Spending on vaccines in France has increased by 70% over the past six years, but the country has not yet met its vaccination coverage targets, according to a recent report by the Court of Audit. The report, presented at the Necker Hospital, provides a critical look at vaccination policies since 2018, highlighting both progress and significant gaps. For instance, influenza vaccination coverage for people over 65 years old reached 54% for the 2025-2026 period, a drop from 2022. The World Health Organization (WHO) recommends a target of over 75% for this age group. The report excludes vaccines used during health crises, such as the pandemic, from its analysis. Another area of concern is the human papillomavirus (HPV) vaccine, which helps prevent cervical cancer and precancerous lesions. Despite multiple public health campaigns, only 55% of 15-year-olds in France have received the vaccine. This is significantly lower than the rates in other European countries like Portugal, Spain, and Sweden, where more than 80% of 15-year-olds are vaccinated. Meanwhile, measles vaccination coverage remains historically low, with an 80% increase in cases from 2024 to 2025, totaling 800 additional cases. In comparison, the United States recorded over 2,800 measles cases in August 2025 alone, a number equal to France’s total for the entire year. This surge is linked to anti-vaccine policies promoted by former U.S. health minister Robert Kennedy Jr. under former President Donald Trump. France’s annual spending on vaccination programs is estimated at 1.4 billion euros, with 617 million euros reimbursed by the Health Insurance in 2024. This represents a 70% increase since 2018, mainly due to the use of more expensive vaccines. The Court of Audit calls for a careful evaluation of the efficiency and financial impact of each new vaccine. For example, a more effective influenza vaccine for the elderly would require an additional 200 million euros, raising questions about whether these funds could be better allocated to improve vaccination rates among younger populations. The report also points out that the increase in the number of vaccinators, including pharmacists, has not led to improved vaccination coverage. Other healthcare professionals and care sites remain underutilized in vaccine delivery. Additionally, medical laboratories and hospitals do not fund vaccines, which limits the ability to expand access. The Court of Audit recommends analyzing vaccine performance in real-life settings and calls for the full population to have access to the shared medical record (DMP) and the national health data system by 2028. Currently, only 35% of the population has opened their health space, and just 11% have a vaccination record. Pharmacists are the main contributors to this data, while doctors rarely update it, and many healthcare professionals, including those in occupational and school medicine, lack access. Without this data, tracking vaccination status during an epidemic would be challenging. The report also highlights social inequalities, with lower vaccination rates in secondary schools located in priority areas. It recommends strengthening vaccination policies in schools, integrating them into school health strategies, and allowing school nurses to prescribe and administer vaccines.