Experts welcome France’s Covid-19 vaccine strategy – with precautions

When the UK launches the world’s first nationwide Covid-19 vaccination campaign, France has begun revealing its own strategy. With the first phase beginning next month, FRANCE asked 24 researchers for their views on the government’s plan.

Do not mix speed with speed. This is at the heart of the French Government’s strategy for its vaccine strategy. While Russia began administering its Sputnik V vaccine in 70 centers in Moscow last weekend and Britain launched its nationwide Covid-19 vaccination effort on Tuesday, France is now only beginning to reveal its own plan.

Professor Alain Fischer, a pediatric immunologist appointed by the government to lead France’s vaccine strategy, outlined his vision in the weekly Journal de Dimanche French on December 6: Vaccines will be administered in three phases starting on January 4, 2021 and starting with the most vulnerable.

In line with the recommendations of the French National Agency for Health, approximately one million vaccines will be administered in January to carers and staff at risk of developing a serious form of the disease.

The campaign has been expanded since February to an estimated 14 million senior citizens and people with underlying medical conditions.

The third and final phase of the campaign begins in the spring of 2021 and this time extends to the rest of the population.

Vaccines are administered free of charge and are not mandatory.

‘Good strategy’

“Prioritizing the elderly, the most vulnerable to the virus, is a good strategy,” said Professor Antoine Flahault, an epidemiologist and head of the Institute of Global Health at the University of Geneva’s Faculty of Medicine, in an interview with FRANCE 24. “There is however, there are some objections to the strategy in the scientific community. “

The reluctance is primarily due to the issue of immunosenescence, or the gradual deterioration of the immune system, caused by aging, Flahault explained. “The elderly have a weaker immune system so the vaccine may be less effective with them.”

Second, “it is more complicated to attribute the cause of a disease that may occur after the injection of the vaccine in these more vulnerable people, because they may already have or are more likely to have underlying medical conditions,” he said. “We therefore risk incorrectly blaming the vaccine for certain pathologies.”

But these arguments are “special,” said the epidemiologist. “Without the vaccine, the elderly who suffer the most can die. Vaccines at this stage have been shown to be effective, so these reasons are not enough to deprive the older vaccines. ”

Pauline Londeix, researcher and co-founder of the Observatory for Transparency in Drug Policies, agrees. But she cites the lack of a strategy to identify and meet the needs of citizens, not just in France but everywhere.

“Countries have all funded laboratories with millions without setting any conditions. Research institutes have all started a hectic race, all in the same direction. It is a pity, because we could have diversified the approaches according to different populations and had different vaccines, she said.

Some vaccines are more effective in limiting transmission, a formula suitable for people who are more likely to have frequent contact with others, such as doctors or teachers. others have been shown to be more effective in limiting complications and are recommended for elderly and vulnerable patients, Londeix explained. “But all vaccines that are currently available are more or less the same. They only focus on limiting the risks with Covid-19. ”

‘Lack of coordination’

Londeix also lamented the lack of coordination between different sectors of civil society. “The government relied solely on the advice of doctors and manufacturers to determine vaccination centers. It should also have consulted with many other representatives of civil society, such as elected officials, associations and sociologists, in order to better target as broad a public as possible and offer a more diversified distribution route, she said. In this way, patients with chronic medical conditions can receive the vaccine during their regular doctor visits, while more marginalized populations can turn to compounds to be vaccinated.

In fact, the distribution of the vaccine “depends primarily on how France will receive its supplies,” Flahault explained.

In the UK, the first deliveries came in batches of 1,000 vaccines, which meant that they could only be administered in specialist centers, as the vaccines, once defrosted, could only be stored for a limited time. Other vaccines require storage at -70 ° C (-94 ° Fahrenheit). Even these can only be distributed by specialized centers.

If the vaccines are delivered in single doses, it is possible to be vaccinated at your doctor or at the pharmacy, Flahaut explained. “This is the best way to administer because it is performed in the confidence of a treating physician.”

There are still some gray areas. Researchers do not know how long the effect of the vaccine will be and no one still knows if it will stop the spread of the virus.

“The government presents the vaccine as a miracle solution. But if the transmission continues, we may still have to live with the virus, says Londeix.

Flahault offered a more reassuring view: “The most important thing is to protect the most vulnerable,” he said. “The virus can still circulate, but if the disease remains mild, there is no need to worry.”

As for those who insist they do not want to be vaccinated, Flahault said they are free to refuse the vaccine.

“We should not force it on those who do not want it. There are vulnerable people in some poor countries who are very happy to be able to take advantage of these vaccines, as there are currently not enough to go around for all of humanity. ”

This article has been translated from the original into French.