Why aren’t French seniors standing in line to get vaccinated against Covid?

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                La France a lancé sa campagne de vaccination Covid avec pour objectif de donner la priorité aux personnes âgées et au personnel des maisons de retraite médicalisées: un total de près d'un million de personnes.  La campagne a mis du temps à démarrer et, malgré la vulnérabilité de ces résidents âgés, nombreux sont ceux qui ne souhaitent pas recevoir le coup.  Comment venir?
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                                    <p>La décision de la France de privilégier la vaccination des habitants d'Ehpad (établissements d'hébergement pour personnes âgées dépendantes) avait du sens.  Selon le régulateur de la santé français, neuf personnes sur dix qui ont succombé au Covid-19 ont plus de 65 ans, et un tiers des 66000 décès sont survenus à Ehpads.

But surveys show that, in a country already skeptical of vaccines, older people are no exception. Laurent Levasseur, president of Bluelinéa, which works with nearly 1,000 retirement homes across France, highlights what may seem a surprising phenomenon.

This story is part of the Spotlight on France podcast:


Spotlight on France episode 46 © RFI
    «60 pour cent des personnes dans les maisons de retraite n'acceptent pas la vaccination», a déclaré Levasseur, «20 pour cent la refusent et 40 pour cent sont indécis».

Skepticism about the safety of this new rapidly deploying Pfizer BioNTech vaccine is part of the explanation.

“Everyone is afraid of side effects,” Levasseur explained, “so they should get informed medical advice from their family doctor. But it’s not easy to get it.

While young people have become accustomed to seeking medical advice and appointments online, the older generation still relies on their tried, tested and trusted GPs.

Not enough information

While it’s technically possible for nursing home residents to keep their GPs, Levasseur says it’s complicated, slowing the decision-making process.

In addition, many general practitioners feel unable to provide an informed medical opinion based on the limited information they have received from authorities.

“Until a few days ago, they had only received press releases about the vaccine. It is not enough to be able to advise a patient, it is not very professional, ”he says.

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The staff of the nursing homes were able to learn from the first wave and improve the care of the elderly (illustrative image).
The staff of the nursing homes were able to learn from the first wave and improve the care of the elderly (illustrative image). Getty Images
    </div><h2><strong><sup>Une paperasse lourde</sup></strong></h2>Afin de renforcer la confiance dans le processus de vaccination, la France insiste pour obtenir un consentement préalable, mais cela a encore ralenti le tout.  Lorsqu'un résident âgé est jugé mentalement incapable de donner ce consentement, cela revient à un mandataire, généralement un membre de sa famille proche.  Mais l'équipe de Levasseur a constaté que les proches se sentent souvent mal équipés pour prendre une décision aussi importante au nom de leurs parents.

“It’s a big responsibility. It’s very easy to make a decision for yourself, but it’s much more complicated when you do it for your parents, ”he insisted. “In 90% of these situations, these trusted people would like to seek medical advice from their mother’s or father’s doctor.”

So, again, the system hangs.

And then there is the administrative process itself which consists of two meetings: a pre-vaccination meeting with the nursing home doctor to obtain consent or not, followed by a subsequent appointment for the vaccination. Levasseur wonders about the merits of having two meetings: “It’s so easy to do a vaccination but it is not the current process in France.”

Little incentive

Even if the vast majority of nursing home residents agreed to receive the vaccine tomorrow, as long as it is not 100%, says Levasseur, little will change in retirement homes. Unvaccinated people would still be at risk of catching the virus if family visits were made more open and regular. As such, “there is no real benefit for people to accept the vaccine,” he regretted.

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After confinement, the Geoffroy brothers visit their mother for the first time in two months, at the nursing home."Golden age" from Monestier-de-Clermont in Isère.  Photo: June 2020,
After confinement, the Geoffroy brothers visit their mother for the first time in two months, at the “Golden Age” nursing home in Monestier-de-Clermont in Isère. Photo: June 2020, David Baché / RFI
    </div><h2><sup><strong>Pourquoi moi?</strong></sup></h2>Les équipes de Bluelinéa ont passé du temps à s'entretenir avec des habitants âgés d'Ehpad et une chose ressort: après avoir survécu à deux crises pandémiques en mars et en décembre, les personnes âgées se considèrent moins vulnérables que les «seniors actifs».

“It’s very interesting talking to them,” said Levasseur. “They explain:” It’s more dangerous for my son, he drives a car, he does the shopping. Isn’t it better if my son or daughter, aged 60 or 70, is vaccinated before me? ”

A natural reaction for parents whose “primary responsibility is to take care of your children, even if your children are 60”.

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FILE PHOTO: Alain, 92, receives a dose of the Pfizer-BioNTech COVID-19 vaccine at the EHPAD in Champmaillot (retirement homes and day centers for the elderly) as France begins vaccination against coronavirus disease ( COVID-19) in Dijon, France December 27, 2020. Philippe Desmazes / Pool via REUTERS / File Photo
FILE PHOTO: Alain, 92, receives a dose of the Pfizer-BioNTech COVID-19 vaccine at the EHPAD in Champmaillot (retirement homes and day centers for the elderly) as France begins vaccination against coronavirus disease ( COVID-19) in Dijon, France December 27, 2020. Philippe Desmazes / Pool via REUTERS / File Photo REUTERS – POOL
    </div><h2><sup><strong>Des objectifs trop ambitieux</strong></sup></h2>Même si la France a accéléré la campagne de vaccination ces derniers jours, l'objectif de vacciner 1 million de personnes âgées et vulnérables d'ici fin janvier semble très ambitieux.

“Most nursing homes have not even received vaccines yet, those who have started to vaccinate are mainly pilot tests,” said Levasseur. “Some say they expect to receive doses on January 14 at the earliest, and most around February 4 or 6. ”

While France is unlikely to achieve its goal, Levasseur believes it will eventually catch up with its European neighbors such as Germany. “We have to trust our staff and our professionals. I think there will be an elastic effect. It will take time to get started but once in place the campaign will kick off. ”

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