Illustration of the AstraZeneca vaccine.
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FRANCOIS GREUEZ / SIPA / SIPA
With the arrival of the AstraZeneca vaccine, anti-Covid vaccination began in medical offices.
The Ministry of Health is counting on city vaccinators, especially general practitioners, to speed up the campaign, and 30,000 private doctors have volunteered to vaccinate their patients over 50 with comorbidities.
But in practice, some face problems in delivering vaccine doses.
Skip the second and frankly accelerate the anti-Covid vaccination campaign: this is the objective of the government, which relies on the deployment in cities of the AstraZeneca vaccine.
However, the Ministry of Health acknowledged on Tuesday that only 25% of the doses of the British vaccine received in France have been used.
"On AstraZeneca, there is a situation which is particular: we are Sunday evening at 24-25% of consumption of stocks", against "almost 70%" on average for all the vaccines available, explained the ministry.
Why are AstraZeneca stocks not sold out?
Heavy logistics for doctors, and especially delays in deliveries, explain these low figures.
AstraZeneca under-consumption
On February 25, vaccination was therefore opened in city medicine to people aged 50 to 64 with co-morbidities.
“35,000 general practitioners have registered on the platform of voluntary vaccinators: they are very active.
We delivered vaccines in town, in the pharmacy network.
(…) The flow dynamic of these doses was very strong the first days, with more than 120,000 injections ”, welcomed the Ministry of Health.
The following week, however, the number of vaccinators fell below 20,000.
"There was a drop in orders, probably because they had planned their vaccination periods with the vials they had available for the first order," says the ministry.
But they relaunched their orders this week.
We will therefore have a key vision of physician membership, which will allow us to adjust the government's strategy, which wants doses to be made available in the field as quickly as possible ”.
As for the vaccinating doctors, the provision is far from going fast enough.
"The Directorate General of Health (DGS) wrote to pharmacists on Saturday to tell them that they were not certain to deliver the vaccines before Thursday or even Friday," indicates Dr. Jean-Paul Hamon, general practitioner and president of honor of the Federation of Doctors of France (FMF).
When we were told last week that the volunteer vaccinators would receive three vials of ten doses, we all made appointments for our eligible patients ”.
Vaccine target "narrow" and "non-deliveries"
In Dr. Hamon's office, “twenty patients made an appointment this Thursday, ditto Friday.
My doses are assured for Thursday, but for Friday, I do not know yet, specifies the doctor.
One thing is certain: if we do not have the vaccines, if I have to cancel, I will stop immediately.
If there are vaccines, where are they?
I have other things to do than make appointments to cancel them behind, it is not tenable.
It is up to the DGS to know how to manage its stocks ”.
For vaccinators, scheduling these vaccinations therefore requires significant logistics.
“AstraZeneca comes in a 10-dose vial, which must be used quickly so as not to waste any dose.
It requires rigor, anticipation and personnel to contact patients in addition to our consultations.
It takes time, describes Dr Jacques Battistoni, general practitioner and president of the MG France union.
Especially since until now, the vaccine target has been quite narrow: patients aged 50 to 64 with co-morbidities are ultimately not very numerous in the patient population of each doctor.
These are 40 to 50 patients, so you have to be very proactive in bringing together a group of ten people each week to be vaccinated ”.
But “the first logistical constraint is the supply of bottles to the pharmacy, insists Dr Battistoni.
The testimonies attesting to non-delivery of doses are increasing, and even today, one of my colleagues told me that he had not received the doses ordered.
These are blocks of ten patients that must be deprogrammed at once when a vial is missing, it is very demobilizing.
We vaccinators are at the end of the chain.
We do not know at what level it gets stuck, but it is clear that it gets stuck in all regions!
"
An expanded vaccine target and massive deliveries to come
On the side of the Ministry of Health, it is assured that by the end of March, a total of 6.4 million doses of AstraZeneca will have been delivered to France.
Added to this is an expansion of the vaccine target of the British vaccine.
Monday evening, the Minister of Health, Olivier Véran, announced the extension of the use of AstraZeneca to people aged 65 to 74 years with comorbidities.
This decision is based on an opinion from the High Authority for Health (HAS), published Tuesday, which takes into account new studies carried out in the United Kingdom, showing that AstraZeneca is effective in reducing hospitalizations in the elderly.
"Now that we have good news on AstraZeneca, it is imperative that this vaccine finds its place in the vaccine strategy," said the Ministry of Health.
“For the very first vaccinations, we contacted the patients.
Now they are starting to come to us to get vaccinated, ”observes Dr Hamon.
"The knowledge that the population has of this vaccine is greater and the opinion better compared to only a fortnight ago, thanks to the latest scientific data, abounds Dr Battistoni.
With the expansion to 65-74 years, we will have more patients to be vaccinated: there is a significant demand from this age group.
However, the Department of Health keeps telling us that we are going to have many more doses, but for the time being, we do not have many.
So we can't make an appointment beyond what we have in stock, otherwise it's too risky.
In terms of doses, it's when we see them that we will believe it!
"
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