PARIS (AP) – The few hours it took to give the first vaccination shots with the coronavirus to 14 residents of the John XXIII nursing home – named after a pope and not far from the birthplace in eastern France of vaccine pioneer Louis Pasteur – took weeks of preparation.
The home’s director, Samuel Robbe, first had to work his way through a tight 61-page vaccination protocol, one of the many great guides from the French government which describes in detail how to proceed, to the number of times (10) each vial of vaccine must be turned upside down to mix the contents.
“Fine”, says the booklet. “Don’t shake.”
While France tries to find out why its vaccination campaign got off to such a slow start, the answer lies partly in the woods of bureaucracy and the decision to give precedence to frail older people in nursing homes. They are arguably the most difficult group to start with, due to the need for informed consent and difficulty explaining the complex science of accelerated vaccines.
Claude Fouet, still full of vim and good humor at the age of 89, but with memory problems, was one of the first in his Parisian nursing home to agree to a vaccination. But in conversation it quickly becomes clear that his understanding of the pandemic is spotty. Eve Guillaume, the director of the house, had to remind Fouet that he survived his own brush in April with the virus that killed more than 66,000 people in France.
“I was in hospital,” Fouet recalled slowly, “with a dead person next to me.”
Guillaume says getting the consent of her 64 residents – or their guardians and families if they are not fit enough to agree on their own – appears to be the most labor-intensive part of her preparations to start vaccinations later this month. Some families have said no, and some want to wait a few months to watch vaccinations unfold before deciding.
“You can’t count on medicated care homes to work quickly,” she says. “It means every time you start a conversation with families, talk to guardians, take collegial steps to make the right decision. And that takes time. “
In the house of John XXIII, between the fortified city of Besancon and Pasteur’s birthplace in Dole, Robbe had a similar experience.
After the European Union gave the green light for the use of the BioNTech-Pfizer vaccine In December, Robbe said it took two weeks to put all the pieces together to vaccinate 14 residents this week, just a fraction of his total of more than 100.
Getting consent was the biggest hurdle for a doctor and psychologist going from room to room to discuss vaccinations, he says. Residents’ families were given a week during the December break to approve or deny, a decision that had to be made unanimously by the immediate family members.
When a woman’s daughter said yes, but her son said no, no shot was given because “they can turn on us and say, ‘I never agreed,'” explained Robbe. “No consensus, we don’t vaccinate.”
Only by cutting back and dutifully bringing residents to agreement can the process go faster, he says.
“My friends say, ‘What is this circus? The Germans have already vaccinated 80,000 people and we have not vaccinated anyone, ” he says. ‘But we don’t share the same history. If you offer Germans a vaccine, they all want to be vaccinated. In France, there is a lot of reluctance about the history of vaccinations. People are more skeptical. They have to understand. They need clarification and reassurance. “
France prioritized nursing homes as they have seen nearly a third of the deaths. But the first vaccination on December 27 of a 78-year-old woman in a long-term care facility, it soon turned out to have been just the symbolic launch of a rollout that the government never really wanted to get going this week.
It was only Monday, as planned, that authorities launched an online platform where health workers were required to register all vaccinations and demonstrate that those vaccinated received a mandatory consultation with a doctor, adding to the red tape.
In some countries that are moving faster than France, the bureaucracy is leaner. In Britain, where nearly 1.5 million people have been vaccinated and there are plans to provide jabs to all nursing home residents by the end of January, those who can give consent only need to sign a one-page form. that provides basic information about the benefits and possible side effects.
No doctor interviews are required in Spain. It started vaccinating on the same day as France, but received 82,000 doses in the first nine days, while France only managed a few thousand.
Germany, like France, also mandates a meeting with a doctor and prioritizes admissions for nursing home residents, but it reaches them faster with the help of mobile teams. At the current rate of nearly 30,000 vaccinations a day, it would take Germany at least six years to vaccinate its 69 million adults. But while the German government has been criticized for its alleged slow rollout, France has got off to an even slower start, at least in numerical terms, but has pledged to reach 1 million people by the end of January.
Other countries have amassed greater numbers by offering shots to wider cross-sections of people who are easier to reach and negotiate on their own. The vast majority of the more than 400,000 doses administered in Italy have gone to health professionals.
Lucile Grillon, who runs three nursing homes in eastern France, says the many hours invested in preparing vaccinations for 50 residents and staff who received injections on Friday were well spent. She worked through the holidays to prepare.
“We can’t wait until we have the doses in our refrigerator to realize we are not ready to vaccinate yet. Then we have to throw out doses and say, ‘Rats! I didn’t think about that, ” she adds. “The doses are too expensive.”
“It takes us two months to prepare for flu shots. Here we were asked to set records, to vaccinate against COVID in less than 15 days, ”she says. “I don’t see how we could have gone faster.”
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Writers from Associated Press Pan Pylas in London, Nicole Winfield in Rome, Ciaran Giles in Madrid and Kirsten Grieshaber in Berlin contributed.
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