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French health regulator recommends AstraZeneca’s Covid vaccine for under-65s only

France's top health authority has approved the AstraZeneca vaccine for use on 18 to 65-year-olds only, following the lead of several other European countries who say there is not enough data to show its effectiveness on over 65s.

Published: 2 February 2021 17:11 CET

French health regulator recommends AstraZeneca's Covid vaccine for under-65s only

The AstraZeneca vaccine. Photo: AFP

The European Medicines Agency has licenced the AstraZeneca vaccine for use on all age groups, but health regulators in Germany, Sweden and Austria have cleared it only for 18-65-years old, saying there is not enough data to prove its efficiency for the over 65s.

The French medical body Haute Autorité de santé on Tuesday followed their lead, recommending it only for under 65s.

French President Emmanuel Macron was on Tuesday evening holding an emergency meeting with vaccine producers and laboratories in France.

The object of the meeting was to “take stock of the current state of vaccine production capacity” at the French and European levels and to “call for this capacity to be maximised in the short term” in order to “increase it rapidly and significantly”, the president's office said.

The meeting was attended by France's health minister, industry minister and director general of public health, along with the European Commission's health chief Sandra Gallina by video link.

The French pharma giant Sanofi has already announced that it will produce an extra 125 million doses of the Pfizer vaccine, since its own vaccine will not be ready for the market for many months yet.

It comes as the European Commission indicated that it is shifting its early Covid-19 vaccination strategy away from AstraZeneca after the Anglo-Swedish company fell far short in its delivery of doses.

Gallina told MEPs the firm has been able to guarantee just 25 percent of the more than 100 million doses promised and that this was “a real issue” for the EU's 27 countries.

“AstraZeneca was going to be the mass vaccine for quarter one,” she said, referring to the first three months of 2021. “The fact that AstraZeneca is not there in the quantities that were stipulated in the contract is quite problematic for all member states.”

Gallina added that the Commission was now looking to the vaccines made by BioNTech/Pfizer and Johnson & Johnson to fill the gap.

France had based its vaccine strategy largely on the Pfizer BioNTech and Moderna vaccines for January and February.

Unlike the Pfizer BioNTech vaccine which must be stored at -70C, the AstraZeneca one can be stored at between 4C and 8C and is therefore easier to administer in the community.

The French government has given the go-ahead for pharmacies to begin offering the AstraZeneca, vaccine, with the first doses expected to be available in pharmacies by the third week of February.

French pharmacies already offer vaccines including the flu vaccine, although the Covid jab is expected to be on an appointment basis within the priority group timetables, which place the most vulnerable at the front of the queue.

The French government has been the subject of much criticism for its slow start to the vaccine programme, although this has picked up speed in recent weeks and now 1.4 million people have received the injection.

4 560 personnes ont été vaccinées hier, soit 1 486 493 depuis le début de la campagne vaccinale (données non consolidées) https://t.co/aUNdntMuM1 pic.twitter.com/aIeus9zeXz

— GRZ – CovidTracker (@GuillaumeRozier) February 1, 2021

France has decided not to delay the second dose of the vaccine and is sticking with the manufacturer's recommendation of 3-4 weeks between the first and second dose – a feared shortage of doses lead to some first-dose appointments being cancelled last week.

However even with the increased pace of the vaccination campaign, France is still lagging well behind many other European countries.

La France bon dernier de la classe européenne en part de la population immunisée (personnes ayant reçu deux doses). pic.twitter.com/mRra4Y3Itj

— Vincent Glad (@vincentglad) February 1, 2021

Health minister Olivier Véran has said that everyone who wants the vaccine will have it by the end of August, but supply problems with the AstraZeneca vaccine have lead to France's February target of 4 million people vaccinated being downgraded to “between 2.5 million and 4 million” people.

At present the vaccine programme is France is only to four groups; over 75s, people under 75 with serious health conditions, healthcare workers over 50 or with a health conditions and residents and staff in the country's Ehpad nursing homes.

The next two groups – 65-74-year-olds and all healthcare workers – are expected in February but no date has yet been set for this.

Anyone who is in a priority group can book an appointment direct.

Member comments

Anonymous - 3 February 2021 at 00:11 CET

I hope Macron has agreed to this. His well known expertise in all matters medical is valuable.(Not)
Sanofi screwed up so they are having to produce Pfizer’s vaccine Quel honte!
Anonymous - 3 February 2021 at 11:25 CET

Latest studies from the USA show that the UK is absolutely right in its rollout of this drug and that Franc has got this badly wrong. As someone over 65 I hope France gets up to date on this asap.I would also point out that 5 million EU citizens resident in the UK will be getting vaccinated according to UK protocols. Is France saying any EU citizens in Britain over 65 should not accept an AZ vaccination ?
Anonymous - 3 February 2021 at 20:06 CET

What the story is saying is that it’s not RECOMMENDED for over 65s ( not withstanding it’s not for any children, pregnant or lactating women and certain other medically compromised people). It then talks about the 65-74 age cohort being vaccinated- so the government is STILL vaccinating these people AGAINST HEALTH recommendation? I would go with the experts advice, its there for a REASON.

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Explained: How dangerous are French heatwaves?

A recent report highlighted the potential risks to athletes’ health if this summer’s Paris Olympic and Paralympic Games take place during a heatwave. The report, backed by climate scientists and athletes, warned of the potentially fatal risks of high temperatures at this year’s Games.

While most people are unlikely to be trying to break a 100m record during a heatwave – or any other time in fact – high temperatures bring with them serious risks to health.

