Why did France purchase (precisely) 200 million doses of the vaccine?

Almost imminent launch. Within a month, France will begin its Covid-19 vaccination plan. Thanks to the orders taken at the European level, “it will have a potential of 200 million doses, which will allow to vaccinate 100 million people, since the vaccine currently requires two injections” given a few weeks apart, a said the Prime Minister. this Thursday, during his presentation of the vaccine strategy in France.

Large plan to be provided after marketing authorization

200 million doses, divided by two injections, minus 67 million inhabitants: you don’t need to be a math genius to see that France has planned very large by potentially ordering 66 million doses of vaccines too many. Figures that question the more that the closer the coronavirus vaccination is, the less the French seem to want to be vaccinated: only half of them intend to do so, according to official data unveiled this Friday by Health. public France. “In November 2020, only half of the people interviewed (53%) replied that they definitely or probably wanted to be vaccinated against Covid-19 *. This result is down compared to the month of July, when 64% said they wanted to do so ”, indicates the health agency in its weekly update.

So why did France buy 200 million doses? Purchasing and distribution were organized on a European level. “The prices are the same for everyone” and will be delivered simultaneously in all the countries of the European Union, said Jean Castex. The distribution will be made “in proportion to the population of each country, or about 15% for France,” he said.

For now, these are pre-orders only. The State has therefore seen a large margin left on the basis of the authorizations that will be granted to the various vaccines. The European Medicines Agency (EMA) is reviewing marketing authorization applications submitted by Pfizer in association with the German company BioNTech, whose vaccine has just been authorized in the UK, and by Moderna. It is therefore a question of avoiding finding yourself with too low a supply of vaccines, even if it means finding yourself with an excess on your hands, as happened in 2009 during the vaccination campaign against the H1N1 flu. The then Minister of Health, Roselyne Bachelot, ordered 94 million doses and found herself with a large unused supply.

Wide plan to avoid the fiasco of the first wave masks

“Lack of anticipation”, “amateurism”, “catastrophic” management of the health crisis. Since the start of the first wave last spring, the government has suffered a storm of criticism. The original sin was not to have prevented the shortage of masks and to have been able to say that, in the absence of a sufficient supply, they should have been reserved for caregivers. It is then up to the population to make homemade masks or buy masks for the general public. So today it is better to have too much than not enough. There is no doubt that the government accumulates other communication errors and management errors. Especially since broadly vaccinating the population is one of the main means of avoiding successive waves of epidemics. To achieve this, the executive has chosen to make the anti-Covid vaccination free: for this, 1.5 billion euros are entered in the 2021 pension budget. “And obviously, and this is another advantage of the negotiations conducted at European level, we will pay only what will actually be delivered to us in the end “, underlined the prime minister.

And the very nature of Covid vaccines poses a huge logistical challenge to ensure their safe transportation and storage. Pfizer-BioNTech’s messenger RNA vaccine, which is expected to be the first available on the market, requires storage at -70 ° C. “We have designed a specific thermal container, using dry ice, to maintain the recommended storage conditions during transport. and at the vaccination site, “Pfizer says. After delivery, these vaccines will need to be stored in special super freezers, the global demand for which has soared in recent weeks. France has ordered about fifty. And after this step? “It is desirable that the primary care physician be the heart of the system, and especially the treating physician,” said Jean Castex. Everyone must be able to be vaccinated by a health professional near their home that they know and trust ”. But not all GPs will have a super freezer! There could be losses linked to specific storage conditions, and therefore to be anticipated (back to tens of millions of excess doses). The American-German duo, however, ensures that their vaccine, once unpacked and then taken out of the super freezer, can be stored for five days in a normal refrigerator.

Logistics should be simpler for Moderna’s vaccine, which should soon also receive its marketing authorization in Europe and France. It can be kept for six months at -20 ° C, in conventional freezers, and can be kept for one month in the refrigerator. It would also be stable for a dozen hours at room temperature.

Do you have a plan to vaccinate a second time?

If the French plan is to inject the vaccine as a priority to nursing home residents, health care workers and then patients suffering from comorbidities before hitting the general public, how long will the immunity induced by the two injections last? According to the first elements communicated by Moderna, his vaccine confers an immunity of at least three months: it produced persistent antibodies 90 days after vaccination, according to the study of 34 participants at the start of clinical trials, published Thursday in the medical journal. New England Journal of Medicine. Does this mean that you will have to get vaccinated two, three or even four times a year against Covid? Or four, six or even eight injections per person in total? Fortunately not: the duration of protection is probably longer, but these are the first data over a period of several months, independently validated by a scientific journal. Participants will be followed for thirteen months to test for long-term protection, the authors say.

In France, Inserm’s Covireivac platform will begin clinical trials on three vaccines in the coming weeks: Astra Zeneca, Janssen and Moderna. “Even if the vaccines will be authorized in the coming months, it is imperative to continue testing to deepen knowledge, particularly on the duration of protection and the quality of the immune response,” inserm inserm. For the moment, “the duration of protection is linked to the delay we have since the implementation of clinical trials, which began at the end of July for Moderna and Pfizer, remembers Pr Odile Launay, coordinator of Covireivac, professor in infectious and tropical diseases at the University of Paris and coordinator of the CIC Cochin-Pasteur. At the moment we have limited data over time ”. Covireivac will study Moderna’s vaccine, “on which we will conduct tests to more accurately assess the immune response,” adds Professor Launay.

But antibodies are only one component of the immune response. There is also immune memory housed in cells, with B (immune memory, antibody production) and T (killing infected cells) lymphocytes. American Anthony Fauci, director of the Institute of Infectious Diseases, said in a recent interview that he was “certain” that the immune memory created by the vaccine would last for some time. But “we don’t know if it will be one, two, three or five years, we don’t know,” he said. By then, we will know if France, with 200 million doses, has planned (too) big or not enough.