France has long been one of the most vaccine-sceptical nations on earth. As recently as last December, 60 per cent of the French population said they didn’t want to get jabbed against Covid-19, compared to 23 per cent in the UK. And yet, over the summer, France has become one of the most vaccinated countries in the world.
The acceleration of France’s vaccination campaign against the coronavirus is largely believed to be due to its controversial “health pass” policy. Between late July and early August, showing proof of immunisation or a negative Covid-19 test has become mandatory for people entering cinemas, museums, restaurants and bars, and for those using long-distance public transport. The move, announced on July 12 by French president Emmanuel Macron, took much of the country by surprise. In a bid to further encourage vaccinations, the government will soon be putting an end to free tests, unless prescribed by a doctor.
While similar “vaccine passport” measures were taken elsewhere in Europe around the same time, the impact has been particularly striking in France, both for the boost that they have given to vaccinations and for the backlash that they have sparked.
Over the week that followed Macron’s televised address, an unprecedented 3.7 million people booked their shots on Doctolib, France’s main medical online platform. The seven-day rolling average of daily doses skyrocketed from 565,000 on the eve of the announcement to almost 700,000 ten days later, according to Our World in Data, an online database.
France’s vaccination rate has now caught up with that of countries that had led it for months. Sixty-three per cent of its population has now completed the Covid vaccination cycle, just one point behind the United Kingdom. Between July and August, the share of French people having received at least one jab, currently at 73 per cent, overtook those of the US, Germany, Italy, Israel, and the UK. The milestone of 50 million people (out of a population of 67 million) with at least one dose is expected to be passed in days. Vaccinations have now slowed down, like in much of the Western world. But new vaccines remain among the highest in Europe, well above the UK’s.
“The health pass did its job,” says immunologist Alain Fischer, a top government advisor on France’s vaccination campaign. He estimates that four to five million people got jabbed as a result of the measure, “which helped make many people aware, especially among the younger public, of the benefits of the vaccination.”
According to French Health Ministry data shown on the Covidtracker website, the steepest rise in vaccination rates following the health pass announcement was registered among people between 18 and 50: young and middle-aged adults for whom the risk of developing serious Covid symptoms is lower, and who therefore used to have fewer personal incentives to get jabbed. In the 18-24 age bracket, the partially vaccinated rose from less than 50 per cent right before Macron’s speech, to over 86 per cent last week. “I was expecting the health pass to have an impact, but not this big,” says Fischer.
In other good news for the government, not only the French responded to the health pass mandate by seeking the shots; a 60-70 per cent majority also appears to genuinely approve of the policy, according to polls. “This is a good measure,” says Pierre Mbaye, a middle-aged engineer enjoying a pint of lager outside a bistro in southern Paris, on a muggy mid-September day. “It may be a little coercive, but defeating this pandemic is our collective duty.” At a cafe a few blocks down the road, a man in his early forties agrees: “I’m against curfews and confinements, but sign me up for the health pass, since it allows me to enjoy this coffee,” he says, pointing at his cup (he wouldn’t give his name because he is a civil servant and was on duty).
In France, vaccine-hesitancy used to be extremely high well before Covid vaccinations were introduced. In a 2018 Gallup survey carried out in 144 countries, France emerged as the most sceptical, with one-third of respondents saying they considered vaccines in general as unsafe.
With this widespread distrust in mind, authorities originally devised a cautious vaccination process, which in its first phase only targeted care homes for the elderly. As a result, in early January 2021, two weeks into the rollout, only 100,000 people had been jabbed in France – seven times fewer than in Germany. But when the French vaccine campaign came under fire for being too slow, it was significantly sped up, then lost some steam in June and early July, which led to Macron’s decision to give it a fresh boost by imposing the health pass.
Experts say that the months-long mass vaccinations, with extensive media coverage and a clear, beneficial impact on hospitalisations, have made the general public much less wary than it used to be, helping people accept Covid passports. In July, ahead of Macron’s announcements, the share of people who still refused to get vaccinated against Covid was down to 15-20 per cent.
However, while France’s vaccine passport policy has gone down well with much of the population, the minority that opposes it is very vocal. Protests against vaccine passports have also taken place in other countries, such as Italy and Germany. But in France, the movement has proven particularly resilient, drawing tens, sometimes hundreds of thousands of people to the streets every Saturday since the measures were first announced. Demonstrators have dwindled since their 240,000 peak country-wide in early August, according to authorities. But fears remain of another season of protracted tensions in the streets, just like in late 2018 and early 2019 – when the “yellow vest” movement against economic inequality was at its strongest.