Mercury rising

Any temperatures in France are getting higher, the country has endured a series of record heatwaves in recent years.

The all-time temperature record for Paris is 42.6C, set during a heatwave in 2019. It’s entirely possible this record won’t last long – 2022 was the hottest year on record in France, with a record 33 days meeting officially defined heatwave conditions: five in June and 14 in both July and August.

Vérargues, in the southern Hérault département, holds the highest recorded temperature in France – 46C set on June 28th, 2019.

The highest national average temperatures in France were recorded later in the year: August 5th, 2003, saw an average national temperature of 29.47C, followed by July 25th, 2019, when the average daily temperature was 29.4C.

And remember – air conditioning is not standard in French homes.

Health risks

There is no question that heatwaves can be fatal – some 400 people died in France in a two-week heatwave in August 2023 when new local temperature records were set around the country, according to public health data.

Over the whole of last summer, some 5,000 excess deaths were recorded between June 1st and September 15th, 2023, of which 1,500 were attributed to the heat.

Over the same period, nearly 20,000 heat-related emergency calls were recorded, according to a report by Santé Publique France published in February this year, and 10,600 additional hospitalisations followed a visit to the emergency department during periods of high temperature.

The risk is highest among the elderly or people with chronic health conditions, but also at risk are outdoor workers and people exercising – including hiking – during the hottest part of the day.

The government issues weather warnings – ranging from yellow (be aware) to red (potential risk to life) during heatwaves and we would strongly advise people to take notice and follow the advice, even if you come from a hot country.

Climate trends

And it seems that the situation is not going to get better soon, even if the response has improved.

“By the end of the century, heatwaves will be more frequent, more intense, and spread over a period from May to October,” warned France’s Haut Conseil pour le climat (High Council for the Climate) in a report in 2021.

Around 80 percent of the French population will experience 16 to 29 abnormally hot days each year over the three decades to come, as climate change takes hold according to a 2022 study by national statistics institute Insee – with Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté and Occitanie the most affected regions.

It estimates that more than 9 million people will have to endure more than 20 extremely hot days each year in the years to come. Nighttime temperatures will also rise, with some areas seeing up to 19 abnormally hot nights each year, compared to seven between 1976 and 2005.

The phenomenon of ‘tropical nights’ – where the temperature does not drop below 23C even at night – is linked to sleepless nights and heat stress, as the body does not get the chance to cool itself.

Meanwhile, Santé Publique France’s figures underline the impact of high temperatures during heatwaves, it said, and confirmed the need for measures throughout the country, and for a reinforced strategy of adaptation to climate change, to reduce the impact of heat on health.

The unusual Pentecôte public holiday in France, when many people work ‘for free’ by donating that day’s salary a government ‘solidarity fund’ for the elderly, was introduced in 2005 following the disastrous 2003 heatwave, when more than 15,000 French people, most of them elderly, died in the sweltering temperatures.

Heat islands

The particular problem with Paris – and other major conurbations – is that it is a noted ‘urban heat island’, where temperatures can be up to 10C warmer than in the surrounding countryside, due to a combination of human activities, concrete surfaces that reflect heat, and heat pollution such as air conditioning units and cars.

The phenomenon also leads to significantly warmer nighttime temperatures, as heat accumulates during the day but cannot escape in the same way it might in a less dense environment – making for sticky nights that make it hard to sleep and increase the effects of heat stress, especially among the elderly or ill.

Emergency plans

One thing that has improved in recent years is how France deals with its heatwaves.

After 2003’s fatal summer, the French government introduced new protocols to protect the public whenever the temperature rises above a certain threshold.

Today, when the temperature soars, the government issues health advice on staying safe, which includes: drinking plenty of water to stay hydrated, staying indoors during the hottest part of the day (afternoon and early evening), keeping in the shade, exercising only during the coolest parts of the day (early morning and late nights) and eating regular meals.

Most cities now have heatwave plans. Parks stay open at night and ‘cool rooms’ open up to give those in at-risk groups a chance to be taken somewhere they can cool down.

Fire risk

Extreme temperatures and long periods without rain also increase the risk of wildfires.

The year 2022 was the worst on record for wildfires in France. In total 72,000 hectares, or an area seven times the size of Paris, burned over the summer.

Overall, 90 percent of fires are caused by humans – either deliberately or accidentally. But while casually throwing away a cigarette is objectively dumb, heatwaves can – and do – increase the risk of fires.

Where weather conditions do have a major effect is in turning what would perhaps have been a containable fire into a wildfire that devours thousands of hectares of ground and prompt evacuations.

High temperatures make it more likely that fires will start, but drought conditions cause these fires to spread – parched vegetation with no moisture catches extremely easily. In the height of summer, large parts of the south of France are particularly at risk of wildfires.

This is far from a new phenomenon. It’s why there has always been a wildfire ‘season’ in the hottest months of the year and why wildfires are much less common – though not unheard of – in winter.

In October 1970, 11 people died in a wildfire near France’s far southeastern border with Italy and in 1985 an inferno in the same area killed five volunteer firefighters.

Deaths are more unusual today, thanks to improved techniques and technology, but the fires themselves are getting more common, bigger and occur over a wider geographical area.

Poor air quality resulting from wildfire smoke can be a serious health risk to those with respiratory conditions.

If you live in an area where wildfires are common, make sure you sign up to the government emergency text alert system so you get the latest advice on whether you need to evacuate. You can also keep track of the risk of wildfire in your area by checking the government’s forest fire map, which is updated daily.

And you have legal obligations, too, relating to keeping your property as clear as possible of fire hazards during key wildfire periods.

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