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Očkovanie vo Francúzsku


 | 3.9.2013 | komentárov: 306

Očkovanie je jedným z najúčinnejších prostriedkov prevencie proti infekčným chorobám. Očkovacie látky majú v porovnaní s inými liekmi svoje špecifiká. Podávajú sa osobám, ktoré sú a priori zdravé, aby ich v budúcnosti chránili pred vznikom choroby. Vakcinácia má aj nesporný celospoločenský prínos, keďže zabraňuje šíreniu infekčných chorôb medzi obyvateľstvo.

Obrazok

Od roku 1970 sa politika očkovania vo Francúzsku výrazne modifikovala. Nové vakcíny prešli z označenia „povinné“ na označenie „odporúčané pre celé obyvateľstvo“. To však v žiadnom prípade neznamená, že sú menej prospešné. Vakcinačnú politiku má, podľa zákona z 9. augusta 2004, ktorý sa týka  verejného zdravia, na starosti minister zdravotníctva. Ten určuje podmienky imunizácie, formuluje nevyhnutné odporúčania a rok čo rok vydáva očkovací kalendár. 

Očkovací kalendár je dokument, ktorý sa aplikuje na osoby žijúce vo Francúzsku v závislosti od ich veku.  Kalendár každoročne aktualizuje Technický výbor pre očkovanie (Comité technique des vaccinations, CTV), stály výbor bezpečnostnej komisie Vysokého úradu verejného zdravia (Haut Conseil de la santé publique, HCSP). Ostatný očkovací kalendár na rok 2013 dostal prívlastok zjednodušený. Cieľom reformy Ministerstva zdravotníctva je predovšetkým znížiť počet injekcií pre dojčatá a preočkovaní pre dospelých do 20 rokov, uľahčiť memorovanie dátumov preočkovaní a tým pádom zvýšiť počet zaočkovaných Francúzov.

Vakcinačná politika sa v krajine galského kohúta realizuje prostredníctvom duálneho systému povinného a odporúčaného očkovania. Úprava obligatórneho očkovania sa nachádza v Zákonníku verejného zdravia (Code de la Santé publique).Všetky deti vo Francúzsku sú povinne zaočkované proti záškrtu, tetanu a detskej obrne. Vakcinácia sa vykonáva simultánne dvoma injekciami pri dovŕšení 2. a 4. mesiaca a preočkovaním vo veku 11 mesiacov. Rodičia alebo poručníci maloletých sú osobne zodpovední za jeho vykonanie. Potvrdenie o zaočkovaní je nutné predložiť pri nástupe do školy, materskej školy, tábora alebo iného detského združenia.  Očkovanie je povinné okrem prípadu zistených zdravotných kontraindikácií. Odmietnutie povinného očkovania alebo snaha zabrániť jeho vykonaniu sa chápe ako  delikt. Dôsledky takého konania upravuje Zákonník verejného zdravia, ktorý ustanovuje sankciu 6 mesiacov väzenia a pokutu vo výške 3750 Eur.

Ministerský výnos z roku 1967 upravuje povinné očkovanie proti žltej zimnici, ktoré sa týka výhradne územia Guyany. Vakcináciu musia obligatórne podstúpiť všetky osoby staršie ako 1 rok, ktoré na jej území bývajú alebo sa zdržiavajú viac ako 15 dní.

Povinne očkovaní sú aj zdravotnícki zamestnanci vystavení nebezpečenstvu nakazenia a to konkrétne proti záškrtu, tetanu, detskej obrne, tuberkulóze a hepatitíde typu B. Pracovníci laboratórií sú povinne očkovaní proti brušnému týfu. Obligatórne očkovanie sa týka aj študentov daných profesií.
Očkovanie proti ďalším chorobám nie je povinné, ale v niektorých prípadoch sa veľmi odporúča. Ich taxatívny výpočet ako aj očkovacie schémy podrobne stanovuje očkovací kalendár. Vykonanie očkovania, povinného alebo odporúčaného, je potrebné zapísať do zdravotnej karty.

Náklady spojené s povinným očkovaním hradí nemocenské poistenie (l'Assurance Maladie). Kompletný zoznam vakcín hradených prostredníctvom nemocenského poistenia bližšie určuje nariadenie Ministerstva. Sú refundované na základe lekárskeho predpisu do výšky 65% z ceny uvedenej na obale. Vakcíny, ktoré sa odporúčajú pri vycestovaní do určitých krajín si pacient hradí sám.

Úplnú náhradu škôd, ktoré priamo súvisia s vykonaním povinného očkovania zabezpečuje Národný úrad pre odškodnenie zdravotných úrazov (l'Office national d'indemnisation des accidents médicaux). Neuhrádza však ujmy spôsobené odporúčaným očkovaním, nakoľko tieto je často krát zložité preukázať.
Odporcovia vakcín tvrdia, že očkovanie nie je jediným prostriedkom prevencie a že k zdraviu vedie viacero ciest. Jeho privilegované postavenie preto označujú za neopodstatnené.  Zdôrazňujú, že ľudské telo je nedotknuteľným vlastníctvom človeka a je posvätné. Nikto nemôže druhého prinútiť, aby sa podrobil akejkoľvek liečbe, preventívneho alebo kuratívneho charakteru, bez jeho výslovného súhlasu. Obligatórny status vakcinácie sa často interpretuje ako zásah do fyzickej a morálnej integrity jednotlivca, do slobody svedomia a spravidla vedie k vzniku „protiočkovacieho“ hnutia. Vo Francúzsku je ním Národná liga za slobodu očkovania (Ligue National Pour la Liberté des Vaccinations). Jej cieľom je dosiahnuť úplnú slobodu očkovania,  právo slobodne vybrať sebe a svojim deťom lekára, ktorý očkovanie vykoná a ktorému budú dôverovať. A napokon dosiahnuť, aby všetky nežiaduce následky spojené s povinnou vakcináciou boli predmetom náhrady škody zo strany štátu.

Spracovala: Katarína Zubková

Zdroje: http://www.ameli.fr/assures/offre-de-prevention/la-vaccination.php
http://sante.lefigaro.fr/mieux-etre/vaccination-depistage/calendrier-vaccinal/vaccinations-obligatoires
http://www.sante.gouv.fr/calendrier-vaccinal-2013.html
http://www.infovaccin.fr/legislation_vaccinale.html
http://www.pseudo-sciences.org/spip.php?article2037
http://vosdroits.service-public.fr/particuliers/F704.xhtml
http://www.hcsp.fr/Explore.cgi/PointSur?clef=1



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