When 66-year-old cardiologist Jean-Jacques Monsuez slipped one arm out of his blue-and-white checked shirt and offered it to a nurse holding a syringe filled with the Pfizer COVID-19 vaccine, he was doing what many in the world plan to do as soon as they have the chance.
Just not in France.
This may be the land of Louis Pasteur, the scientist renowned for discovering the principles of vaccination. But it is also one of the most reluctant nations in the world to get the COVID-19 shot, leading to the lowest uptake so far of any developed country to start inoculating its citizens.
In the first six days after the vaccine was rolled out Dec. 27 across Europe in a coordinated European Union effort, just 516 people received shots in France — such a low number out of a population of 67 million that it is statistically indistinguishable from zero. By contrast, Germany vaccinated more than 200,000 of its residents in the first week and Italy more than 100,000.
For Monsuez, the decision to get the injection was an obvious one, both for his own safety and that of his family and patients.
“There is a duty. You see one sick person after another,” he said, adding: “It didn’t hurt. I felt the same before and after.”
But many of his compatriots appear not to agree. In a poll conducted last month by Ipsos Global Advisor, in conjunction with the World Economic Forum, only 40% of French residents said they intended to get vaccinated. That put France dead last out of the 15 nations surveyed, in stark contrast to countries such as Britain and the U.S., where 77% and 69% of respondents, respectively, are eager to be inoculated.
The Gallic hesitancy springs from various factors. Many here cite concern over potential side effects and the speed with which the vaccines were developed. Distrust of the government has risen following missteps in its handling of the pandemic and from memories of previous health and vaccine scandals in France.
A cumbersome consent process has bogged down the vaccination campaign in some instances. And prominent healthcare professionals have complained of the lack of a clear official strategy for rolling out the vaccines and for convincing people of their value and efficacy.
Over the weekend, President Emmanuel Macron — who survived his own bout with COVID-19 — promised that the pace of vaccination would pick up “quickly and powerfully,” and authorities added healthcare workers over 50 to the list of those eligible for the shot.
Anne Muraro, an art advisor, is in no hurry to join the queue. “We don’t know the secondary effects,” said Muraro, 50. “It’s too fast. There is not enough hindsight.”
Muraro cited the new messenger RNA technology in the Pfizer-BioNTech vaccine as a cause for unease. The same technology is also used in the Moderna COVID-19 vaccine, which has not yet been authorized for use in Europe. Many in France worry that the vaccine was rushed to the market in part for the financial benefit of big pharmaceutical companies.
While such qualms might be understandable given the relatively short time the vaccine has been in circulation, they don’t reflect the medical community’s understanding of vaccine development and approval, said Catherine Hill, a retired epidemiologist in Paris. And the gravity of the public health emergency facing France demands that people step up for the COVID-19 shots, she said.
The country is one of the hardest-hit in Europe, with 2.7 million confirmed coronavirus cases and 65,164 deaths, according to a tally by Johns Hopkins University. After two complete lockdowns, residents are currently under curfew, and bars, restaurants and cultural attractions remain closed. Officials have promised to ease these restrictions once the number of new cases drops below 5,000 per day, a target that still seems a long way off.
“This virus is killing 400 people per day in France,” Hill said. “Imagine a big airplane falling out of the sky every day.”
In a television interview over the weekend, French Health Minister Olivier Veran defended the slow pace of vaccinations and said France would catch up with its European neighbors by the end of the month.
Veran’s management of the coronavirus crisis has inspired some mistrust among his compatriots. Early on, he said masks were “unnecessary” for the general public. Mask-wearing has since become mandatory, and many in France believe his initial counsel against it rose from a supply shortage that the government didn’t want to exacerbate rather than out of sound health policy.
As for vaccinations, a spokeswoman for the health department said it would “not be useful” to start a public information campaign now because most in France won’t be eligible for a shot until the spring, after priority is given to residents in nursing homes and to front-line healthcare workers.
The country’s recent history with new vaccines has sparked some public skepticism. In late 2009, the French government ordered far too many doses of the H1N1 flu vaccine, for which there was little demand, leading to accusations of financial mismanagement.
More pertinently, there were concerns that the hepatitis B vaccine being given in France in the 1990s was tied to an increase in multiple sclerosis. Multiple studies examined the link, with varying conclusions. In 2002, the World Health Organization affirmed that, “despite a slightly elevated odds ratio observed in the initial studies, none showed a statistically significantly elevated risk.” Many here remain unconvinced.
Edvart Vignot’s sister developed MS after receiving the hepatitis B vaccine, which is partly why he prefers to wait to see what side effects the COVID-19 vaccine may have before letting anyone stick a needle in his arm. Vignot, who is Muraro’s partner, also wants to hear what scientists not linked to governments or pharmaceutical companies have to say.
“We need other people,” he said, “independent experts.”
Also key is winning over family doctors and pharmacists, on whom the French lean heavily for advice. Eliette Gauthier, who lives in a suburb of Bordeaux, said she is still not sure whether she will get vaccinated, largely because her doctor told her he doesn’t yet have enough information to counsel her one way or the other.
“We don’t have enough information about the composition” of the shots, the 71-year-old retired schoolteacher said. “I’m going to see what my doctor advises.”
France’s inoculation campaign has further been bogged down by a complex consent process that has mandated pre-vaccination consultations with patients to ensure their consent. Because the campaign is currently targeting the elderly in retirement homes, some of whom suffer from cognitive issues, the process has been particularly laborious. Veran vowed Tuesday to simplify the process.
In the meantime, both Muraro and Vignot are taking other preventive measures, such as observing social distancing, wearing masks and taking vitamin D, which some researchers believe helps ward off infection. The couple has long since given up shaking hands or greeting friends with kisses on the cheek, as was the French habit until the pandemic broke out.
And both have already had the coronavirus, leading them to believe that they probably have some level of immunity for the time being.
Muraro said she would revisit taking the vaccine in the fall, when she will likely be eligible and when the risk of transmission is likely to rise as colder weather spurs people to move indoors.
Frederic Adnet, head of the emergency medicine at the Avicenne Hospital in the suburbs north of Paris, believes that most people in France are like Muraro and Vignot: not flat-out refusing to take the vaccine but adopting a wait-and-see approach.
“When they see it’s effective and safe, opinions will change,” Adnet said, adding that high rates of vaccination in the U.S. and the U.K. should help boost public confidence here. “I think the French are reasonable, and in two months you will see that we are all yelling that there isn’t enough vaccine.”
El-Faizy is a special correspondent.
This story originally appeared in Los Angeles Times.