On Monday, the High Authority for Health (HAS) expressed several recommendations regarding France's vaccine strategy against the new coronavirus.

A five-phase plan detailed in Europe 1 by Jean-Daniel Lelièvre, member of the HAS and head of the infectious diseases department at the Henri-Mondor Hospital in Créteil.


The High Authority for Health (HAS) presented this morning its recommendations for France's vaccine strategy in the face of Covid-19.

It defined "five progressive phases" and a guideline: priority for the most vulnerable and those who care for them.

Jean-Daniel Lelièvre, member of the HAS, head of the infectious diseases department at Henri-Mondor Hospital in Créteil, immunologist specializing in vaccination, deciphers these recommendations on Europe 1, drawn up according to the number of doses available at the end in the month of December or at the beginning of January. 

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Five phases in order of priority 

In the first phase, the elderly living in nursing homes, around 750,000 people, must be vaccinated as a priority, as well as the staff of these establishments presenting risks of comorbidities, according to the HAS.

"For this first phase, which will take place in nursing homes, the easiest way is to go directly to contact and not to send residents out", specifies Jean-Daniel Lelièvre.

The pre-existence of an organized medical structure may facilitate vaccination. 


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Then comes a second phase concerning all the elderly, starting with the over 75s, then the 65 to 74 year olds with comorbidity, then the other 65 to 74 year olds ", as well as" professionals. sector of health, medico-social and medical transport, by prioritizing professionals aged over 50 years "or presenting a risk factor of serious form. In a third phase, would follow" all people over 50 years old or less than 50 years old but at risk of serious form because of their comorbidities "as well as" all the professionals of the health and medico-social sector "and the" professionals from the sectors essential to the functioning country "(security or education for example).

The fourth phase will be extended to "professionals whose work environment favors infection (regular contact with the public, closed environment ...)" and to "vulnerable or insecure people with a less favorable prognosis in the event of infection by the Covid -19 (resident in a psychiatric hospital, homeless, inmates, etc.) ".

Finally, in a fifth and final phase, "provided that the vaccine dose allocations have been sufficient to vaccinate each of the priority populations, the vaccination of people over 18 years of age and without comorbidity could then be initiated".

Age, a determining factor

Before developing the order of priority, HAS first tried to understand the people most at risk.

"Age is the major determinant of severity", explains Jean-Daniel Lelièvre.

"From 55, every ten years, the risk is greater."

As for younger people, it is those with comorbidities, especially diabetes or overweight, who are most at risk.

"All of this will be taken into account," says the immunologist.

"It is an algorithm that may seem complicated, which took a long time to set up, but it is to offer this vaccination initially where the number of vaccines will be limited to the people who will need them the most. . "


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Pregnant women, for example, will not be the priority.

"This is a population that is not the most at risk of severe forms of Covid and for which we prefer to have more perspective, especially in clinical trials," he explains.

"The vaccination will be spread throughout the year 2021", adds the member of the HAS.

"It is not sure that we can vaccinate the entire population, but what we hope is to be able to already vaccinate all populations at risk". 

"We are not going too fast"

"The HAS makes recommendations according to the priorities and the expected severity of the disease but does not set the vaccination 'to music'. These are proposals," recalls Jean-Daniel Lelièvre.

"At the same time, all the players are working to find out how to put this vaccine policy in place. There remains all of December and part of January to put all this into action."

For those most skeptical of vaccination, Jean-Daniel Lelièvre is reassuring.

"We have a two-month follow-up on these vaccines, as requested by the WHO. Other side effects are possible, these are new vaccines, but we have already vaccinated a large number of people with these vaccines which will be available and we have not seen serious adverse effects, "he says.

"It's a benefit-risk balance. At the moment, in the midst of an epidemic, the risk of catching the Covid and of having a severe form is much greater than a hypothetical risk concerning these new vaccines."


 For the French, the vaccine was developed "too quickly"

"We are not going too fast. No study has been published but the ANSM experts, who are looking at the vaccine files, are analyzing the documents. Certainly, there have only been statements. press release but we already had results on the first phases of these trials, experiments carried out in animals, ”he adds.