five things to know about the French vaccination plan

The High Authority for Health presented new recommendations in terms of vaccination strategy on Monday.

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As the results of the latest clinical studies are published, the vaccination plan against COVID-19 is emerging. If they prove conclusive, the doses of the six candidate vaccines pre-ordered by the European Union will arrive in droplets. The vaccination campaign, that is “fast and massive “, could start “probably, from late December to early January”, indicated Tuesday, November 24 Emmanuel Macron in a speech.

The Pfizer-BioNTech tandem vaccine, which currently dominates the competition, could be validated by the European Medicines Agency (EMA) in mid-December and be distributed in France in January 2021. However, pre-ordered doses will not allow vaccinating the entire population. It is therefore necessary to give priority to the public who will have first access to the coronavirus vaccination and to ensure that the vaccination campaign does not turn into a fiasco, like the one conducted in 2009 against the H1N1 virus. The High Authority for Health (HAS), an independent government body, released new recommendations on Monday, November 30, outlining what the French vaccination strategy should be.

1. No mandatory vaccinations at this stage

“I will not make vaccination compulsory”, assured the President of the Republic in his last speech. A position consistent with the one defended this summer by the High Health Authority. The institution reiterates its recommendation in its latest press release : “The HAS reminds us not to advise, at this stage, to make vaccination against Covid-19 mandatory”. Such a measure could prove counterproductive due to the current lack of visibility and the context of distrust of many French people towards vaccines.

2. Two priority recipients

The vaccination campaign must achieve a double goal: “reduce hospitalizations and deaths and maintain the country’s essential activities, especially those of the health system during the epidemic”, explains the High Authority for Health. For this, the institution recommends targeting two audiences as a priority: those at greatest risk of developing a severe form of Covid-19 and healthcare workers, paramedics, medical assistants, stretcher bearers, social workers and other professions. be susceptible “being in contact with Sars-CoV-2 infected patients”.

As for the primary public, the institution explains that it has examined the scientific literature to determine the most vulnerable profiles. It notes that age and the presence of the following comorbidities are the two most important risk factors: “obesity (BMI> 30) especially in younger people, COPD and respiratory failure, complicated hypertension, heart failure, type 1 and 2 diabetes, chronic renal failure, recent cancers under the age of three, solid organ or stem cell transplant hematopoietic and trisomy 21 “. HAS specifies it “other pathologies or forms of disability can be integrated as knowledge is acquired”.

3. A plan for a phased vaccination

The delivery of the doses will not allow to vaccinate all the groups of the public considered “priority” at once. This is why the High Authority for Health proposes to stagger the campaign “five progressive stages”. The first three steps should allow you to vaccinate all people at risk to develop severe Covid-19.

During this first stage vaccination, lOlder people residing in nursing homes or another type of collective housing should be vaccinated, the HAS recommends. Medical-social and medical transport professionals working in nursing homes or long-term care units (USLD) over the age of 65 and / or with comorbidities will also be vaccinated.

The Second step it is aimed at people over the age of 75, then people aged 65 to 74 with one or more comorbidities and finally people aged 64 to 74 without comorbidities. The Professionals from the socio-medical and medical transport sectors over the age of 50 and / or with comorbidities will also be involved.

The third step it will vaccinate people identified as a priority audience who have not been vaccinated during the first two phases. That is people under 64 years of age with comorbidities and all professionals in the medical-social sector and healthcare transport not interested in the first two phases. Depending on the dose supply, “the vaccination of professionals from sectors essential to the functioning of the country could be undertaken and determined by the government “, specifies the HAS, citing professionals from the security and education sectors.

The fourth and fifth stage they concern the rest of the population. The professions most exposed to the virus and vulnerable and precarious people who in fact have a higher risk of worsening the disease in the event of infection should be vaccinated as a first step, before the vaccine is open to people over the age of 18 and not. has comorbidities.

4. An effort on transparency

To ensure the success of this vaccination campaign, the Haute Autorité de santé “recalls the need for clear and publicly accessible information at all stages of vaccine supply”. The institution reminds in its press release that the vaccination plan should only be implemented if “Studies show that vaccines have a possible effect on virus transmission and that vaccine availability (is) enough “.

One of the challenges for the health authorities will be to convince the French. For this, HAS relies on the transparency of the directives and scientific information available. Because only 41% of French people intend to be vaccinated against Covid-19, according to an Ifop poll for the Sunday newspaper, published on Sunday and made on a sample of 1,013 people.

5. Monitoring of vaccinations

Also recommends the High Authority for Health “monitor the distribution of vaccine doses to be able to reactivate them if necessary for priority people” and allow the “collection of real data“to monitor vaccination. These data could prove invaluable to ensure the pharmacovigilance, i.e. the evaluation of the secondary risks of the inoculated vaccine.

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