The debate: making the vaccination of caregivers compulsory, a good idea?

In Italy, the decision was taken in April.

For doctors, pharmacists, paramedics, vaccination is no longer an option.

This week, it was the turn of the British, in the grip of an outbreak of cases due to the Indian variant, to take the plunge: obligation for all people working in retirement homes.

And in France ?

Disappeared from radar screens in recent weeks, the debate is necessary again, especially since this Thursday and the exit of Olivier Véran.

The Minister of Health assured that the question of compulsory vaccination would arise for caregivers in nursing homes, if the situation did not improve by the end of the summer.

"

There are 60% of French adults who have already received an injection, there

are less than 60% of caregivers who work in nursing homes

[who have received it]

, this is not justifiable,"

he said. moved.

VIDEO.

Covid-19: vaccinated caregivers want to set an example for the French and ... their colleagues

According to Public Health France, which evokes "a ceiling", only 55% of these professionals have had a dose, 42%, both.

In the hospital, the data is slightly better, with 64% of first-time vaccines against nearly 80% among the liberal ones.

But in a context of health establishments in tension, where the gowns are lacking in arms, can the country afford "the luxury" of an unpopular measure?

If for some, we must go, otherwise collective immunity will suffer, others warn of a stigmatization effect which would have the consequence of exacerbating hesitation.

FOR

"When pedagogy is no longer enough, we go through the obligation"

Karine Lacombe, head of the infectious disease department at Saint-Antoine hospital, in Paris

After having done educational work, Karine Lacombe no longer understands the reluctance in an environment that is accustomed to vaccination.

LP / Philippe Lavieille 

She had been thinking about it for a long time, without having a clear opinion.

But as the months go by, Professor Karine Lacombe, patron of the infectious disease department of Saint-Antoine hospital in Paris, leans for obligation among caregivers.

A question of responsibility.

You were still hesitating a few weeks ago.

And today ?

KARINE LACOMBE.

Overall, I am not for the obligation for the entire population.

For her, encouragement, support, and pedagogy must always be privileged.

For caregivers, the configuration is different.

When all the educational tools have been made available and that, despite everything, that is not enough, we go through the obligation.

The vaccine is effective, its safety has been demonstrated, there is no reason why there is still so much reluctance in the healthcare community.

Especially since we are not in unknown territory.

That is to say ?

In France, we already have compulsory vaccinations in healthcare establishments, for example against hepatitis B. This is implemented when there is a risk of public health, of transmission of serious infectious agents.

Which is the case with the Covid-19.

This is true everywhere, not just in the middle of care!

Yes, but we have seen real epidemics of nosocomial Covid in the hospital.

Of course, caregivers have been infected through contact with patients, but there have also been many patients infected by caregivers and in particular populations at risk, such as the elderly.

A heavy price has been paid.

However, the categories which are today the least vaccinated are those which are in the closest contact with the patients: the nursing assistants, all the paramedical professions in the nursing homes… The most at risk are the least protected.

Read alsoPierre, dead after catching the Covid in hospital

To oblige is to stigmatize, defend those who are against ...

Not at all !

The obligation is not a bad word, it shows on the contrary to what extent the caregivers are a driving force in the control of the epidemic.

No stigma but responsibility.

Protecting others is our core business.

The epidemic is slowing down but we will continue to have patients and we fear, because of the variants, a difficult re-entry.

And then, if one day we want to take off the mask, even in the hospital, it will be impossible if everyone is not vaccinated.

You are the patron of a department, have you managed to convince everyone?

No, but almost everyone is vaccinated: 100% of doctors, 90% of nurses, 80% of nursing assistants.

I spoke a lot with those who did not want to understand the reasons, but like everywhere, there are some people that we feel we will not be able to convince.

AGAINST

"It's counterproductive"

Patrick Chamboredon, President of the National Order of Nurses

For Patrick Chamboredon, nurses are like other young people: their turn arriving, they will go to be vaccinated.

ONI 

In substance, as in form, Patrick Chamboredon, boss of the Order of Nurses, has little taste for the idea of ​​compulsory vaccination for caregivers.

A threat that he believes may exacerbate hesitation when the summer could on the contrary be conducive to vaccination.

According to the figures, vaccination among caregivers is leveling off.

The obligation, a solution to remedy it?

PATRICK CHAMBOREDON.

I am against anything that is stigmatizing for caregivers.

After having brought them to the pinnacle, it is now suggested that they are the cause of all ills.

We even forget their role, their investment in vaccination centers.

Who vaccinates today?

Them!

I would therefore like to have a much more detailed analysis of the figures: where do they come from, are they representative?

You have to take a closer look before putting everyone in the same basket.

A little less than 60% for the nurses you represent ...

Of course, this is not enough, and I repeat it: vaccination is an ethical duty.

But considerable efforts have been made.

Take the flu: 40% vaccinated.

There, 60!

That's 50% more!

Nurses are a young population, they will go there like people their age from now on.

Going out before summer is counterproductive.

Better to try to understand than to scapegoat caregivers.

Where does this hesitation, almost historical, come from?

It is a very complex phenomenon, which has been built up over the years and over which we have few levers.

Can stigma be one?

I doubt.

I prefer pedagogy.

The caregivers can see that the difficulties of side effects are behind us, they too want to resume a normal life.

The holidays are coming, they will be more relaxed and will go to be vaccinated.

Hence the importance of setting up “second dose” devices on resort sites.

To read also "Finally, I will get vaccinated": these French people who have changed their minds

What if that is not enough?

I trust.

You'll see, we'll talk about it again at the start of the school year!

The more we will brandish the obligation, the more we will exacerbate mistrust.

And then, concretely, when the hospital is understaffed, how will a HRD do if a person tells them that they are not vaccinated?

If ten people are not, do we close a department and no longer treat patients?

Putting it in place would be rock'n'roll.

You have to think about the application in "real" life.

And have you vaccinated yourself?

Obviously!

All is well, I am not talking to you from beyond the grave!

And I will continue to try to convince, I believe a lot in proof by example.