One dose of Pfizer's coronavirus vaccine.

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UGO AMEZ

  • Criticized for the slowness of the vaccination campaign, the government announced the opening of hundreds of vaccination centers as of January.

  • The executive had however refused to integrate vaccinodromes into its vaccine strategy.

  • Why this turnaround?

    Is there a difference between vaccinodromes and vaccination centers?

Did the government do an about-face?

Pressed by the opposition, local elected officials and health professionals, the executive revised its vaccination strategy.

While the creation of large vaccinodromes was excluded, the government, criticized for the slowness of the campaign against Covid-19, finally announced the opening of 500 to 600 vaccination centers throughout France by the end of the month of January.

Should this be seen as a total turnaround?

And in practice, how can the deployment of these centers be organized to ensure an effective campaign without wasting a single dose of vaccine?

Avoiding the H1N1 Vaccinodrome Fiasco

Why has the government repeated and insisted that there was no question of opening large vaccine drifts?

Initially, phase 1 of its vaccination strategy only concerned nursing home residents and their caregivers over the age of 50.

A public whose vaccination was planned directly within the establishments concerned.

A decision that may also have been motivated by a precedent that the government did not especially want to relive: the fiasco of anti-H1N1 vaccinodromes.

Small flashback: in 2009, another pandemic occupies the spirits.

Influenza A, or H1N1, arrives in France and causes deaths, especially via a more virulent mutant strain.

The Minister of Health at the time, Roselyne Bachelot, launched a major vaccine campaign in the fall, for which 94 million doses of vaccine were ordered, and large vaccinodromes were emerging.

But the pandemic is coming to an end and the French largely shun the vaccine.

Barely 5.35 million of them will be vaccinated.

The minister canceled more than half of her orders.

“These H1N1 vaccinodromes were places where we saw queues stretched out with people in the rain, and from which we had completely excluded health professionals - both general practitioners and nurses in private - , remembers Dr Luc Duquesnel, general practitioner in Mayenne and president of the general practitioners - Confederation of French medical unions (CSMF).

Result: millions of doses ended up in the trash.

Obviously, no government would want to relive the same fiasco ”.

A change of scale

But while the launch of the anti-Covid vaccination is announced for the end of December in nursing homes, at the beginning of January, only a few hundred residents have received their first dose.

Health professionals and local elected officials denounce the unacceptable slowness of the campaign, calling for an acceleration of the pace while many European neighbors have already vaccinated tens of thousands of people.

Valérie Pécresse, president of the Ile-de-France region, speaks of "bureaucratic shipwreck", and Xavier Bertrand, former Minister of Health at the head of Hauts-de-France, suggests that the regions take over.

Under fire from critics and pressed by the arrival of the English variant, which makes the coronavirus more contagious and raises fears of an exponential epidemic rebound, the government passes the second.

Prime Minister Jean Castex and his Minister of Health Olivier Véran announce the imminent extension of vaccination to all caregivers over 50 and to all people over 75 before the end of January (from the 18th for the latter).

That is to say 5 million people to be vaccinated much faster than expected.

And in February, it will be the turn of at-risk people over 65.

A new schedule that requires logistics to be revised.

Fiercely opposed to vaccinodromes, Olivier Véran announced on January 5 the opening, by the end of January, of 500 to 600 vaccination centers, "which will be accessible to the city".

Visiting Tours the same day, the Head of State, Emmanuel Macron, confirmed the implementation of this device.

But no gigantic gymnasiums as in 2009: the government changes scale and relies on smaller structures cleverly disseminated.

But vaccinodromes or vaccination centers, is it really different, or is it just semantics?

“What is being put in place today is totally different,” replies Dr. Duquesnel.

We had a meeting on Friday with Olivier Véran's cabinet, then with the department and the region.

In Mayenne as in the rest of the territory, around ten vaccination centers will be set up in each department ”.

And the organization looks pretty good.

"It's similar to the organization planned a year ago for the Covid screening centers, and everything is done in connection with the healthcare establishments that house the freezers in which the vaccines are stored and which are all the more concerned that they must vaccinate their eligible and voluntary personnel ”.

The objective of these structures: "to promote the finest and most efficient territorial network possible", emphasizes the doctor.

Do not waste any dose of vaccine

“I think we were a little too defensive in the approach to the vaccine, a little too cautious,” admitted Olivier Véran on January 7, half-acknowledging a delay in ignition.

So today, while new contaminations with the British variant were identified on Monday in Lille, on the logistics side, nothing should be left to chance.

"Very quickly, there was great momentum and coordination between the hospital, the outpatient health professionals (general practitioners and nurses) to set up these vaccination centers, says Dr Duquesnel".

And to achieve optimal efficacy, the goal, “is not to waste any dose, insists the doctor.

We have created a pool of general practitioners who will both supervise vaccinations in nursing homes and in vaccination centers.

And we are working on the imminent launch of a tool that makes it easier to book an appointment and that will give a reminder by SMS the day before the vaccination ”.

To be sure of optimally managing vaccine stocks, health authorities and health professionals ensure that the pre-vaccination consultation stage is scrupulously respected.

"It's fundamental," says Dr Duquesnel.

The doses that will be ordered at the central pharmacy of the department will be evaluated according to the appointment book.

It is therefore necessary to ensure that each person who comes to a center can actually receive the vaccine, and for this a doctor must first check that there was no contraindication or risk of allergy.

Doses are too precious and supplies too tight to risk having people come forward for the vaccine who ultimately cannot receive it.

It is out of the question to throw away doses when we already fear running out of them ”.

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