly or those with with underlying health conditions.

Studies have shown children who catch the virus generally get either mild or no Covid symptoms – although there have been rare cases of serious illness and deaths – but they can spread it.

Vaccine approval

The European Medicines Agency has now approved the Pfizer BioNTech vaccine for use on the 12-15 age group. It was already approved for 16-18-year-olds.

The French vaccine programme is heavily dependent on Pfizer’s vaccine, so this approval was key. Both the AstraZeneca and Johnson & Johnson vaccines are only licenced for over 55s in France.

The French medical regulator is yet to publish its opinion on the use of Pfizer for under 16s and it does not automatically follow the EMA’s ruling, but in this case it is expected to approve Pfizer for the 12-15-year-old age group.

16 and 17-year-olds

As mentioned, seriously ill 16 and 17-year-olds can already be vaccinated, but discussions are ongoing about opened this up to everyone in that age group.

France’s vaccine co-ordinator Alain Fischer said on Monday that it was “a matter of days” until an announcement is made on this subject.

He told LCI radio: “For 16-17 years-olds, we have all the authorisations, in any case for the Pfizer vaccine. So I think it’s a matter of days.

“The option is on the table for adolescents in this age group to be vaccinated at the very beginning of the summer.”

Under 16s

For under 16s, the consensus seems to be that it will happen, but what is less clear is the time-frame.

This may depend on the number of available doses and how the rollout of vaccines to adults goes. France’s next target is to have given at least one dose to 30 million adults – around 60 percent of the adult population – by June 30th. If the current vaccination rate continues, this target will be hit.

The next target is to have offered a vaccine to all adults who want one by August 31st.

The choice for the government is whether to wait until all the adults who want a vaccine have got one before opening up to under 16s, or whether to run the vaccinations of children in parallel with adults.

Prof Fischer seemed keen to open up the programme to children as soon as possible, saying: “Young adolescents also transmit the virus. So if they get vaccinated, we limit transmission, and they will participate in the collective immunity.”

The general consensus is that 80 percent of a country’s entire population (children and adults) need to be vaccinated to achieve collective immunity.

The French medical body Académie nationale de médecine has also recommended vaccinating children as quickly as possible to increase collective immunity, declaring: “The extension of vaccination against SARS-CoV-2 to adolescents and children should be considered as soon as the vaccine protocols are approved for these age groups.”

School closures

As well as the benefits to collective immunity, there is also the disruption of education to consider.

Although France had among the fewest school closure days in Europe over the course of the pandemic, education was still disrupted by the closure of all schools in spring 2020 and then a three-week closure around Easter in 2021. On a local level, many schools have had to close classes after outbreaks of the virus among pupils or teachers.

Arnaud Fontanet, an epidemiologist at the Pasteur Institute and member of the Scientific Council, writes in French newspaper the Journal du Dimanche: “Let’s look ahead to the autumn.

“By that time, since a large proportion of adults will have been protected, secondary schools will be the main places where the virus circulates.

“If even more contagious variants were to enter the game, there would be new pressures on hospitals. It would not necessarily be a fourth wave, but the risk of having to close schools would reappear.

“A consequence that is of course damaging for schooling but also for the mental health of those concerned. Paediatricians tell us that although the majority of teenagers have minor forms of Covid and paediatric multisystemic inflammatory syndrome is rare, more and more of them are suffering from psychological disorders such as anxiety, depression or anorexia.”

Vaccine hesitancy

The other thing the government will need to take into account is vaccine hesitancy. Although this has fallen dramatically in France since the beginning of the vaccine rollout – from 40 percent of people to 20 percent of people saying they do not intend to be vaccinated – how parents feel about having their children vaccinated is at present unclear. 

The fact that children do not themselves tend to suffer from the severe forms of Covid could lead parents to be more wary of having them jabbed.

Clinical trials conducted in the USA on the 12-15 age group found that children are less likely to suffer from common side effects of the vaccine including headaches, fevers and fatigue while no severe side effects were reported in the trial group of 2,200 teenagers. 

Compulsory?

There are 11 vaccinations that are compulsory for anyone registering a child in school in France, including vaccines against measles and polio. However, there has been no suggestion that the Covid vaccine will be made compulsory for children, as it is voluntary for adults. 

