IA few years ago, during my annual attempts to promote influenza vaccination among emergency personnel, a nurse’s aide asked me about the obligation to vaccinate. If it was so important that caregivers are vaccinated, why not make it compulsory to vaccinate against the flu, especially since she was young and feared nothing? And in the event that it was not made compulsory, why force her to be vaccinated? One of the nursing executives supported her publicly, saying that the vaccination had made her sicker than the flu and that she would not get vaccinated again. Of the transmission to the patients, there was no question.
In the first quarter of 2021, vaccination against Covid-19 became available and mandatory. We had passed two very difficult waves, with many dead and sick, overwhelmed hospitals, material and organizational difficulties. We were entering the third wave. There were many questions about these new vaccines, uncertainties about protection and already a lot of misinformation. When most caregivers went to get vaccinated, some opted out. Either because the fear of adverse effects took over, or because they adhered to the sometimes eccentric theses that were already surging on social networks and in the media.
We often forget that this is not the first episode. Vaccination against hepatitis B had caused enormous mistrust, already in a context of “fake news” prior to the advent of social networks. But, to use the words of the Academy of Medicine: “Far from being an attack on individual freedom, the vaccination obligations that apply to healthcare professionals are essential preventive measures to avoid the nosocomial transmission of infections; admitted by caregivers among the practices aimed at protecting patients (…)they bring honor to their profession. » Whatever the reasons, caregivers have broken with the obligations of our profession, in a mistrust of what constitutes medical practice based on studies and scientific consensus.
Situation of no return
Since then, the virus has evolved, serious patients have become less frequent and Covid is often the trigger for other pathologies in fragile patients. The recall rate of professionals has also dropped, at the same time as compliance with barrier measures. The High Authority for Health (HAS) published on March 30 an incomprehensible text without explanation in which it recommends “strongly recommend vaccination”, while lifting the vaccination obligation for Covid, diphtheria, tetanus and poliomyelitis, but retaining hepatitis B. Where is the consistency and, above all, why mix everything up? We also forget that the HAS recommendation specifies that its decision is made “without prejudging the opinion of the CCNE [Comité consultatif national d’éthique] on ethical aspects and social acceptability”, who himself was careful not to give it away.
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