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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 French government scheme that helps cover the cost of therapy

The French government launched 'Mon Soutien Psy' in 2020, in an effort to help people afford psychological care. In June, the scheme will be expanded.

The French government scheme that helps cover the cost of therapy

What is ‘Mon Soutien Psy’?

It is a scheme that allows anyone aged three and over who is suffering from anxiety, depression or mental distress to benefit from psychological support sessions, the cost of which is partially reimbursed by the state.

Currently, people can benefit from up to eight counselling sessions in a year with the assistance of Assurance Maladie, as long as the appointment is done with a psychologist registered to the scheme. 

Previously, it has been difficult for people to find an available psychologist due to high demand. However, with the changes coming into effect on June 15th (increasing the price per session and the number of sessions covered, as well as removing the requirement to visit a doctor for a referral beforehand), the government hopes it will be more accessible.

That being said, patients must use the psychologists who are registered with the scheme, and as a result, English-speakers may be limited.

READ MORE: Ask the expert: How to find an English-speaking therapist in France

Who can participate?

Anyone who is “anxious or depressed; feeling unwell; with a smoking, alcohol or cannabis problem; or struggling with an eating disorder” can participate.

It is not intended for patients in emergency situations – ie those risk of suicide or dealing serious psychiatric issues. They will be referred to a psychiatrist or specialised facility.

How does it work?

As things stand in May 2024, the patient must first visit a doctor. This normally would be your GP, but it can also be any other doctor ‘charged with your care’, including other local GPs, paediatricians, geriatricians, and more.

After evaluating you, the doctor can give you a referral (courrier d’adressage) to a psychologist. This step will change in June 2024, and patients will be able to consult registered psychologists directly.

You can find the list of participating psychologists (HERE) to make an appointment.

Your first session will be for evaluation purposes. The psychologist will then determine the number of follow-up sessions (up to seven, but soon to be increased to 11) based on your needs. 

How much is reimbursed?

As with other medical appointments in France, you pay the practitioner and later receive a reimbursement. 

The reimbursement rate is 60 percent, and the remaining 40 percent is either out-of-pocket or covered by your complementary healthcare plan (mutuelle).

The fist session costs €40, and the follow-up sessions currently cost €30. However, starting in June 2024, they will be increased to €50 in an attempt to attract more psychologists to participate in the scheme. They will remain reimbursed at the 60 percent rate.

READ MORE: Health insurance in France: What you need to know about a mutuelle

If you are in the following situations, then you do not have to pay anything up-front.

  • Beneficiaries of the Complémentaire santé solidaire scheme ;
  • Beneficiaries of state medical aid (AME);
  • People with disabilities or long-term illnesses (Affection de Longue Durée – ALD) 
  • Pregnant women (from the 6th month of pregnancy);
  • People under care in connection with an accident at work or occupational illness.
How can I get reimbursed?

In the coming years, the system will be incorporated into your Carte Vitale, so you will not need to mail in any reimbursement forms.

However, as things stand, you must request a feuille de soins at each session and mail it into Assurance Maladie to get your reimbursement. You would also send this to your mutuelle, depending on your situation.

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