Covid-19: who decides to make a vaccine mandatory and on what criteria?



Yes it is mandatory“: EELV MEP Yannick Jadot is categorical on franceinfo: on behalf of”trauma experienced by our societies“, the next vaccine against Covid-19 must be made compulsory. For its part, the High Health Authority believes that, in the current context,”vaccination against Covid-19 should not be compulsory, neither for the general population, nor for health professionals“. A position shared by the Scientific Council which judged last July the obligation “neither desirable nor conceivable”.

But who will ultimately decide whether this future vaccine will be mandatory or not? And how will this choice be made? The True from False Cell explains to you.

“The vaccination policy is drawn up by the minister responsible for health, who sets the conditions for immunization, sets out the necessary recommendations and makes the vaccination schedule public after consulting the High Authority for Health.” This is the rule set out in the Public Health Code. Whatever the subject, in terms of vaccination, the final decision rests with the government.

But another player has his say: the Technical Committee on Vaccinations (CTV). Created in 2017, it “analyzes the data contained in the scientific literature, collects the opinions of professionals and users, then formulates recommendations for the public authorities. These reflections have a practical aim: we have a vaccine, what vaccination schedule we recommend and for which audience?“, explains the Haute Autorité de santé to Franceinfo. The Minister is then free to take these recommendations into account or not.

When in 2017, Minister Agnès Buzyn tabled her bill to make eleven vaccines compulsory for children from January 2018, the CTV “had made its recommendations for a vaccine strategy with regard to each of the diseases concerned, but not with regard to a vaccination obligation on this ‘batch’ of vaccines.

The rules on vaccination are evolving. The Public Health Code specifies this, “a decree may, taking into account the evolution of the epidemiological situation and of medical and scientific knowledge, suspend, for all or part of the population, the obligations”Vaccine. Obligations which can then be reinstated if a new situation requires it, or if a new, more reliable vaccine has been found.

A decree adopted in 2007, when Roselyne Bachelot was Minister of Health, thus suspended the obligation of BCG vaccination of children and adolescents before entering the community (school, daycare, day center, etc.). The government felt that in the fight against tuberculosis, targeted by the BCG vaccine, it was enough to focus on the young people most exposed to this disease.

On the side of the High Authority for Health, if we emphasize that we must take into account “countless issues“Before making a vaccine mandatory, several avenues are being put forward to justify such a decision. Imperativity, first of all, in cases where in the very short term, the protection of people depends on it. “If a very deadly disease such as Ebola spread in France, forcing citizens to get vaccinated would help ensure their safety.

The other thing to take into account is acceptability. The vaccination obligation then becomes a tool intended for health professionals to help them convince citizens of the interest of being vaccinated. But it’s a double-edged sword: to oblige is also to give up convincing, and it is potentially fueling movements hostile to vaccines in a country already particularly suspicious. Because the main issue is that of effectiveness: how to achieve a sufficient vaccination coverage rate to control an epidemic.

Finally, the other criterion to take into account is that of vaccine availability. Making a vaccine compulsory requires being certain that you have the necessary stock to apply this decision. In the case of an upcoming vaccine against Covid-19, the High Authority for Health notes that “the progressive availability of vaccine doses could impose choices on the populations to be vaccinated as a priority“, especially health professionals and vulnerable people.

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