INFOGRAPHIC – The first patients received an injection against the coronavirus in two hospital structures, in Sevran (Seine-Saint-Denis) and Dijon (Burgundy).
“Things are getting hot!”, Mauricette reacted immediately after the injection. At 78 years old, the former resident of Le Bourget (Seine-Saint-Denis) welcomed in the long-term care unit of the René-Muret hospital in Sevran (Assistance publique-Hôpitaux de Paris, Seine-Saint-Denis) yesterday became the first French woman to benefit from Pfizer and BioNTech’s vaccine against Covid-19. She will be given a second dose in 21 days. Her immune system will then produce effective antibodies to fight Sars-CoV-2, protecting her from Covid-19, which has already claimed more than 60,000 lives in the country. According to data published by the German laboratory, the vaccine could even be effective from the 11e day after the first dose.
In the morning, about ten other residents over 75 years of the same care unit, as well as one of their doctors (over 65 years old), were also given a first dose of vaccine. At the beginning of the afternoon, a dozen residents of the geriatric center of Champmaillot, dependent on the Dijon University Hospital, and a specialist doctor (over 65 years old) who succeeded them.
“We have witnessed a symbolic launch of the vaccination campaign”, analysis Jérôme Marty, general practitioner and president of the French union for free medicine (UFML). The Dr Marty fears, however, that the real campaign will prove to be more complex to implement. “The protocol distributed by the authorities is quite heavy, and seems more suited to large structures like the AP-HP than to the reality of nursing homes. I have real questions about the ability of all these establishments to set it up correctly. ” The main area of concern is patient consent. As the vaccine is not compulsory, everyone must clearly express their choice. “In nursing homes, many residents do not have all of their cognitive abilities, continues the doctor. In this case, the person of trust must be mobilized. What do we do when it is not designated? What if the family doesn’t agree? It is not a matter of a simple injection, there is a whole process upstream for which the personnel do not seem to be sufficiently supported. “
The government hopes to have vaccinated 15 million people by this summer, with 100% free vaccines for all policyholders.
By the end of February, a million people should follow the residents of Dijon and Sevran in the 7,000 nursing homes in France. The ramp-up of the vaccination campaign will then be gradual. Next week, it will concern 23 establishments in the regions of Paris, Lyon, Lille and Tours, before intensifying to reach around a hundred places in the first two weeks of January. “This is when we can judge the device and our good preparation, Judge Jérôme Marty. All retirees over 65 will follow until the spring, then the rest of the population aged 16 and over, again on a voluntary basis. The government hopes to have vaccinated 15 million people by this summer, with 100% free vaccines for all policyholders.
A first weighty victory
With France, it is all the countries of the European Union which began their vaccination campaigns against Covid-19 on Sunday, welcoming a first major victory in the fight against the coronavirus. “We cannot afford to let the epidemic flare up again”, reacted in the Sunday newspaper the Minister of Health, Olivier Véran, while the epidemic has marked a slightly rising plateau since the beginning of December. “If the slow rising trend continues, hospital services will remain under pressure, explains on Twitter the modeling team of epidemiology and the evolution of infectious diseases of Montpellier (CNRS, IRD, University of Montpellier). If we add a Christmas Eve effect, this would unfortunately be enough to restart the epidemic with a pronounced risk of having more than 3,000 people in intensive care in 1er February.” Asked about the possibility of a third confinement, the Minister of Health said he was ready to take “The necessary measures if the situation were to worsen”.
Could the vaccination campaign dispense us? It is still impossible to know what the epidemic trajectory will be in the coming days, the end of year celebrations opening a completely unpredictable period. The family gatherings of December 24 and 25 risk increasing contamination within homes, while the holidays, including the closure of schools for two weeks, can contribute to the opposite effect. As for the discipline of the French during the New Year’s Eve, difficult to anticipate.
Over the longer term, the mathematical models developed by the Institut Pasteur and presented by the High Authority for Health (HAS), indicate that the vaccination of 5 million people would prevent 47.6% to 48.6% of 2021 deaths due to Covid by targeting people aged 75 and over with a vaccine that is 90% effective. It is interesting to note that the results are much less impressive for the other age groups: thus we would avoid 11.3% to 11.5% of deaths by targeting the 65-74 year olds, 3.6% by targeting the 50 -64 years and 0.2% targeting 18-49 years.
Prevent severe forms
Data which confirms the HAS in its prioritization recommendations, that the vaccine is content to prevent serious forms or that it also makes it possible to limit contagiousness. “The results of the model indicate that the maximization of vaccine-avoided deaths and hospitalizations is achieved by first targeting populations aged 75 and over”, can we read in the HAS report.
On the other hand, the question is less obvious for the establishment of the “Second wave” vaccine. If the vaccine only makes it possible to reduce the severity of the disease, it seems more appropriate to subsequently vaccinate 65-74 year-olds with at least two comorbidities and 50-64 year-olds with at least two comorbidities. The aim is to prevent them from developing serious forms. On the other hand, if the vaccine also makes it possible to reduce transmission, it seems advantageous to favor in a second time the groups contributing more to this one, in particular the 18-49 years. Only the careful monitoring of the first vaccinations will make it possible to have a more precise idea of the efficacy on transmission, and to adapt the vaccination strategy according to the information provided.
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