“As long as there are so many unvaccinated fragile people, France will be under the threat of an epidemic rebound”

Vaccination for all should not make people forget that many priority people have not yet received a single dose – FRANCOIS LO PRESTI v AFP

  • France runs an average of 550,000 vaccinations per day over the past week, and has 27 million first-time vaccines.
  • Figures that can make you forget that a huge number of people vulnerable to the coronavirus have not yet received the slightest dose of vaccine.
  • For the doctor Yvan le Flohic, it is necessary to ensure these vaccinations in absolute priority.

Thursday, more than 700,000 vaccinations were carried out in France, a record. On average, France used 550,000 doses per day over the week, again, a level never reached. Vaccination is accelerating, and more than 27 million people have already received at least one dose of the vaccine against the coronavirus.

But if the vaccination campaign finally seems to have found its cruising speed, do these raw data guarantee that it will be successful? Not sure, according to Yvon le Flohic, general practitioner, for whom the number of people vaccinated in total is not the most relevant indicator.

Why the raw figures of the number of injections are not sufficient to account for the French vaccination campaign?

While it is increasingly established that vaccination reduces the risk of transmission, it is necessary to recall the initial objective of vaccines against Covid-19: to avoid serious forms and deaths. Starting from this primary role, we cannot say that the vaccination of a healthy young person and an obese 70-year-old person will have the same effectiveness on a possible new saturation of hospitals.

Remember that a person over 80 is 180 times more likely to die from the coronavirus than a person between 18 and 39 years old. We could therefore say, schematically, that it takes 180 vaccinations among young people to have the same results on the death curve as with the vaccination of a single elderly person. The same goes for obesity: this comorbidity is present in 47.6% of severe cases of coronavirus.

They are therefore essential audiences to be vaccinated. Currently, we have 27 million first doses, but above all we have 20% of over 75s who have not received the slightest dose, 24% of 60-74 year olds, and more than 50% of obese people … therefore has a problem somewhere! This does not mean that young people should not be vaccinated, or that it is wrong to do so. Just that the priority must remain to vaccinate vulnerable people. We will avoid an epidemic rebound much more this fall with all vulnerable people vaccinated than with 70% of the total vaccinated population, including 70% of fragile people.

Achieving collective immunity is not the goal?

It is a noble and important objective, the final objective if you will, but it must not make us forget the absolute priority of vaccinating vulnerable people first and foremost. If vaccination decreases transmission, it does not cancel it for all that, and there is nothing to say that the virus will not circulate in September-October, as it did in 2020. It is even already circulating in some nursing homes, where residents are mostly vaccinated, but this is not disturbing because there are no more serious forms or heavy hospitalizations thanks to the vaccine.

This is what we are really looking for: not to completely cut off viral circulation – which we are not sure we can do – but to prevent it from having an impact. As long as there are so many unvaccinated fragile people, France will be under the threat of an epidemic rebound and saturation of its hospitals. And, the figures in certain fragile populations, in addition to being insufficient, are starting to stagnate, especially among the elderly. In one month, only 4% of people over 75 years of age were vaccinated.

Make no mistake about it, if France opened vaccination for all in advance, it is because the priority public adhered less well than expected, and that there was a risk of unused doses. It is annoying, especially since the summer will perhaps also slow down the vaccination… We will have to see the percentage of priority people not vaccinated this fall, because it is on this which will depend the fragility of France to a new wave.

Even today, resuscitators are desperate to see heavy hospitalizations or deaths of people who have been eligible for vaccination for months and who have not received a dose. It’s a failure, and these are the people who continue to fill resuscitation beds and account for most of the deaths today.

What would it take to change the situation?

You can’t just brag about the raw immunization data. Instead of communicating on the millions of French first-vaccinated, we should highlight the percentage of vulnerable people vaccinated. The stake is there, and for the moment, France does not answer it, or seems to do it with difficulty.

The vaccination campaign must therefore be adapted, made more specific for certain priority audiences, and better communication about the vaccine and its benefits in severe forms and deaths. Why do we not have the figure for the number of vaccinated and unvaccinated people in intensive care? This could be very telling about the vaccine interest for fragile audiences.

We must move away from the idea of ​​equal vaccination for all. All the doses do not have the same importance, it is necessary to prioritize and seek out the fragile public. I am not saying that the vaccination should be taken away from young people, but, with vaccination for all, we have entered into a universal vaccination where everyone has the same chances of having an appointment, there is no more priority audience. However, there are vaccinations with higher priority than others.

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