While the government is trying to speed up the schedule to launch the anti-Covid vaccination campaign from the first days of 2021, or even the last week of December if everything is going perfectly, there are still some modalities to be defined. Which people will be given priority for the first vaccines and who will not be at all? The High Authority for Health (HAS) just published new recommendations, to clarify a little its five-phase strategy, unveiled on November 30.
Trisomy 21, a priority comorbidity
Asked about the case of people with Down’s syndrome, the HAS recalls that they are particularly vulnerable. Trisomy 21 will therefore be considered in the same way as the other co-morbidities of Covid-19 (obesity, diabetes, hypertension, etc.), allowing more or less priority vaccination depending on the age of the person.
No skip-the-line for disability and pregnancy
HAS also provides clarifications on the “People with disabilities accommodated in social and medico-social establishments” : they are not a priority if they do not present a particular risk factor such as advanced age or comorbidity.
Pregnant women are not a priority either, reaffirms the HAS, because they are not included in clinical trials of vaccines and there is therefore a lack of data on the effect of a vaccine on pregnancy. Anyway, “The foreign national recommendations (especially English) identified at this stage do not recommend vaccination during pregnancy”. This opinion could possibly be modified in the future if studies make it possible to verify that there is no risk.
No vaccine recommended for ex-patients
What about people who have already caught the coronavirus? They are at the bottom of the list, judges the HAS. We know that ex-patients must have naturally acquired some immunity against the virus, even if its duration remains uncertain – several weeks or months. Today there are only about ten cases of re-infections “Duly documented” by scientific studies, recalls the HAS, which allows us to suppose that immunity works effectively for the majority of former patients.
In this context, the institution “Considers that there is no need to systematically vaccinate people who have already developed a symptomatic form” of the Covid. They will not be actively counseled about the vaccine, but they can still ask for it. “If they wish, following a decision shared with their doctor”. For these volunteers, it will be “Preferable to respect a minimum period of three months from the onset of symptoms”, even if there is no risk a priori: “The data available shows that there is no particular serious side effect when a person who has already had Covid-19 is vaccinated.”
The five phases of vaccination
As a reminder, here is the order of priority audiences when the first doses of vaccine arrive in France:
1. The 750,000 elderly people residing in nursing homes or other collective accommodation and the professionals who take care of them. High priority are the staff of nursing homes and long-term care units, those who are in regular contact with patients, and who are themselves elderly (over 65) or have comorbidity.
2. People over 75, then people 65 to 74 with a co-morbid condition, then others between 65 and 74 years old. The second phase also concerns health and medical transport professionals over 50 years of age or with co-morbidity.
3. All people over 50 and those under 50 but with one or more co-morbidities. The third phase should also make it possible to finish the vaccination of all health and medico-social professionals.
4. People under 50 and without co-morbidity whose work environment favors infection (contact with the public, closed environment, etc.), and vulnerable or precarious people (in psychiatric hospitals, homeless, inmates, etc.).
5. The rest of people over 18 and without comorbidity will be able to access the vaccine.