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Is France falling behind in vaccination against Covid-19?



By spring, millions of people will have been vaccinated

Alain Fischer

Pediatrician, immunologist, chairman of the Steering committee for the anti-Covid-19 vaccine strategy

France is not late. Our vaccine strategy is only partially different from other countries. The primary goal of vaccination is to save lives. In this sense, the timetable proposed by the High Authority for Health and validated by the government is respectable and coherent. A third of the deaths linked to Covid-19 took place in nursing homes, so the choice was made to vaccinate the most vulnerable and most exposed people first, where they live.

In Germany, for example, the population has to travel to vaccination centers. Sending the vaccine directly to nursing homes requires a much heavier and more complex organization. We must also respect the ethics of vaccination: it is free for all. However, obtaining the consent of people residing in nursing homes and long-stay establishments can prove to be more complicated.

In addition, all French people must undergo a pre-consultation so that a doctor can ensure that their state of health allows vaccination, that there is no risk of serious allergy. This consultation can immediately precede the vaccination or be carried out by telemedicine. Then – and this is what is happening at the moment in nursing homes – nurses can vaccinate, a doctor must be reachable but not necessarily present at the moment T. We must really make sure that all the safety conditions are met. gathered.

All of this explains why we are going slower than some of our European neighbors. But it’s actually a false impression of slowness, you have to take a step back and look at a horizon of two or three months. In the spring, several million people will be vaccinated in France and in the end, it will be roughly the same for all countries.

Knowing that two injections are needed three weeks apart, we will have enough doses to vaccinate just under 900,000 people by the end of January. Of course, that doesn’t cover all vulnerable people, but we won’t have the stock to vaccinate 12 or 13 million people in a month anyway. It is a question of manufacture because the distribution of the doses of vaccines between all the European countries was made in an equitable way: it is done in proportion to the population.

In addition, so far, only Pfizer-BioNTech’s vaccine has received the green light from the European Medicines Agency. The decision for Moderna is expected on January 6, 2021. It is unavoidable, because it is this authorization that validates the vaccine as being sufficiently safe and effective to be injected into the population. The vaccination schedule in France as everywhere in Europe will in any case have to gradually adjust to the authorizations granted or not and to the number of doses available.

Collected by Laureline Dubuy

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France has learned lessons from the H1N1 pandemic

Antoine Flahault

Epidemiologist and Director of the Institute of Global Health at the Faculty of Medicine of the University of Geneva

In terms of administrative authorization of the Pfizer vaccine, all European countries were on the starting line at the same time. This is a chance, linked to the centralized registration procedure for medicines in Europe.

Marketing authorizations are the result of collective expertise, there is no reason that they are different from one country to another. On the other hand, the organization of logistics is a national prerogative. The strategies adopted are not necessarily the same because the stakes and the experience of each nation are different.

Thus, France has learned the lessons of the past and did not want to reproduce the vaccination strategy of 2009, during the H1N1 pandemic. She rejected the centralized, military model which, at the time, had been considered a fiasco. The whole population could have been vaccinated in a relatively short time, but only 10% were.

Today the French state relies on trust and consent. I have no recollection of another campaign where the written consent of the population was requested, it is unprecedented. This can be a brake but it is rather a sign, in my opinion, that the public authorities do not want to rush and want to rely on this bond of trust.

All European states do not have the same collective memory, which explains the differences in the strategies adopted. Therefore, it is difficult to judge the campaigns carried out, it will depend on the support of the populations.

In all countries, priority audiences have been defined for logistical reasons. We could not vaccinate the entire population in a month, there would not be enough doses. In Europe, a number of vaccines have been allocated to states in proportion to their population. These allocations are fixed and, to date, non-negotiable. If some countries vaccinate faster than others, they will not have more doses. But if other vaccines pass the stage of registration by the European Medicines Agency, that could release new stocks and I do not know until when the egalitarian policy could then hold.

Sign of a certain transparency, it is possible to follow day by day the number of people vaccinated by country on a planetary scale on the website Our World in Data (the data of France not yet being recorded). This will make it possible to make comparisons, and it will then be necessary in the weeks or months to come, to distinguish the different causes of delay. It would be unfortunate to learn that vaccines are lying dormant in freezers. On the other hand, if the health authorities wish not to confuse speed and haste and to bet on a certain slowness necessary to gain the confidence of the population, it cannot be imputed to the public authorities.

Collected by Laureline Dubuy

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