Eligible for vaccination, dependent or non-mobile people over 75 years of age have difficulty accessing the anti-Covid vaccine.
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Daniel Cole / AP / SIPA
While people over 75 living at home now have access to the anti-Covid vaccine, for those who are dependent or have difficulty getting around, it is not possible to go to a vaccination center.
However, the vaccine strategy developed for the government does not provide for specific measures to promote access of these more vulnerable people to the vaccine.
Only a few local initiatives have seen the light of day, but some of them are already thwarted by vaccine supply concerns.
We must vaccinate.
As many people as possible, as quickly as possible.
After a first phase dedicated to nursing home residents and their caregivers, the government has accelerated the anti-Covid vaccination campaign by launching phase two earlier than planned, opening on January 18 vaccination to caregivers over 50 years of age as well as to people aged over 75 living at home.
On paper, 6 million people are eligible.
But it is still necessary to be able to move to a vaccination center.
In practice, for elderly people outside nursing homes who are dependent or not mobile, it is more complicated.
Bring patients closer to the vaccine
For these people, it would seem that nothing was specifically considered.
"A certain number of people can move around thanks to family caregivers, but this is not the case for everyone, so we will have to develop solutions", responds to
20 Minutes
the Ministry of Health, confirming that no
ad hoc
mechanism
has been put in place.
"These people are the blind spot of this campaign, because the appointment system has favored people who are mobile and accustomed to modern communication tools", regrets Dr Jacques Battistoni, president of the general practitioners' union MG France .
"A certain number of over 75 years do not have the possibility of being vaccinated", confirms Dr. Luc Duquesnel, general practitioner in Mayenne and president of the union Generalists - Confederation of French medical unions (CSMF).
To remedy this, local initiatives have emerged.
"In our department, we have made arrangements with the local authorities to set up a shuttle system which drops off seniors at the vaccination center," explains Dr Duquesnel.
In addition, requests have been filed with the Health Insurance by several departments so that people with total incapacity to move can benefit from a taxi or a vehicle dedicated to medical transport, and which is covered ” .
"Vacci-buses" to bring the vaccine directly to patients
And for those who can't get the vaccine, sometimes the vaccine comes to them.
Thus, in the Marne, a “Vacci-bus” has been created to travel through rural communities.
"It's good, the bus is now coming to us", rejoices André Grogan, 80, accompanied by his wife Marie-Jeanne, 73, ready to be vaccinated.
“Our doctor advised us to do this.
So, when the town hall called us, we said to ourselves that this was the occasion, ”he says in the post-vaccination rest area at the back of the bus.
Without that, "I wouldn't have come because I hate asking other people for services, and since I don't have children here…", adds Marie-Jeanne.
"I had this idea by discussing with the teams and exchanging with the mayors", confides Catherine Vautrin, LR president of Reims Métropole.
The operation was set up in less than a week.
In practice, the Vacci-bus is a revamped standard bus.
Curtains demarcate two spaces: one dedicated to vaccination, where pre-vaccine interviews are also conducted, another dedicated to post-vaccine surveillance.
Each day, the logistics department of the Reims University Hospital gives Transdev thirty doses, in a cooler with a control probe, to supply the Vacci-bus, equipped with a small refrigerator.
And in the territories, it is emulated.
Particularly in the Allier, which has set up a similar traveling bus, or in Gironde, where the mayor of Libourne wants to "arm buses to vaccinate dependent people at home".
Initiatives thwarted by supply difficulties
In Strasbourg, "we are inventing new forms to go and vaccinate the most socially vulnerable or the most dependent," says Dr Alexandre Feltz, general practitioner and deputy to the town hall in charge of public health.
We have thought of operations by district, via multi-professional urban health centers, which would act as ephemeral centers.
We are also planning to develop mobile lines for home vaccinations ”.
Another initiative: "organize the group vaccination of elderly people living not in nursing homes, but in senior residences, with medical teams," adds Dr Duquesnel.
"But for the time being, everything is at a standstill because of supply difficulties" jointly deplore Dr Duquesnel and Feltz.
Because to vaccinate everyone, the sinews of war are vaccines.
"The vaccinators, we have them," says Dr Jacques Battistoni.
But if we don't have vaccines, we can't do anything.
Doses should be reserved for vulnerable patients who cannot leave their homes.
I am afraid that all of the vaccines planned for phase 2 will be preempted by the system for making appointments at the vaccination center, at least until mid-February (…) However, this audience , particularly vulnerable, dependent and not mobile, who receives care and sees nurses, nursing assistants and home helpers on a daily basis, needs to be protected as quickly as possible ”.
The AstraZeneca vaccine, the solution?
We will therefore have to wait.
But could the solution come from AstraZeneca?
Its vaccine, "in theory, will present much less logistical constraints, and can be provided to doctors and nurses for home vaccination," says Dr. Duquesnel.
So ?
"Yes, but no," replies Dr Battistoni.
Yes, because this vaccine is easier and more handy, and does not need to be stored in super-freezers like the one from Pfizer.
But AstraZeneca's vaccine is a little less effective than those that employ messenger RNA technology.
In addition, in clinical trials, it has not been studied in people over 65 and is probably less effective in them.
So among those over 75!
"
At the end of January, the European Medicines Agency (EMA) "should give its approval to the AstraZeneca vaccine, but we do not know the conditions of use which will be set by the High Authority for Health (HAS), points out Dr Battistoni.
And if the HAS decides that it is not intended for over 65s, we will still have no solution.
Perhaps it will be necessary to review the vaccination strategy by reserving AstraZeneca for the youngest health professionals and keep the vaccines from Pfizer and Moderna for the older ones ”.
For the time being, "we are working on all the scenarios concerning the AstraZeneca vaccine, there are many issues related to population targeting," replied the Ministry of Health on Tuesday.
Who, "at this stage, awaits the opinions of the EMA and the HAS to know how (he) will fit into the vaccine strategy".
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