How is France preparing for a mass vaccination campaign?

With the imminent arrival of one or more anti-Covid vaccines on the market, France is preparing to launch a massive vaccination campaign. – Alexander Demianchuk / TASS / Sipa U / SIPA

  • France could launch the vaccination against the coronavirus from the first half of 2021.
  • A vast campaign which requires significant logistical resources.
  • And which requires the support and confidence of the population in a new vaccine.

They will be here soon: the anti-Covid vaccines. So France is already preparing for a mass vaccination campaign. The government is thus “in the starting blocks to be ready to distribute a vaccine against Covid-19” from January if it is validated, and has budgeted for this “1.5 billion euros for 2021 to buy a first series of vaccines ”, assured Tuesday its spokesperson, Gabriel Attal.

After the announcement last week by the American laboratories Pfizer and German BioNTech, of a vaccine effective at 90%, the company Moderna said Monday that its had an effectiveness of 94.5%. But when will these vaccines receive their marketing authorization? How will France ensure their conservation? Who will it vaccinate first and how will it overcome the mistrust of part of the public to convince of the value of mass vaccination?

First go through Europe

For the time being, no vaccine has received its marketing authorization, a prerequisite for its distribution. “At this stage, I remind you that phase III is not finished, that these are preliminary results, that it is better to be careful”, recalled the spokesperson for the government. The French vaccination campaign is therefore being played out first and foremost on a European scale. The European Medicines Agency (EMA) has set up a fast-track procedure that allows it to examine vaccine safety and efficacy data as they become available, even before a formal request for it is made. authorization is filed by the manufacturer. Moderna on Monday became the third vaccine project subject to this “continuous review”, after those of Oxford / AstraZeneca and then Pfizer / BioNTech in early October. Vaccinations in the EU could thus begin “in the first quarter of 2021” in an “optimistic” scenario, indicated last week Andrea Ammon, director of the European Center for the prevention and control of diseases.

“We are preparing a campaign to be ready when a vaccine will be validated by European and national health authorities,” Gabriel Attal added on Tuesday on France 2, agreeing to the possibility of a campaign from the start of the year. And when it comes to ordering vaccines, again, it goes through Europe. “You have to anticipate, that means reserving doses,” he added. We are doing this at European level: several hundred millions have been reserved with the various laboratories ”. No less than 300 million doses, to be more precise.

France has already secured 90 million doses through European pre-orders, report The echoes. Enough to ensure two injections to 45 million French people.

Super-freezers to store vaccines

While the long-awaited vaccine from Pfizer and BioNTech could be the first available on the market, it requires significant logistics to be anticipated well in advance. It requires storage at – 70 ° C, which implies investing in equipment to this. “We have designed a specific thermal container, using dry ice, to maintain the recommended storage conditions throughout transport and at the vaccination site,” says Pfizer.

And how do you keep them once they’ve been delivered? “We are preparing to start a vaccine campaign as soon as possible,” assured the Minister of Health, Olivier Véran, during his last update on the epidemic. Thus, “with regard to the vaccine marketed by Pfizer and BioNTech, we have already purchased fifty super-freezers which allow the storage of health products which are connected to alarms, which will be stored in secure places from which teams can deploying and then supplying all those who will need to be vaccinated is a monumental task ”. An expensive site, since only one of these super-freezers costs between 6,000 and 12,000 euros.

And once out of these high-tech freezers, how to ensure safe distribution? The vaccine can be stored for two weeks in the packaging provided by Pfizer and BioNTech, a sort of trunk which should contain up to 5,000 doses. BioNTech also ensured that once outside of those same special freezers, the vaccine could be stored for five days in a refrigerator. If the Moderna vaccine receives its marketing authorization, its distribution should be less complicated, since it can be stored in conventional refrigerators, between 2 and 8 ° C. Just like that of Sanofi.

Determine priority populations

But will there be vaccines for the entire French population? Probably not for many months, since only a few tens of millions of doses are expected to be produced on the planet before the end of this year. So who to vaccinate first? The Scientific Council is expected to deliver its opinion on the matter in the coming weeks, but did not wait for the announcements from Pfizer-BioNTech and Moderna. He thus opted, in his opinion of July 27, for “targeting priority populations”, which he considers “a crucial component of the vaccine strategy” against Covid-19.

“All the countries which are developing their vaccine strategy in the face of Covid-19 are moving towards a prioritization of vaccination, because the doses will not be produced all at once, but gradually”, indicates to 20 Minutes Prof. Daniel Floret, vice-president of the Technical Committee on Vaccinations, attached to the
High Authority of Health (HAS). This is why the Scientific Council recommends “a prioritization of access according to health risks, populations at occupational risk, strategic jobs as well as socio-eco-demographic characteristics”. Clearly, “the vaccine would be administered as a priority to people exposed to the virus in the course of their professional activity: nursing staff, those who work in contact with the public or in an exposed environment, but also all those who are vulnerable in because of their age or their state of health, ”suggests Professor Floret.

For the time being, the details of the campaign’s deployment are not yet known. What is certain is that with a new vaccine which, for the German-American, must be stored at very low temperature, reaching all the priority people will be a real challenge. “In the current state of the exchanges that we have with the DGOS and the Ministry of Health, it is established that since it will be a primary vaccination with possible reactions, the presence of a doctor will be obligatory during inoculation, explains to 20 Minutes Dr Luc Duquesnel, general practitioner and president of the union
General practitioners – Confederation of French medical unions (CSMF). This point is not without its problems, since the idea has been raised that vulnerable people who are at home and cannot move around are excluded from priority people. But the representatives of general practitioners indicated that it was out of the question to leave this priority public aside: we will organize ourselves to go and vaccinate vulnerable people at home. We do not have super-freezers, but we should receive small packages to ensure vaccination in the city. No question of reproducing the fiasco of the H1N1 vaccination, with more vaccines that ended up in the trash than people vaccinated ”.

Involve city health professionals to restore confidence

It remains to be seen whether the French will rush on the vaccine – with a risk of shortage to be expected – or whether they will shun it, in their capacity as world champions of mistrust of vaccines. According to a survey carried out by Odoxa for franceinfo and Le Figaro published last Thursday, only 50% of French people say they intend to be inoculated with the vaccine if it is soon deployed in the territory. And 60% of those questioned oppose it being made compulsory.

“That people are asking questions about a vaccine that we do not know, it’s normal,” said Dr. Duquesnel. Regarding the choice of the future vaccine (s), “there is a battery of criteria and that is why we have health authorities who can enlighten us”, and “obviously, there is a criterion on which we do not. not derogate, it is that of security and that of the least risk ”for health, assured Gabriel Attal. “We will take the vaccine which is available as quickly as possible and which guarantees significant efficacy,” he added.

“What is important for the population, as for me who am a doctor, is to have perfect readability of the effectiveness of vaccination and its possible side effects,” insists Dr Duquesnel. When we start the vaccination, it must be safe. Confidence requires clear information ”. And also by city health professionals, who teach their patients. “When people see that health professionals are vaccinated against the coronavirus as they do against the seasonal flu, it will send a strong signal of confidence and security,” thinks the general practitioner. We could even wear a small badge on our gowns to indicate that we have been vaccinated. When I have been vaccinated, I will post it. And at the end of the day, all that will be resisted are the anti-vaccine conspirators. And it will be us, vaccinated against Covid, who will protect them ”.

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