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With the increase in Covid-19 cases, the French National Academy of Medicine has called for mandatory vaccination of care providers against seasonal flu to prevent integration of the health care system, sparking a debate on ethics medical.
The Covid-19 pandemic, which risks returning to epidemic proportions in France in the fall and winter months, means public authorities should reconsider whether to make vaccines mandatory for healthcare workers, the academy said. in a statement Saturday.
“It is urgent to make the influenza vaccine mandatory for all health personnel,” said the academy, a scholarly society that advises the government on matters related to medicine, disease and public health.
“The current evolution of epidemiological indicators generates fears of the persistent circulation of SARS-CoV-2 at epidemic levels until next spring”, that is, “the risk of a saturation of hospital services with the addition of severe cases of influenza in addition to Covid-19 cases, exacerbated by the incapacity of sick personnel, they cannot take the risk ”.
Health experts fear that a flu epidemic, which has killed between 8,000 and 14,500 people in France per year for the past three years, could increase pressure on intensive care units occupied by Covid patients.
Care providers receive less than average vaccination
France’s campaign for the seasonal flu vaccine targets groups most vulnerable to complications from flu infection, including the elderly, people with pre-existing medical conditions, and pregnant women.
About 45 percent of the population receives the flu vaccine in an average year, and while the vaccine is highly recommended, the participation of healthcare personnel is lower than the overall average.
Citing figures from the health agency, the academy said that roughly 35 percent of hospital care staff participated in the flu vaccination campaign in 2018-2019, including 67 percent of physicians, 48 percent of midwives, 36 percent of nurses, and 21 percent of auxiliary nurses.
In nursing homes, the overall figure was slightly lower (32 percent), including 75 percent of physicians, 43 percent of nurses, 27 percent of auxiliary nurses, and 34 percent of nurses. paramedic personnel.
“Vaccination among health personnel against seasonal flu remains insufficient,” the academy said.
Ethical debate
In general, each country decides whether vaccines are voluntary or mandatory and for which populations. Some members of the academy even recommended extending mandatory vaccinations beyond care providers.
“It should be mandatory for people over 65 and for care providers,” former Minister of Health and current president of the academy, Jean-François Mattéi, told the newspaper. The parisian.
The flu vaccine tends to be voluntary because it provides individual protection for a season. It is never 100 percent effective, and its effectiveness varies from season to season, as it is based on predictions of mutations that are sometimes incorrect or imprecise.
“In terms of individual protection, you have the correct risk of getting the flu rather than getting the vaccine. It is an individual freedom, ”says Daniel Floret, vice president of the HAS Vaccine Technical Commission, a high authority that advises the government on public health matters.
The academy argues that the duties of healthcare professionals to protect and be available to patients creates an ethical obligation for them to receive the vaccine, a view shared by some physicians.
“For health professionals, there is another dimension,” says Serge Gilberg, a general practitioner and professor at the Paris-Descartes University medical school who specializes in vaccines.
“They run the risk of infecting their patients, and if they have the flu, they cannot work, which could leave health services understaffed at a time when professionals are needed. So it would not surprise me if the flu vaccine was mandatory for healthcare personnel, but not for the general population. “
To date, no public official has indicated that the flu vaccine would be mandatory, and the government has not asked HAS for a recommendation in this regard.
