Coronavirus: seven questions on the implementation of vaccination in France

INTERVIEW

The vaccination plan against the SARS-Cov-2 coronavirus in France was unveiled this week by Prime Minister Jean Castex.

The campaign will start in January for a million people, mainly in nursing homes, then in March, for 14 million other people (over 75, those with chronic pathologies, health personnel over 50). .

For the rest of the population, it will be after the end of March, the beginning of April.

While France has ordered 200 million doses of vaccines - enough to vaccinate 100 million people - Elisabeth Bouvet, president of the Technical Committee on Vaccinations of the High Authority for Health, responsible for establishing recommendations for the government, responds to questions that arise about the implementation of this non-compulsory vaccination in France.

Why start in January when the British start getting vaccinated next week?

"I think it's already extremely fast. What surprised us is rather that the British are already vaccinating next week. We have to wait for the opinion of the European Commission which issues the opinion on vaccines . It is a commission which will give its approval to one or more vaccines, at best next week. We cannot do faster than that. I do not think that starting in December or in January changes much ".

>> LIVE -

 Coronavirus: follow the evolution of the situation on Saturday 5 December

Do we know enough about each of these vaccines to say that they are safe and effective?

"As I do not yet have a marketing authorization for these vaccines in France, I cannot comment on that, also insofar as the Technical Committee on Vaccinations will have to give an opinion on these vaccines. knows that if these vaccines have reached a stage where the dossier is submitted to the competent authorities, it is because they probably have guarantees in terms of efficacy and safety ".

These vaccines would prevent getting sick;

but do they prevent transmission of the virus?

"Knowing whether these vaccines are capable of completely preventing infection is one of the questions which remain important and to which we will have to have answers to go further. We know that they prevent the symptomatic forms and the serious forms But it is not known if they also prevent asymptomatic forms, or if they do not turn severe forms into asymptomatic forms, which would mean that people can eventually continue to be infected and transmit. transmission, we don't have it yet. I think we will have it in a few weeks because it requires a little different studies to find out. Obviously, it is very, very important for the rest of the process. countryside."

How did we manage to find a vaccine so quickly, when HIV still does not have one after 37 years?

"On the one hand, we ourselves were astonished at this speed: the ability of researchers first, then industry then, to produce vaccines that appear to be effective, is absolutely extraordinary. has used new platforms, called RNA, but which have been under study for more than ten years. We are able to produce inside the vaccinated person the protein against which they will be immunized. In terms of research , it is the culmination of many years of studies to make messenger RNA drugs or vaccines. It is something that finally comes at the right time. The added benefit is that making messenger RNA is relatively easy, and once you have the exact sequence of molecules to produce, you can imagine making extremely large quantities of vaccines in a very short time.

On the other hand, AIDS is a very special problem.

The HIV virus enters cells and remains there chronically, which raises a very difficult question in terms of immunity, especially since it is the immune cells that are attacked.

These are cells that have very long lifespans and therefore the problem of AIDS is really quite apart.

On the other hand, with acute infectious diseases like Covid, the virus arrives, infects a number of cells and it disappears.

In these cases, we are not surprised that we can manage to find a vaccine. "

How are the vaccines going to be delivered?

"Certain vaccines will indeed come from the United States, others will be produced in Europe and maybe even some in France. I think that this importation, the arrival of the vaccine doses, does not pose a problem. plus the conservation and logistics around the use of vaccines which is going to really require a well organized chain to get it done quickly and the vaccines to be used and prepared quickly. "

CORONAVIRUS ESSENTIALS

> Three questions on the messenger RNA vaccine, probably the first available

> What do we know about "long Covid", these patients who are going through hell?

> These three facets of the coronavirus that you may not have heard of

> When are we in contact?

And other questions that we ask ourselves every day

> Coronavirus: the 5 mistakes not to make with your mask

Hospitals, barracks ... where will the vaccination take place?

"We (the Technical Commission for Vaccinations of the HAS) give a general opinion. The first phase will rather happen with structures where people are grouped together, such as EHPADs. So it facilitates the production and administration of a number. relatively large number of people in one place.

Afterwards, it gets more complicated.

Everything will depend on the type of vaccine we have: it is likely that the vaccines that will come after the first vaccine used are vaccines that will be easier to transport and which will not have the same constraints in terms of storage.

So it will be much easier.

Our idea at the Haute Autorité de santé was that the process be relatively flexible and that there be several vaccination methods: in the first sequences of vaccination, it will involve vaccinating elderly, fragile people, often at home. .

It will therefore be necessary to develop means to vaccinate at home.

Doctors, of course, but also nurses, and why not also as close as possible to people, do not rely a little on pharmacists.

[...] Finally, there are already vaccination centers.

What we have suggested to the Haute Autorité de santé is to already use the existing structures to vaccinate and strengthen the personnel to vaccinate in these places, rather than going to create new places where we do not have to. not used to going, which are not made for that and which will further complicate the organization ".

In France, less than half of the population is ready to be vaccinated.

Could this be a problem?

"These are intentions, they are not confirmed in the facts. For now, we will see how people react. For this membership to increase, it is a first phase to show that things are going well and that we are perfectly transparent about the way it is going. What also seems very important to me to increase adherence is that health professionals, especially doctors, are really very involved and promoters of vaccination. a lot on them to convince and address the patients they follow. [...] I think that things will evolve. We will vaccinate in priority the people at risk who are themselves requesting vaccination, and in a second time, I think that the role of health professionals and the information that will be given on the first phase should make it possible to increase, I hope, the support of the population. "