Should vaccination be more massive in the East than in the rest of France?

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Anthony Behar / Sipa USA / SIPA

  • This week, doses of the Moderna vaccine are delivered specifically in the Grand-Est, in the Auvergne-Rhône-Alpes region and in PACA.

  • Regions particularly affected by the epidemic rebound, and which have become “priority” for vaccination.

  • Is this strategy effective?

While the vaccination of people over 75 years old outside nursing homes starts in France on a national scale on Monday, January 18, it has been brought forward to this Wednesday in all of Greater Nancy.

Five days in advance that the president of the region justifies "in view of the situation in our territory.

We are two beds from saturation in intensive care at the Nancy University Hospital ”.

This local adaptation is no exception.

Thus, France received 50,000 doses of the Moderna vaccine on Monday, doses directly sent to the Grand-Est, Auvergne-Rhône-Alpes and PACA to be used during the week, said Minister of Health Olivier. Véran.

A choice that owes nothing to chance: these are the French regions most affected by the epidemic rebound.

While the government has instead poured so far into nationwide measures to fight the coronavirus, why adopt such a local strategy and is it really relevant? 

20 Minutes

takes stock.

Why a localized vaccination?

To fully understand the value of this strategy, it must first be noted that the coronavirus does not strike all of France in the same way.

For example, if the national average of the incidence is 191 cases per 100,000 inhabitants over the last seven days, it rises to 519 cases in Nice.

In all, seven French departments are above 300 cases per 100,000 inhabitants: the Alpes-Maritimes, Jura, Doubs, Haute-Marne, Territoire de Belfort, Haute-Saône and Meuse.

On the contrary, in Finistère for example, the incidence is only 68 cases per 100,000 inhabitants.

Differences that can also be seen in the rate of resuscitation beds for Covid-19 patients: "Only" 23.5% in Brittany or 36.3% in Occitanie, against 68.4% in the Grand-Est, 68% in PACA and 87.4% in Bourgogne Franche-Comté.

All the regions delivered as a priority have a resuscitation bed filling rate of over 50%.

Is there an alternative now?

France has ordered 225 million doses of vaccine, but these are slowly arriving.

Thus, for the month of January, France should have received - all vaccines combined - only 2.7 million doses, and ten million in February.

Largely insufficient to cover the entire population, or even just those at risk.

Suddenly, as there is a priority for the most vulnerable people, France is setting up "a priority for the most fragile regions", indicates Hélène Rossinot, medical specialist in public health.

A strategy "logical in view of the disparity of the epidemic: there is statistically much more chance of catching the virus in the East than in Brittany, a vaccine administered in the East is more likely to have saved a life - or avoid resuscitation and therefore relieve a little bit of congestion in hospitals - than a vaccine given in Brittany, at least at time T ”.

This is also the solution for which Michaël Rochoy, doctor and researcher in epidemiology pleads: "Rather than having localized curfews or restrictive measures at the regional level, localizing the vaccination seems more relevant, and we are sure to its effectiveness, unlike a 6 p.m. curfew.

As long as we do not have enough doses, we must concentrate them where they are most effective.

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Better than a national strategy?

“In theory yes.

In practice, on the other hand, ”emphasizes Hélène Rossinot.

“We can strengthen the regions most at risk, on condition that we also cover the entire territory.

The localization of certain vaccines should be a bonus applied to a national strategy, and not the spearhead of the vaccination campaign.

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The reason for such an indication?

The epidemic is particularly unpredictable, "and regions can change trend in a week", worries the expert.

By enlarging the line, nothing indicates that next Tuesday, it is not Occitanie which will blaze while Nice will be in clear epidemic decline.

However, the vaccine is not effective at the time of the bite, but there is a delay of about two weeks for the rise of antibodies.

Two weeks leaving plenty of time for the epidemic to strike elsewhere.

"Since we cannot predict the future of the epidemic, we must vaccinate all regions," notes Hélène Rossinot.

As for additional doses for the most affected regions, "why not, the idea is good, but we must then be ready to change priority regions very quickly, and reorganize vaccination where the epidemic resumes", supports the doctor.

This would require major and complex logistics, enough to encourage, here too, to prioritize above all a national vaccination.

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  • Covid 19

  • Coronavirus

  • epidemic

  • Vaccination

  • Vaccine

  • Health