The suspension of AstraZeneca's coronavirus jab on Monday marks the latest setback for France's vaccination drive.
As with other EU countries, Paris' jab rollout has been plagued by shortages and other hurdles.
The latest figures show France has vaccinated 11,029 people per 100,000 inhabitants, compared to 39,863 in the UK, Hungary at 17,767 and Denmark with 14,805.
Until the suspension of AstraZeneca's shots, France's pace of vaccination was picking up in March with over 2.9 million shots injected in the first 15 days of the month.
But that doesn't mask over the problems of the rollout. Here we look at the reasons for the delay and what impact the AstraZeneca suspension will have.
What are the vaccines currently authorised in France?
The French medical regulator has followed the European Medicines Agency in approving jabs by Pfizer-BioNTech, Moderna, AstraZeneca and more recently Johnson and Johnson's single-dose vaccine.
Johnson and Johnson's first deliveries will not get to EU countries until mid-April.
France, like several European nations, suspended the use of AstraZeneca’s COVID-19 vaccine on Monday over reports of dangerous blood clots in some recipients.
The company and European regulators have said there is no evidence the shot is to blame.
The suspension will last until the European Medicine Agency publishes its opinion by Thursday afternoon.
As a result, only Pfizer-BioNTech and Moderna's shots were in use in France at the time of writing.
What's the impact of anti-vax sentiment?
According to a recent Euronews survey, vaccine scepticism is higher in France than in some other European countries.
Two-thirds of respondents either told Euronews they would not take the coronavirus vaccine (42%) or were unsure (21%) about whether to have it.
Just 37% in France said they would take the jab, while the vast majority in Italy (71.3%) and Germany (63%) would also take it.
But French epidemiologist Martin Blachier, CEO of Public Health Expertise, told Euronews that anti-vax sentiment only played "a minor role" in the slow rollout of the country's vaccination campaign, noting that French people always registered "en masse" whenever vaccination slots opened.
The expert added that the impacts of vaccine scepticism were more visible at the beginning of the vaccination campaign.
At the time, the French government appeared very cautious not to impose vaccination on a reluctant population and set up complex procedures to collect the consent of care home residents, slowing down the process.
Why was France slow to kick off its campaign?
Contacted by Euronews about the reasons why France was slightly behind European neighbours in the rollout of its vaccination campaign, the French health ministry said it was "due to the delay in the start of the campaign at the very beginning of January".
The delay, the ministry explained, "is linked to a more progressive public vaccination strategy, in accordance with the recommendations of the High Public Health Authority. This interval is mechanically reflected in the current figures."
"It should be noted, however, that we have experienced a sharp increase in the number of first injections in recent weeks with more than 5.2 million first injections and more than 2.2 million second injections cumulatively as of March 16, 2021," it added.
But epidemiologist and biostatistician Catherine Hill told Euronews that the slow start was "just typical French bureaucracy".
"They organise different systems. You have some doses that are going to be reserved for nursing homes that will be stored in one place; then the doses to be used for the general population would be stored somewhere else," Hill said.
"Authorities have been slow to start but now they're doing their best," she told Euronews, noting that the French situation was "not so abnormal" compared to other EU nations.
How bad are delivery shortfalls?
Both Hill and Blachier agreed that the key limiting factor in France's vaccination drive was currently the availability of doses.
"I'd say 80% of the French delay in vaccination rollout is due to delivery issues," Blachier told Euronews.
"I know that more people want to get vaccinated than there are doses available," Hill said.
France relies on a coordinated approach at the EU level for the purchase of doses, with each country receiving doses proportionally to its population.
The EU has contract commitments with six companies for 2.6 billion doses for a population of 450 million.
Brussels openly clashed with AstraZeneca after the company said its first-quarter promises of 80 million doses would in reality amount to less than half as many due to what it called technical issues.
Speaking on BFMTV on Tuesday, French Prime Minister Jean Castex slammed the delivery delays as "profoundly abnormal" and said that "Europe should show its teeth" to ensure manufacturers respect contractual commitments.
According to CovidTracker, a leading data website, France was due to receive 10,806,130 doses as of March 15, for a population of 67 million.
The Health Ministry would not confirm how many of these doses had actually been received but if the number is accurate, 7,552,120 doses or 69.88% of all doses allegedly received had been injected as of March 15.
What are the other obstacles?
Beyond logistical issues, Blachier told Euronews that France had a "political management rather than a strategic and military management of vaccination".
The expert noted that most successful nations had a "military" management of their campaigns with mass vaccination centres for all vaccines and a centralised registration system.
Israel, a world leader in terms of vaccination per capita, has literally set up a military coronavirus task force, utilising the army's vast infrastructure and resources to combat the spread of the virus.
The French approach has been shifting in recent weeks, with hundreds of large vaccination centres opening throughout the country.
On Monday, a giant vaccination centre opened in Marseille's famous Velodrome stadium, with an initial capacity of 500 injections per day.
How much will the suspension of AstraZeneca impact the campaign?
Even before its suspension, the AstraZeneca vaccine was met with scepticism in France.
President Emmanuel Macron first told foreign reporters that the British-Swedish jab "was almost ineffective for 65+" before a U-Turn.
"They really made so many communications mistakes with the president himself saying that that was no good for people over 65, whereas there was absolutely no evidence for that," Hill told Euronews.
Earlier this month, the Health Ministry warned that only 25% of AstraZeneca doses received in France had been used, compared to almost 70% for other vaccines.
However, the pace was picking up as the AstraZeneca vaccine was distributed to pharmacies and GPs.
Blachier told Euronews that a brief suspension of AstraZeneca would not have such a big impact on the country's vaccine drive, provided the government communicated well enough to redress the vaccine's reputation after the European Medicines Agency review.
He also noted that the suspension had not affected trust in other coronavirus vaccines.
Castex expressed confidence on Tuesday that the EU regulator would re-authorise the AstraZeneca jab, making France's objective to have vaccinated 10 million people by mid-April "reachable."
Who can get a vaccine in France?
France says it has chosen to focus its vaccination campaign on "the most vulnerable" with a "progressive" extension to new groups as the country receives more doses.
People currently eligible for vaccination include, among others:
- Care home residents;
- All those over 75 years old;
- All health professionals;
- People of all age with a pathology exposing them to very high risks if they contract COVID-19;
- People aged 50-74 with coexisting medical conditions such as diabetes or obesity;
- Disabled people living in specialised institutions.
How do you get a vaccine in France?
Where and how to get the vaccine largely depends on the situation of the person vaccinated.
Care home residents can receive the jab at their institution, while eligible employees can get it from their companies.
Other priority groups can refer to vaccination centres. People in France can call a number for free (0 800 009 110) or check this website to find a vaccination centre.
Another option is to get a vaccine from general practitioners. According to health authorities, more than 1.6 million doses have been or will be delivered to GPs, while at least 620,000 were already injected. However, GPs used only the AstraZeneca vaccine which has now been suspended.
France's suspension of the AstraZeneca vaccine also cut short a nationwide campaign in pharmacies that launched on Monday.
More than 18,400 pharmacies out of the country's 21,000 registered to inject AstraZeneca doses, AFP reported, but the recent suspension has halted the plan.
Other vaccines currently in use in France -- namely Pfizer's and Moderna's -- require special refrigerators that general practitioners and pharmacies do not have.
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