Europe wields the stick to boost vaccination as Delta variant spreads

According to the thousands of protesters who took to the streets of Paris, Montpellier and other French towns this week, their country has become “a dictatorship” and its president is reinstating “the apartheid”.

The reason for their ire: Emmanuel Macron’s decision to make Covid-19 vaccinations compulsory for all healthcare workers, before possibly imposing it on the rest of the population. French people now have to show that they are either vaccinated or that they recently tested negative for the virus to enter cafés, restaurants, cinemas, high-speed trains or shopping malls. In the Autumn coronavirus tests will no longer be free.

A little less than a year before presidential elections, the marches have revived the spectre of the gilets jaunes who shook France in 2018 and 2019, when the grassroots protest triggered by motorists’ anger over a fuel tax developed into a months-long anti-government movement.

Macron’s move comes as countries across Europe struggle to contain the fast-spreading Delta variant first found in India and is now dominant in most EU countries. With less than half of their populations fully vaccinated, governments are seeking to compel their citizens to get the jab to limit a new surge in infections and avoid new restrictions.

Macron is following in the footsteps of Italy’s prime minister Mario Draghi, who in April was first in Europe to impose vaccinations on health workers after outbreaks in hospitals and care homes. Greece and Latvia have followed suit this week, threatening those workers with job losses if they do not toe the line.

About 4,000 people protested in Athens on Wednesday, and in the UK, a petition against compulsory vaccination for health and social care staff has received more than 93,000 signatures.

Mandatory vaccination in Europe is not novel: 40 per cent of countries have some form of enforced vaccination, including against Hepatitis B, measles and meningitis for children, said Anna Odone, a professor of public health at Università Vita-Salute San Raffaele in Milan.

Compulsory vaccines “need to be used in case of emergency and we are living in emergency times”, she said. 

There is a direct link between hospitalisations, rising again in Europe, and whether or not people have been immunised. Across France’s 30 biggest hospitals, every intensive care patient had not been vaccinated, the government said this week. In Greece, the figure is 99 per cent.

Despite a loud protesting minority, data from France and Italy suggest governments’ coercive approach is yielding results.

Since Italy issued its decree in April, Covid-19 cases, hospitalisations and deaths among care home residents have decreased, so much so that cases have all but disappeared. This bolstered a trend that began when the country imposed a targeted vaccination campaign among residents in February.

In France, more than 3m vaccine appointments have been booked since Macron’s speech on Monday, with daily bookings far exceeding previous records, according to appointment website Doctolib. About 60 per cent of these were people under the age of 35 who had previously been slow to seek vaccination.

Vaccine hesitancy has been declining in Europe. In France, more than eight out of 10 adults said they have or will get the vaccine, double the proportion in December, according to Odoxa, a pollster.

Three out of four support compulsory vaccination for carers and 61 per cent approve the extended use of “health passports”, according to a poll published in Le Figaro. Only 20 per cent of Italians are against mandatory vaccination, another poll suggested.

The soaring bookings “show that there was, in those who were not vaccinated, a very small minority of anti-vaxxers”, said Clément Beaune, French European affairs minister.

The fear of a looming fourth wave of infections means most people are willing to do what it takes to keep the virus at bay, said Mircea Sofonea, an infectious disease modeller at Montpellier university.

“The fourth wave in hospitalisations can be delayed, it can be mitigated, if we get 60 or 70 per cent of the population vaccinated by the end of the summer,” he said.

However many still have misgivings about the ethics of these mandates. To Prof Adam Finn, who sits on the UK government’s Joint Committee on Vaccination and Immunisation, the most successful vaccine programmes “don’t have to provide sticks or carrots” and instead rely on clear communication.

“It’s taken decades to build up this level of trust,” he said. “My instincts are when it’s working well, be careful about meddling with it.”

Additional reporting by Daniel Dombey, Eleni Varvitsioti and Guy Chazan