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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

French health authorities warn of risk of ‘epidemic’ from mosquito-borne disease

French health authorities have sounded the alarm about the 'fairly high risk' of an epidemic of mosquito-borne illnesses in the next five years in France.

French health authorities warn of risk of 'epidemic' from mosquito-borne disease

ANSES (Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail), the French body for environment and health safety – published a report on Friday finding that France is at a ‘fairly high risk’ of epidemics linked to tiger mosquitoes.

Tiger mosquitoes (Aedes albopictus) are known for their ability to carry dangerous diseases such as dengue, chikungunya and Zika virus. These diseases can be dangerous, but deaths are rare in countries where people have access to good healthcare.

So far, the insect has been detected in 78 of France’s 95 mainland départements – gradually spreading north as global temperatures warm.

READ MORE: MAP: Tiger mosquitoes reach northern France

ANSES wrote in their report that “in the next five years, an epidemic of mosquito-borne illnesses has a probability between 6 and 7, on a scale of 0 to 9.”

In terms of when the ‘epidemic’ level is reached, one of the two coordinators of the study, Émeline Barrès, explained in the report: “We talk about an epidemic when it is not possible to link all the infected people to one single outbreak.

“This means that the transmissions are beyond the control system.”

ANSES also added that “the emergence of an epidemic depends on a number of factors.

“These include the presence of tiger mosquitoes in the country, climatic conditions favourable to their reproduction (in particular the accumulation of hot days over a given period and rainfall), the arrival of infections in people from areas where viruses are circulating, and the effectiveness of measures to combat tiger mosquitoes and the transmission of viruses.”

What would happen if there was an epidemic?

Experts expressed concerns in a number of areas.

“In the event of an epidemic, the current means to prevent and monitor mosquito-borne illnesses would become overwhelmed”, the researchers wrote.

They also referenced fears about the health system being under strain if a large number of cases were to occur over a wide area, as well as impacts on the tourism industry.

Anses also recommended that local authorities be vigilant in ensuring that under-served populations have access to information, prevention resources and care, out of concern that an epidemic could exacerbate social inequality in France.

What is the current risk?

In recent years, cases of dengue and chikungunya have increased in mainland France.

From May 1st to September 10th, France reported 1,372 imported cases (meaning they were contracted outside of mainland France) of dengue fever.

READ MORE: How serious is the threat from dengue fever in France?

Health authorities also reported 13 imported cases of chikungunya and three of (imported) Zika virus.

Imported mosquito-borne illnesses in France tend to involve people who recently visited the Caribbean islands of Martinique and Guadeloupe – where the such diseases are endemic.

These islands are for administrative purposes part of France – so often show up in French health data – but they are roughly 7,000km away from Paris.

As for cases contracted in mainland France, local transmission remains rare.

In 2024, there have so far been 46 reported cases of locally transmitted (indigenous) dengue fever, according to Santé Publique France. There has been one case of ‘indigenous’ chikungunya so far in 2024.

In terms of location, the majority of these local infections have occurred in southern France.

Screenshot from Santé Publique France of a map of indigenous outbreaks of mosquito-borne illnesses in France.

In 2023, there were nine separate outbreaks of indigenous dengue transmission were identified, one of which occurred in the Paris region. These led to 45 cases of local transmission (in mainland France).

Until recently, researchers had been unable to identify contaminated mosquitoes, despite the presence of local transmission, but in 2023, researchers managed to trap tiger mosquitoes in the Drôme département who were carrying the virus. 

What steps can people take to stop the spread of tiger mosquitoes?

Anses noted that in addition to collective action and a response from health authorities, individuals can also take steps.

These include;

  • Regularly emptying outdoor bowls or receptacles filled with water in order to prevent them from becoming mosquito breeding areas
  • Covering rainwater collectors with mosquito netting
  • Protecting yourself by wearing long, loose-fitting, light-coloured clothing and by using insect repellent.

READ MORE: How to prevent the spread of tiger mosquitoes in France

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