As for nursing homes, we consider it impossible to launch a massive vaccination campaign against Covid-19 as of this Sunday.
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GEOFFROY VAN DER HASSELT / AFP
While the European Medicines Agency authorized the Pfizer-BioNTech vaccine on Monday, the government announced the launch of the vaccine campaign against Covid-19 on Sunday in establishments for dependent elderly people (Ehpad).
But on the Ehpad side, the implementation can only be truly launched during the month of January.
At issue: the time needed to inform residents, to collect their informed consent, but also to organize logistics.
In practice, only a few establishments are expected to offer the vaccine before the end of the year.
Nothing could be launched before the European decision.
And it is now done.
On Monday, the European Medicines Agency gave the green light to Pfizer-BioNTech's anti-Covid vaccine.
The vaccination campaign announced by the government will therefore officially be able to be launched within nursing homes, residents and their caregivers being the priority public concerned by the first phase.
And it is imminent: the executive announced in the wake that the first vaccines developed by the American-German alliance would be administered on Sunday in France, the first day of the launch in the EU of this unprecedented campaign.
An announcement that surprised by its speed the managers of establishments for the elderly (Ehpad), who will therefore be the first concerned.
And if during this first stage, nearly a million people must receive the vaccine, it will not happen in a snap in nursing homes.
"Impossible to launch a massive campaign by the end of the week"
In practice, the start of the Sunday campaign should be done on a "very small scale".
"This first phase will be very weak," declared on Tuesday, during a videoconference, Florence Arnaiz-Maumé, general delegate of Synerpa, union of private retirement homes.
We know that it will start with the long-term care units (USLD) of Ile-de-France, public hospitals and perhaps some private establishments, ”she detailed.
Currently, "the Ile-de-France Regional Health Agency is in the process of determining the voluntary establishments which would agree to enter into vaccination as early as next week", added Florence Arnaiz-Maumé.
"This can only be implemented in such a short time in very few establishments."
"The vaccination will not start in the coming days, at least not in a massive way, confirms
Romain Gizolme, director of AD-PA, the Association of Directors at the service of the Elderly
, to
20 minutes
.
There is a political communication from the Prime Minister in a European context.
But without details on the logistics, the means of communication and information and on the questions of consent, there is not an establishment which is able to start in such short deadlines ”.
An opinion shared by his colleague Pascal Champvert, president of the AD-PA, interviewed Tuesday on LCI: “Undoubtedly, we will be able to vaccinate on Sunday (…).
However, will we massively vaccinate seniors from December 27?
Obviously not ”.
According to him, “beyond this symbolic launch” on Sunday, “the essential will begin in January, probably more around the 10th or 15th”.
Time to inform and collect informed consents
Prior to any injection, representatives of nursing homes were waiting for the imminent publication of a protocol from the Ministry of Health on Tuesday.
A forty-page guide which should detail "the search for consent, the pre-vaccination visit, and details on who can vaccinate and with what type of equipment".
A chain of elements that must fit together.
“Because to massively vaccinate in nursing homes, delivery and vaccination schedules should already be established, with health professionals likely to vaccinate already planned as well,” underlines Romain Gizolme.
To do this, you must already know the number of people being vaccinated, so that the doses can be ordered.
However, prior consent must have been obtained, which is only possible if clear information is communicated to residents, who must all undergo a pre-vaccination consultation with a doctor.
Then, residents will have to be given more time to reflect in full knowledge of the facts and be able to express informed consent.
All this is not going to happen in the blink of an eye ”.
For the moment, the nursing homes are therefore waiting "for the State to transmit the elements of information", continues Romain Gizolme, to support the discourse with the elderly "The challenge will be to make in the coming days a collection of intentions and to create pedagogy, ”added the general delegate of Synerpa, recalling that without the consent of the resident, one of his relatives or his“ trusted person ”there would be no vaccination.
The delicate collection of consents to vaccination
A collection of consents which already promises to be delicate.
“There are three scenarios, explains Romain Gizolme.
First, residents who have all their faculties and can consent or refuse on their own.
Or people who have weaknesses but benefit from arrangements allowing them to turn to a tutor or a legally designated person of trust.
There, it's simple.
But the problem is that many elderly people living in nursing homes have difficulty in formulating informed consent on their own, but do not have a designated representative.
The State will have to look into this problem very quickly ”.
And even when someone you trust is appointed, not everything is obvious.
"The nursing home asked me for permission to vaccinate my mother, but I can't make a decision," says Lydie, who still considers herself too little informed and points to "the lack of perspective.
If I refuse the vaccination and my mother dies of Covid-19, I would be remiss for the rest of my life, and if I accept and she has severe side effects, I would be remiss too ”.
Logistics complicated to orchestrate
In addition, all the logistics related to the transport and delivery of vaccines must be ensured without the slightest hitch, taking into account the constraints and difficulties associated with the Pfizer-BioNTech vaccine, which must be stored at - 80 ° C.
The "logistics chain is operational to start at the end of this week", assured Monday the spokesman of the government, Gabriel Attal.
“The supply for Europe will be provided by the production sites of Pfizer in Belgium (Puurs) and BioNTech in Germany.
(…) The doses will arrive by road for hexagonal France and by plane for the overseas territories ”, for its part indicated the American laboratory.
The two manufacturers have designed an insulated shipping container that "can maintain temperature for ten days without being opened" and "up to 30 days" by renewing the dry ice that fills it, Pfizer said.
“Once thawed, the vaccine vial can be stored safely for up to five days under refrigerated conditions (at 2-8 ° C),” adds the laboratory.
In France, there will be “six logistics platforms distributed evenly over the territory,” says the Ministry of Health.
These platforms will supply the nursing homes which usually get their supplies from hospital pharmacies which will not be equipped with "super-freezers".
The doses will be transported to "a hundred sites with dedicated freezers, which will most of the time be hospital sites, at a rate of about one per department, in order to be able to vaccinate all the nursing homes that are linked to these hospitals" , detailed Tuesday the Minister of Health Olivier Véran, visiting the logistics platform of Chanteloup-en-Brie (Seine-et-Marne).
"We are largely capable of accommodating and storing all the doses that will be allocated to us by the Pfizer-BioNTech laboratory," added the minister, who was to give more details this Tuesday evening to the TF1 newscast.
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