The COVID-19 vaccination strategy now includes a scheme for vaccinations in the workplace, offered to employees on a free and strictly voluntary basis, to be administered by occupational health professionals.
Vaccination within companies began on 25 February 2021 for people aged 50 to 64 with comorbidity.
The vaccine chosen for this vaccination phase is the AstraZeneca vaccine, the use of which is authorized despite recent controversies. In short, after a national suspension of its utilization on 15 March 2021, the French National Authority for Health (HAS) recommended the immediate resumption of the vaccination on Friday, 19 March 2021 following the favorable opinion issued by the European Medicines Agency the day before — Thursday, 18 March 2021.
In order to ensure the proper implementation of the vaccination strategy in companies, the Ministry of Labor has issued a protocol, the key aspects of which are as follows.
Firstly, the protocol confirms that vaccination against COVID-19 is not mandatory within the meaning of the Public Health Code, but is only a recommendation. Consequently, the prior clear and plain consent of the employee is compulsory. As a result, the employee may always refuse to be vaccinated and such refusal cannot lead to any unfavorable consequences or sanctions. Similarly, companies cannot access any information on the vaccination status of their employees, nor information on their acceptance or refusal of the vaccination.
Companies wishing to get involved in the vaccination campaign must therefore address four major priorities:
- Adapting their premises to facilitate the campaign, in particular by making a dedicated space available so that the authorised occupational health nurse or doctor can carry out the injections
- Organise the reception of the vaccination products
- Manage vaccination wastes to avoid contamination risk
- Ensure medical confidentiality
For the time being, the protocol prioritises the vaccination of employees at the occupational health services’ premises rather than at the company’s premises.
As individuals are free to accept or to refuse to be vaccinated, they may also choose to be vaccinated by their General practitioner doctor. Therefore, employees who wish to be vaccinated must contact the occupational health service and explicitly request to be vaccinated by the later, rather than by their General practitioner.
However, the difficulty lies in the fact that employees’ privacy must be protected in the context of the company vaccination campaign. In concrete terms, this means that the employer is currently not authorized to individually contact employees identified as vulnerable. Information on the vaccination campaign must be provided to all employees regardless of their age, and must mention the current national strategy targeting (people aged between 50 to 64 inclusive with comorbidity at this stage of the campaign).
Alternatively, the occupational health doctor can inform employees of the vaccination campaign and can directly target patients identified as potentially affected.
Furthermore, the organization of the campaign within the company can be supervised by the Works Council (so-called social and economic committee or CSE), and/or by the health, safety and working conditions committee, which we recommend should be informed of the campaign.
We would like to draw our readers’ attention to the fact that companies whose staff are, by definition, in contact with the public, such as banks or stores, should be encouraged to implement a vaccine promotion strategy.
However, for now, occupational health does not play a central role in the vaccination campaign and the question of whether companies should be provided with vaccines supplies currently remains unanswered. Indeed, only the Government is authorized to purchase vaccines to pharmaceutical laboratories.
Unfortunately, these elements could lead to the failure of the company vaccination strategy.
The list of pathologies that have comorbidities with COVID-19 is as follows:
- cardiovascular pathologies: complicated arterial hypertension (with cardiac, renal and vascular-cerebral complications), record of stroke, record of coronary artery disease, record of cardiac surgery, NYHA stage III or IV heart failure
- unstable or complicated diabetes
- chronic respiratory pathologies likely to decompensate during a viral infection: obstructive pulmonary disease, severe asthma, pulmonary fibrosis, sleep apnea syndrome and cystic fibrosis
- obesity with a body mass index greater than or equal to 30
- cancer evolving under treatment (excluding hormone therapy)
- cirrhosis at least stage B of the Child-Pugh score
- congenital or acquired immunodepression
- major sickle cell syndrome or record of a splenectomy
- motor neurone disease, myasthenia gravis, multiple sclerosis, Parkinson’s disease, cerebral palsy, quadriplegia or hemiplegia, primary malignant brain tumor and progressive cerebellar disease
- cancers and hematological malignancies undergoing chemotherapy
- severe chronic kidney disease, including dialysis patients
- solid organ transplant recipient
- persons who have received an allogeneic hematopoietic stem cell transplant
- chronic poly-pathologies with at least two organ failures
- certain rare diseases that are particularly at risk in the event of infection (list established by the rare diseases health networks)
- trisomy 21