Par Alexis Souhard
Posted on 06/05/2021 6:04 PM
Updated 06/05/2021 at 6:07 p.m.
Unpublished data published by Health Insurance reveals that the first beneficiaries of the Covid-19 vaccination centers are not always the populations of the department. Like those Landais who particularly benefit from the Basque system.
Does the ramp-up of vaccination in French regions benefit all regions equitably? The latest figures published by the Data Vaccin Covid platform, recently launched by the National Health Insurance Fund, shed light on certain geographic disparities. Contrary to the data disseminated so far by Public Health France, they make it possible to distinguish the place of life from the place of vaccination, therefore to better understand where the people who are vaccinated come from and which departments have known better than others. adapt to the needs of their population.
1 “Vaccine nomadism” has its strongholds
First lesson of this database: vaccine nomadism affects certain territories more than others. If we compare the health insurance data with that of Public Health France (SPF), it is possible to measure the difference between the number of people vaccinated within a department, regardless of where they live. and the resident population effectively vaccinated within its own department. In Creuse, for example, 8.5% of people vaccinated on May 23 did not reside there, making the territory the most “attractive” department of Nouvelle-Aquitaine., Like Seine-Saint-Denis in Ile-de-France.
“We have known from the start that there is porosity in vaccination centers located near borders,” recalls Sylvie Quelet, director of prevention and health promotion at SPF. And for good reason, Boussac, Evaux-les-Bains, La Souterraine … many centers located in the Creuse are only a stone’s throw from a neighboring department. Is this the only reason for all that? “The Creuse is proportionately older, so the distribution was made according to the percentage of the eligible population and many doses were received,” adds the official. Knowing that people were able to travel 50 km to be vaccinated, there was surely a call for air. “
The Pyrénées-Atlantiques are no exception to this trend. Almost 5.8% of those vaccinated there do not reside there either. There is no need to look too far for their origin, according to Sylvie Quelet: “Almost 25% of those vaccinated in the center of Bayonne come from the south of the Landes. This has become a very large center welcoming both locals, but also many people who work there, or those who have accompanied their parents. “However, she notes, this vaccine nomadism tends to slow down” because of the number of doses and dedicated sites henceforth. “
2 The Landais, champions of vaccination
The Landes stand out as the most “efficient” department with regard to the vaccination of its oldest population. Admittedly, nearly 5.8% of its inhabitants vaccinated once went to seek their dose beyond its administrative borders. But the vaccination centers were also in full swing, in favor of the target audiences at the start of the campaign: more than 86% of over 75s found their account there once, on May 23, 77% of over 55s. years.
The department very quickly carried out a proactive policy in the implementation of the campaign: “They were able to diversify their offer, whether with centers supported by hospitals, ephemeral centers in a community of municipalities, or nursing homes. multidisciplinary, congratulates Sylvie Quelet. Their networking was very interesting. “
3 La Creuse, ahead among the youngest, less among the older ones
Conversely, the figures reveal the delays accumulated in certain areas. In Creuse, in particular, where the vaccination rates for the first (41%) and second injection (20.5%) are among the highest in the region, vaccination has not benefited the priority groups as much. As of May 23, only 67% of those over 55 had received a single dose, a rate below the regional average (73%).
For those over 75, the Creuse is also the regional red lantern. On May 23, it hardly reached 74.5% of first-time vaccines, or twelve points behind the Landes. For Sylvie Quelet, the trend is multifactorial. This may be due to the refusal of certain patients as to the lack of structural organization. “The department has nevertheless developed many local actions” she qualifies. Enough to cover a particularly rural area? “It is more difficult to set up the same systems there as in the Landes. “
At Santé Publique France, we advance another potential reason: “In Creuse, but also and especially in Lot-et-Garonne, clusters were frequent in medico-social establishments and nursing homes, underlines Sylvie Quelet. And according to the first recommendations, we did not vaccinate as long as there was a cluster. All residents were then considered as a contact case. It was not until the beginning of March that the rules were relaxed. In the meantime, the vaccination had therefore come to a standstill.
4 Better targeted pathologies
Hitherto absent from government databases, people suffering from at-risk pathologies are now informed about Data Vaccin Covid. The Nouvelle-Aquitaine region seems to be ahead of the national average (71.1%) when it comes to vaccination of people with cancer. 73.5% of them had received at least one dose, as of May 23.
The database also shows the work that remains to be done for other co-morbid factors, including obesity. One in two people with this disease – considered at risk in times of Covid-19 – has still not received a dose, according to Ameli. Blame it on a campaign that started late for those under 50 (early May). Sylvie Quelet agrees: “There is still a lack of location. “