Across the Atlantic, in France, it’s a bet that’s starting to pay off.
Despite a slow start to its rollout of vaccination earlier this year, driven by supply chain problems that culminated in a bruise in the public battle with AstraZeneca over lack of delivery and concerns about blood clots, France finally got its program up and running this spring. In May, the country reached its goal of partial vaccination of 20 million people – 30% of the population. But then it quickly started hitting a wall.
In July, as France’s vaccination rate stagnated and coronavirus cases increased, French President Emmanuel Macron imposed extensive vaccination requirements on much of his daily life.
From Aug. 1, anyone without a “health card” showing proof of their vaccination status or a recent negative test would not be able to enter bars and cafes or travel long distances by train, Macron said. Health workers – a group of about 2.7 million people in France – who have not been vaccinated by Wednesday are facing dismissal or suspension without pay.
Macron’s relocation was a calculated risk in a country where a deep cultural belief in individual liberties and distrust of the government has manifested itself in vaccine will.
“Clearly, Emmanuel Macron took a risk,” said Bruno Cautres, a political analyst at the Center for Political Research at the Sciences Po in Paris.
“He took a risk saying I want to make the lives of the non-vaccinated very difficult, which is a very, very, very dangerous statement for a director.”
When the proposal went to French lawmakers, protesters began weekly demonstrations against the health care system. On July 31, more than 200,000 people took to the streets across France, a mix of those who oppose the health care system and its restrictions on freedoms, and people who are reluctant to be vaccinated completely.
But for all the noise, many more Frenchmen voted with their feet in support of the pass and stretched their arms. On the same day, 532,000 people were vaccinated, according to the French Ministry of Health.
Despite early opposition, Macron’s risk appears to be reaping significant gains.
Immediately after Macron’s speech on July 12, there was an increase in vaccination agreements in France. Doctolib, the most important platform for booking jabs in the country, saw 1 million appointments in 24 hours. Partly thanks to its swelling vaccination rate – coupled with a massive increase in testing in connection with the Covid passport and the reintroduction of mask mandates in regions hard hit by the Delta variant – mainland France largely managed to circumvent the fourth wave sweeping through Europe and the United States.
One month after France’s new health passport regime, data from the country’s health agency show an overall decline in hospital and ICU admissions since the height of the summer. And while public health experts are waiting to see if the decline will continue, many are cautiously optimistic.
“In the few minutes after [Macron’s] announcement, there was a record hit in the number of reservations for vaccination. And this continued in the following days. And what we are seeing now is that they are still rising, ”Vittoria Colliza, a Paris-based epidemiologist at Inserm, the French public health research center, told CNN in a telephone interview in August.
“I think it really works in terms of incentives. And the sanitation pass itself also has another effect … limiting the risk of contact in our social daily lives, so this should have an effect in terms of the number of cases.”
Now the United States is seeking to repeat some of France’s success.
Last Thursday, President Biden introduced strict new vaccine rules for most federal workers, health professionals and companies with 100 or more employees. Biden announced the move, which could hit as many as 100 million Americans, and expressed frustration over the unvaccinated. “We have been patient, but our patience is running out and your refusal has cost us all,” he said, acknowledging that the new steps would not provide a quick solution.
The mandates represent a significant change in thanks to the Biden administration, which previously tried to avoid widespread vaccine requirements. In the United States, mask and vaccine mandates are predominantly left to local authorities. But as U.S. vaccination efforts stagnated in recent months, the administration began turning to more coercive measures to get shots in the arm. In late July, Biden announced that all federal employees and contractors should be vaccinated or subject to regular testing.
Heidi Larson, the founder of the Vaccine Confidence Project, agrees that government coercion is not necessarily a silver bullet for converting the unvaccinated.
“At the end of the day, it [mandates] increases uptake, but for the people who hesitate, things like them make them even more angry. They dig their heels even deeper, ”Larson said.
“We did some national surveys with a lot of people in the UK and brought up the whole issue of vaccine passports, and that was fine for the people who were pro-vaccinated and accepted them, but for the people who were hesitant, it made them even more hesitant and more likely to refuse if they felt they were being told to do so or that it was a moral responsibility. “
For those who are reluctant to receive newly developed vaccines, broader efforts are needed to encourage admission, experts say. The information was “not very clear” about the vaccines, said Catherine Hill, an epidemiologist at the Gustave Roussy Institute in Paris. “There were a lot of rumors of fake news about the lawsuits,” she said.
Prior to the new law, the French government tried to adjust vaccination rates through incentives and public health complaints – an effort they have continued as the health passport has been rolled out.
“Get vaccinated if you love your relatives, your friends, your brothers, your sisters and your parents,” Macron said on Instagram, “because by being vaccinated yourself, you protect them too.”
The thinking about communication coincided with a push to make vaccines more readily available. Seaside deals were opened for them on vacation and walk-in sessions began, which both epidemiologists Hill acknowledges to help with France’s Covid-19 U-turn.
“This [mandates] was really a change of paradigm, “Colliza said.” If you think about vaccination doubts and how the authorities tried to deal with it, in the beginning there was really a lot of pressure on explanations, on communication, and the goal was really not to oblige people, but to convince them. And at some point, given the very large circulation of the Delta variant in several EU countries, the authorities are moving towards something a little more restrictive. “
The final phase of Macron’s law on health passes begins this week, with the mandate for health professionals coming into force.
On August 30, government employees as well as customers of companies covered by the law were required to present a health card to enter the premises. In France, almost 1.8 million workers fell during this enlargement.
Anais Majdoubi, a 27-year-old employee at an escape company in Paris, was initially reluctant to be vaccinated. She used to get a Covid-19 test every three days to show her boss, a strategy that proved impractical when the French government approved the Health Pass Act in August. She reluctantly got the sting, but fears for what it means for those who still resist vaccination.
“I think we just have to be careful with people who are not vaccinated, not to treat them differently,” Majdoubi said.
“We should not point fingers at them.”
CNN’s Eliza Mackintosh wrote and reported from London, England and Joseph Ataman, Saskya Vandoorne and Melissa Bell from Paris, France.