The crowds marching every week include a wide range of people: hardline no-vaxxers and conspiracy theorists, yellow vests who have added the issue to their long list of grievances against Macron, far-left and far-right supporters, but also moderates who don’t want fundamental choices about their health to be dictated from the top. “The government is imposing the health pass on us without a real democratic debate. This is extremely serious,” said Doris, a retired bookseller participating in one of the many protests that took place in Paris over the summer. “We are not necessarily against vaccinations, but against the obligation to get jabbed,” added Morgan, a 40-year-old standing nearby, proudly donning his yellow jacket: “This is an infringement of our freedoms.”
Some fear that the health pass may result in enduring rifts between vaccinated and unvaccinated, further excluding those already on the margins of society. Civil liberties groups around the world have warned vaccine passports can exacerbate inequalities and decrease trust in governments.
“Many people who live in precarious situations still have less equal access to vaccination and information,” says Melissa Fox-Muraton, a philosophy professor at the ESC Clermont- University Clermont Auvergne who has weighed into the debate with an op-ed in the French press. “Those people may have more difficulties coping with their daily lives and feel or be unable to make the efforts necessary to get vaccinated; they may have experienced discriminations that make them more sceptical about the healthcare system and public policies, or simply do not want to be traced even if they are vaccinated, and thus do not wish to use the health pass.”
An academic study published in June this year shows that French hesitancy towards vaccines, including Covid-19 vaccinations, is higher among those with low incomes or education, and among immigrants.
The health pass has also taken a toll on many of the businesses where it is required. Cinemas lost seven million ticket sales in a month due to Covid passports, according to the National Federation of French Cinemas. And 80 per cent of bars and cafes and 60 per cent of restaurants saw their revenues drop by at least one fifth between July and August, according to UMIH, an employers’ organisation (the health pass became mandatory for bars and restaurants on August 9).
“The first week after vaccine passports came into effect was catastrophic,” says Jean Terlon, vice-president of UMIH’s restoration branch. “Restaurants were ready, clients weren’t, since the measure came quite abruptly, in the middle of the summer,” he says. Terlon is critical of the decision to impose the health pass also for outdoor tables, which are harder to control and where virus transmission is less likely. However, he says that after the initial shock the health pass is no longer creating any major problems for restaurants. “It has become part of the normal practices.”
Yet, reports have emerged across the country of a flourishing black market of fake health passes, typically costing a few hundred euros each. Counterfeiters obtain them by inserting their customers’ actual details in the national database, using the accounts of hacked or complicit health workers.
As governments around the world scramble to find ways to keep up the pace of their vaccination campaigns, France offers a good example both of the vaccine passports’ effectiveness and of the risks that they entail. Their positive impact on vaccinations in France has been impressive, but also limited in time. On the downside, they caused some economic damage, and exacerbated the rift between the silent majority and a small, but not insignificant minority who may be pushed further to the margins of social life.
Beyond the country’s borders, vaccine passports have boosted vaccination campaigns almost everywhere they have been adopted. But they aren't necessarily the only path to achieve high vaccination rates: Spain has consistently been ahead of France, with the gap growing over the summer, and has hardly relied on Covid passports – something the UK government might have had in mind when it ditched plans for a limited use of vaccine passports in England this week. Spain has long been characterised by relatively low levels of vaccine-scepticism and a solid trust in the healthcare system by the public, which may help explain the good performance of the vaccination campaign there.
As for France, it’s unclear, at this stage, how long the health pass will remain in place. It is currently slated to end in mid-November at the latest, but it may be extended in some areas if deemed necessary. According to Fischer, it is just a “temporary measure” that will be withdrawn as soon as the virus is fully under control.
But some believe that in the future authorities may be tempted to resort to an even larger use of vaccine passports if the health crisis requires it. Françoise Salvadori, an immunologist at the University of Bourgogne and co-author of a book on vaccine-scepticism, worries about a scenario where “everybody controls everybody, with little conflicts breaking out all over the place.” Although Salvadori admits she doesn’t think there was “much of a choice” with introducing France’s current measures.
She points out that to counter the public’s wariness, France has already had to make eleven vaccines mandatory for all newborns. “It would be great if it were possible to persuade people simply by showing them the figures, by using common-sense arguments. Unfortunately, it is not enough,” she says. Having to resort to coercion “is always a bit of a failure.”
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This article was originally published by WIRED UK