Testing

For international travel, France’s health passport requires either a vaccination certificate or a negative Covid test for all over 11s. Therefore until vaccines are rolled out to under 18s, children aged between 11 and 18 face a Covid test if they want to travel into France. 

READ ALSO How France’s health passport will work this summer

The final decision on both the policy and the timeframe lies with the government.

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HEALTH

The different ways you can make a doctor’s appointment in France

Booking a medical appointment in France can be time-consuming – especially if you are new to the country and are looking for an English-speaking doctor.

The different ways you can make a doctor's appointment in France

You do not need a carte vitale to book a doctor’s appointment in France – anyone who needs medical help while in the country is entitled to it, but you may not be entitled to any reimbursement if you are not part of the social security system.

Booking a GP’s appointment can be as simple as phoning up your friendly neighbourhood GP, or using an online service such as Doctolib. 

It helps a lot, if you have a médecin traitant – an attending GP, who adds you (and your family, if they can) to their list of patients. 

READ ALSO Explained: How to register with a doctor in France

It is not always easy to find one. Some parts of the country are short of GPs, which means doctors’ lists can fill up very quickly. But it is important that anyone who lives in France is registered with a named GP, especially if they have a carte vitale.

As well as being the main point of contact between patients and the medical profession in all its guises, it is financially responsible to be registered with a GP in France.

Reimbursement on consultations is typically 70 percent through the French healthcare system, but just 30 percent for anyone without a declared doctor. Meanwhile, top-up mutuelle health insurance companies usually require you to declare a médecin traitant and if you don’t, you may not be able to receive reimbursements on certain treatments.

Bear in mind, it is your responsibility to register with a local médecin traitant. But, even after you have done so, you can still make an appointment with any doctor, anywhere in France, and arrange specialist treatment, if you need it. 

READ ALSO 5 things to know about visiting a doctor in France

How do you go about making a GP appointment in France?

There are several options.

Some health centres – more often in larger towns and cities – operate a walk-in policy. But expect waits to be lengthy. Do not, however, assume that your GP operates a system like this.

You can phone for an appointment. This is another very common method. Your GP will have their own system for making appointments – which may even include something that looks, to the uninitiated, very much like a casual walk-in policy. 

Some may have an assistant to deal with booking appointments and other administration. Others may deal with appointments themselves, and may – for example – operate some sort of triage system based on voice messages from patients. 

What about online booking systems?

And many practitioners are now attached to websites, such as Doctolib. As of 2023, about half of all GP appointments in France were made using Doctolib.

READ ALSO How to use: French medical website Doctolib

Be aware that other online booking systems are available. Doctolib is one of the best known, but your GP may be attached to another system, like the health ministry approved site ‘LeMedecin.Fr’.

This website also has a feature where you can take an immediate online consultation with whatever doctor is available at that moment. By clicking ‘Consultez en vidéo maintenant’ you will be connected to the next doctor who is free. This option may involve an additional charge between €5-10 on top of the price of the consultation, and you will be expected to pay when booking.

If you have any trouble with either of these websites, you can go through the list of registered generalists per département on the ‘Ameli’ website. If you use this option, you will need to call the doctor to see if they are open or available for appointments.

In terms of wait times, online systems have helped to significantly reduce the delay between booking and getting an appointment.

According to a 2023 study by Doctolib, about half of all GP appointments were available within three days from the time of booking on their platform.

Similarly, you can use online platforms to check the medical professional’s qualifications and languages spoken, as well as filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

An increasing number of doctorsoffer video consultations, known as télémédecine in France. This allows professionals – particularly those in more rural areas – to diagnose less serious conditions remotely. This type of consultation is usually only available from those medical practices that are attached to online booking systems. 

Some pharmacies have also begun offering walk-in télémedicine consults, using ‘Medadom’ machines. More information here.

What about specialists?

In France, you book your own consultations with specialists, even if you are referred by a doctor (your GP may offer a recommendation, but won’t always). The good news is that many specialists do use online booking services. Those that do not usually have assistants to take care of the appointments.

READ ALSO: Urgent care: How to get non-emergency medical treatment in France

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