Regarding the Covid-19 pandemic, the High Authority for Health (HAS) recommends a recall campaign in the fall for people at risk of severe form, at the same time as the flu vaccination campaign. It also recommends that, in the meantime, people at very high risk can benefit from an additional dose if their state of health and their level of vaccine protection so require.
Faced with the Covid-19 epidemic, the first vaccination campaigns targeted the general population – prioritizing the most vulnerable people – in order to protect the greatest number of people from severe forms and deaths, to limit viral circulation and to preserve the health system, which has suffered from successive peaks in hospitalizations. The SARS-CoV-2 virus has continued to circulate on the territory but with a less severe variant – Omicron – since the beginning of 2022. The HAS has thus adapted its vaccination recommendations to protect those most at risk of forms severe Covid-19.
Today she publishes recall recommendations for the year 2023 and determines which audiences are eligible for a new booster dose, and when to do so.
A reminder campaign to be organized in the fall for all people at risk of a severe form, a possible reminder in the meantime for the most vulnerable among them
HAS recommends the administration of a booster dose in the fall of 2023 for people at risk of a severe form of the disease as well as people around them or in regular contact with them (including professionals in the health and medico-social sectors ): people with certain comorbidities regardless of their age, people aged 65 and over, and pregnant women.
In addition, because their vaccine protection decreases faster and more strongly, HAS recommends that people aged 80 and over, immunocompromised people and people at very high risk of the disease can benefit from an additional booster as soon as spring. This vaccination must take into account the medical situation of these people, within the framework of a medical decision shared with the healthcare team.
This new dose is recommended within a period of at least six months since the last dose or infection, regardless of the person’s age or the number of previous boosters. In terms of choice of vaccine, HAS preferentially recommends the use of bivalent mRNA vaccines adapted to Omicron, regardless of the vaccine(s) previously administered.
From a practical point of view and for reasons of mobilization and logistics, it seems relevant to couple the autumn vaccination campaign against Covid-19 with that of influenza which targets the same populations, and to consider that the date of start of the Covid-19 campaign will be determined by the start date of the seasonal flu campaign.
To date, HAS no longer recommends primary vaccination against Covid-19 in the general population, but it nevertheless insists on the importance of allowing anyone who requests it to be able to benefit from a booster dose and to be able to be reimbursed for this vaccination.
In addition, it considers that the possibility of setting up a vaccination campaign at any time should not be ruled out if the epidemiological situation justifies it, in particular for immunocompromised and/or vulnerable people, or even on a larger population scale. general given the unpredictability of the emergence of variants.
Data support the protection conferred by a booster dose
Although, at this stage, it is impossible to accurately predict the evolution of the SARS-CoV-2 virus, HAS nevertheless considers it likely that the health situation this year is characterized by periodic epidemic outbreaks caused by a variant close to the variants which are currently circulating. Vaccination is an effective tool to protect against the consequences of Covid-19, and the booster extends this protection over time.
A recent study conducted in France by EPI-PHARE thus confirms that, compared to no vaccination, the effectiveness of a booster dose of monovalent mRNA vaccine (the first deployed) on the risk of hospitalization is 82% two months after the last injection and 52% more than 9 months after it.
HAS also took into account the data concerning the additional protection provided by the administration of a booster dose with a bivalent mRNA vaccine against the occurrence of symptomatic infections, hospitalizations and deaths. The studies show in particular that the administration of a booster dose with a bivalent vaccine provides additional protection against the occurrence of symptomatic infections (from 21 to 56%), against hospitalizations (from 31 to 84%) and against death (86%) compared to no recall. HAS points out that this protection decreases over time and that this decrease in protection varies according to age (decline in protection faster in people aged 80 and over) and according to the judgment criterion considered (decrease in protection against infections earlier than against severe forms).
Data on the real-life efficacy of adapted bivalent mRNA vaccines against Omicron, although still limited, support the efficacy conferred by a booster dose in persons previously vaccinated with other vaccines.
HAS, press release, February 24, 2023