The month of October usually marks the start of the flu vaccination campaign. This year will be no exception, with a start scheduled for October 13. The stake is twofold: in the midst of the rebound of the Covid-19 epidemic, the authorities and the medical world want at all costs to prevent the seasonal virus from contributing to overloading doctors’ offices and hospitals.
The flu vaccine is usually the least popular of the entire vaccination schedule in France. Less than one in two people at risk (47%) had used it in 2018-2019, far from the 75% recommended by the World Health Organization. But in the particular climate linked to the coronavirus, the government seems to expect more receptivity this year: Olivier Véran indicated that 30% of additional doses have been ordered for this season. Who is concerned? Under what conditions and for what reason? We decipher the challenges of this vaccination campaign like no other.
● Who should be vaccinated first?
People vulnerable to the flu are the same as for the Covid: over 65 years old, chronically ill (diabetics, heart failure, obese, asthma, etc.) and pregnant women. In their case, the vaccination is covered 100% by Medicare. For this, they receive a care voucher at their home, or, if this is not the case, they can ask their doctor to download it for them.
The government also wants to convince as many health professionals as possible to protect themselves. The room for improvement is large: in 2018-2019, there were only 35% of caregivers vaccinated in hospitals, and 32% in nursing homes, while the approach has long been recommended by health authorities. However, and despite the imperatives related to Covid, they will not have the obligation to be vaccinated, said the Minister of Health at the beginning of the week, citing “The principle of reality”: “It’s complicated to impose in an epidemic period”. Instead, health authorities rely on intense awareness.
● And the others?
Adults under 65 without chronic illness are not at risk for flu-related complications and are therefore not particularly targeted. This does not prevent them from being able to be vaccinated, to protect a vulnerable loved one, for example. In this case, the injection is their responsibility, at a cost of between 6 and 12 euros per dose. It is not necessary to present a prescription. Note that some trained pharmacists now offer to vaccinate in pharmacies.
● Does the influenza vaccine protect against Covid?
The influenza vaccine does not protect against Covid-19, but in the current epidemic context, it can have important indirect benefits. As we know, the flu vaccine is not a model of effectiveness (depending on the year, it protects about 60%). It does, however, reduce the circulation of the virus and the serious forms likely to require hospitalization, which can even go as far as resuscitation. An interesting margin to be preserved if the number of Covid patients continues to increase at the same time.
In addition, the signs of Covid and influenza are very close, “In the face of respiratory symptoms, vaccination will make it possible to direct towards the Covid, improving the screening of patients”, explains Dr Vincent Énouf, deputy head of the National Reference Center for Respiratory Infection Viruses at the Institut Pasteur (Paris).
Finally, the High Authority for Health underlined, in an opinion delivered in June, “The difficulty, for the time being, of anticipating the possible impact of a concomitant circulation of Sars-CoV-2 and influenza viruses, or the potential consequences of co-infection”.
● Why does the campaign not start until October 13?
The effectiveness of the flu vaccine decreases over time, and the antibodies are present in patients on average 4 to 6 months after the injection, recalls Vincent Énouf. “To wait 15 more days before starting is to gain as much protection at the end of the season”, he explains. This is all the more interesting as the arrival of the flu in the Northern Hemisphere is difficult to predict this year. (read below).
● Will the vaccine be readily available to everyone?
Initially, vaccination will be reserved for the priority groups described above (people at risk and caregivers). For others, doses will be available for sale from 1er December.
● Are there any special precautions to be observed?
The Haute Autorité de santé recommends that people identified as possible contacts of a case of Covid-19 to postpone their flu vaccination project until the end of the isolation recommended in this context, if no symptoms are present. ‘appears and / or after a negative PCR test.
Very few influenza in the South
Usually, the northern hemisphere relies on the circulation of influenza viruses in the southern hemisphere a season ahead to anticipate future strains and develop its vaccines. This year, surprise: the coronavirus epidemic has “killed” the flu epidemic. “Despite continuous or even more frequent tests than usual in some countries of the southern hemisphere, influenza has been detected very little”, reported the World Health Organization in mid-September.
“Either the coronavirus has taken its place due to competition between viruses, or the barrier measures have limited its expression”, suggests Vincent Énouf, deputy head of the National Reference Center for Respiratory Infection Viruses at the Institut Pasteur (Paris). “The projections were therefore made on the basis of the few signals recorded from December to February-March”. “If we have the same configuration, we will have very few influenza viruses circulating”, he analyzes. However, all this remains very speculative. “So we must not relax the vaccination.”
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