• In a few days, France will reach the first 50 million doses injected into its population.

  • Despite this impressive number, two million fragile French people have still not received the slightest dose.

  • Is the number policy in France showing its limits?

In a few days, France should pass the historic milestone of 50 million French people first vaccinated against the coronavirus, a target that the government had set for the end of August. Side glass half full, this means that 72.6% of French people have received at least one dose of vaccine, including 84.4% of the eligible population, figures difficult to imagine before the health pass. Recall that the government's initial target was 40 million first-time vaccines by the end of the summer, before targeting ten million more in front of the vaccine runaway after July 12 and Emmanuel Macron's speech.

Sorrowful spirits may say that the mission is finalized several days late, but the half-empty glass is elsewhere: 11.2% of over 75s are not vaccinated, just like 8.8% of 60-74 years. A very high rate, when some countries, such as Spain or Belgium, approach 100% of vulnerable populations vaccinated. About 15% of chronically ill (cancer, diabetes, obesity, hypertension) are not vaccinated either, according to the latest Health Insurance count stopped on August 22. "Two million elderly and sick French people" are "the top priority", said Minister of Health Olivier Véran last week,when the Scientific Council indicated in its last note of August 27 that "the major stake of the re-entry is the active continuation of the vaccination by going towards the populations in hesitation vaccine in particular for the more than 60 years, the subjects at risk and economically disadvantaged populations ”.

The politics of numbers

If the “raw” data on vaccination in France are good, they therefore actually hide significant shortcomings.

France is paying a little for its policy of numbers.

By setting targets only in the number of vaccinated, the executive has embarked on a race for numbers instead of targeting vulnerable populations.

Of course, the latter were a priority, but each time a slowdown was noticeable among these populations, the government opened up vaccination to other age groups, in order to take advantage of the new arrivals. to quickly sell out the doses, instead of looking for the recalcitrant in the highest priority categories.

Thus, vaccination for all people with comorbidities, that of people with a BMI> 30, that of people under 50, and that of 12-18 years were each time started ahead of the vaccination schedule. planned. “As we started with a much slower vaccination than in most other countries, there came a time when it was important to make a number, for the game of comparisons,” notes Eric Billy, researcher in immuno-oncology. Victory is now achieved, since France even has better vaccination coverage than the United Kingdom, which for a long time set up as a model, but "the difference with them, for example, is that they waited for a certain percentage of people vaccinated. fragile before opening up the population to young people, ”continues Eric Billy.

Policy of the number but also of the least investment.

Opening up vaccination to young people, “it's easier to set up.

It is enough to open large vaccine centers and young people know how to book on the Internet, make an appointment, move there, ”Eric Billy list.

Quite the opposite of the elderly, who are necessarily not very mobile and much less comfortable on the Internet.

This explains why, for example, 18-24 people have almost the same percentage of vaccination as those over 80 years old.

Deleterious consequences

Going to look for the elderly and frail, that will require "more time, investment, and resources." It is no longer a question of bringing them to the vaccine, but of bringing the vaccine to them, ”notes epidemiologist Antoine Flahault, who takes the example of Spain, which has 99% of vulnerable people vaccinated thanks to a very proactive policy sometimes going to pick them up directly from their homes.

However, there is no question of opposing mass vaccination and vaccination of the vulnerable "both are necessary and France can be happy with its population vaccination coverage, from which some countries could well be inspired, just as it should be inspired by certain policies specific for fragile people ”, qualifies the epidemiologist. If the health pass was a huge success for the vaccination of young people, it shows its limits among seniors, little concerned with bars or sports halls: "All efforts have not been made to get them", deplores he does.

For Eric Billy, there is in any case no choice: "11% of the unvaccinated over 75 years, it will cause carnage with the Delta variant".

It would have been necessary for the researcher to settle these cases before the end of August and the probable epidemic resumption due to the re-entry.

But it is never too late to act, and France can still look at these defective percentages among the fragile and a change of policy towards these populations.

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