Until now, the right to prescribe vaccines was reserved for physicians and, under certain conditions, midwives. However, the latter’s competence was restricted to women, newborns and members of the child’s or pregnant woman’s entourage. As an exception to these rules, the Covid-19 vaccine could be prescribed (subject to certain reservations) by midwives, nurses and pharmacists.
In the first half of 2022, the French National Authority for Health (“HAS”) recommended extending the powers of pharmacists, nurses and midwives to prescribe vaccines[1].
Article 30 of the Social Security Financial Act (“LFSS”) for 2023 drew the legislative consequences of these recommendations. The French Public Health Code was amended to allow the above-mentioned healthcare professionals to prescribe certain vaccines, under conditions determined by decree of the French Council of State (“Conseil d’Etat’”), the list of which would be set by ministerial order.
The implementing regulations were published in the Official Journal (“Journal Officiel”) this morning[2].
As a result, as of tomorrow, dispensing pharmacists, nurses, professionals working in a pharmacy for internal use (“PUI”)[3], professionals working in a medical biology laboratory[4] and midwives will be able to prescribe the following vaccines:
Vaccines listed in the vaccination calendar
The vaccination calendar, which sets out the vaccinations applicable to people living in France according to age, can be consulted here. It contains both general and specific recommendations (for specific conditions or professional exposures).
The vaccines listed can be prescribed (in addition to by physicians) by:
- pharmacists and nurses for people aged eleven and over, according to the recommendations in the calendar, with the exception of live attenuated vaccines for immunosuppressed persons;
- midwives, regardless of age, according to the recommendations set out in the calendar, with the exception of live attenuated vaccines for immunosuppressed persons.
Seasonal flu vaccines
The right to prescribe seasonal flu vaccines has been extended. These vaccines can now be prescribed (in addition to by physicians) by pharmacists, nurses and midwives, to all persons, whether or not they are targeted by the vaccine recommendations.
The aim of this measure is twofold: to increase the population’s vaccination coverage and to save money. The government estimates that prescriptions by pharmacists (whose cost is much lower than prescriptions by physicians) will account for 30% of total prescriptions in the first year of application, and almost 45% in the third year[5]!
[1] HAS recommendations “Extending the vaccination responsibilities of nurses, pharmacists and midwives” of January 27, 2022 for people aged 16 and over, supplemented on June 23, 2022 for people under 16.
[2] Decree no. 2023-737 of August 8, 2023 relating to the vaccination skills of midwives; decree no. 2023-736 of August 8, 2023 relating to the vaccination skills of nurses, dispensing pharmacists, nurses and pharmacists working in internal-use pharmacies, healthcare professionals working in medical biology laboratories and students in the third cycle of pharmaceutical studies; order of August 8, 2023 establishing the list of vaccines that certain healthcare professionals and students are authorized to prescribe or administer and the list of persons who may benefit from them in application of articles L. 4311-1, L. 4151-2, L. 5125-1-1 A, L. 5126-1, L. 6212-3 and L. 6153-5 of the French Public Health Code.
[3] This includes pharmacists and nurses working within a pharmacy for internal use (PUI).
[4] These include medical biologists, physicians and pharmacists authorized to practice as medical biologists, and nurses working in the medical biology laboratory.
[5] It should be noted, however, that this estimate is based on seasonal flu vaccination figures, and does not include the share of prescriptions by midwives or nurses.
