All immune, willingly or by force?
The day after the announcement of the Pfizer and BioNTech laboratories, which rekindled the hope of an imminent vaccine against Covid-19 on Monday, the debate has already left the medical sphere to jump into public debate.
Thunderous ... and dissonant.
MEP Yannick Jadot, interviewed this Tuesday morning on Franceinfo, drew the first, declaring himself in favor of the idea of making vaccination compulsory.
“Look at the trauma our societies are going through.
We cannot afford today to extend the period of confinement, cultural, social and economic collapse of our country, ”argued the elected ecologist.
The Socialists let it be known that they are "for compulsory vaccination", while specifying: "After validation by the World Health Organization.
"
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Marine Le Pen, patron saint of the RN, is against, referring each to their individual responsibility.
LFI MP Caroline Fiat, also a nursing assistant, sees the proposal as "a false good idea", conducive to raising "skepticism and conspiracy".
"I am very favorable to vaccines, but a little more reserved on the fact of making it compulsory", slips for its part the president of LR, Christian Jacob.
The decision would not be a novelty.
"Vaccines are already compulsory for children, DT Polio was in the 1960s, and BCG until 2007", notes Dominique Salmon, infectious disease specialist at the Parisian hospital of Hôtel-Dieu (AP- HP), while specifying that the threat of Covid, as serious as it is, is different: “In 85% of cases, the virus causes mild symptoms.
It is difficult under these conditions to justify that it becomes compulsory.
"
Without closing the door, the Ministry of Health notes that the "trust", necessary to ensure wide public acceptance, "comes more through demonstration than obligation."
Especially in a country that drags its feet to reach out.
According to an Ipsos poll published in October, only 54% of French people say they are ready to be immunized against the new coronavirus ... against 74% globally.
It all depends on where it comes from
And this number is likely to move considerably, depending on the characteristics of the bite to come… and its origin.
This is what reveals a study on the vaccination intentions of the French, conducted among 2000 French people, aged 18 to 64, and about to be published by the Bordeaux University Hospital (Gironde), with the support of the Inserm, CNRS and Public Health France.
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According to the first results, of which the Parisian was aware, 30% of people are already certain of their refusal of the vaccine, whatever its characteristics.
Among the remaining 70%, "acceptance will depend on two main parameters: the degree of effectiveness of the vaccine, and its geographical origin" reveals Michael Schwarzinger, doctor of public health at Bordeaux University Hospital, and co-author of the study.
He did not “expect” that the nationality of the doses would have “such an impact” on the acceptability of treatment.
If he's European?
It could be well received by patients.
American?
" Less good ".
And Chinese?
“Not at all”, observes the researcher.
But other parameters will also come into play.
The debate on the risk of side effects, "which will not fail to be strong in the coming months", could reshuffle the cards, as could the mode of administration of the vaccine, "better accepted if it is done. by pharmacist or general practitioner than in a mass vaccination center ”.
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"A compulsory vaccine, people will not want it: it is better to appeal to the responsibility of the French", estimates Benjamin Davido, infectious disease specialist at the Raymond-Poincaré hospital in Garches (Hauts-de-Seine), who prefers to concentrate on another facet of the same debate: who to target first, and at what pace?
The question is crucial, because after the race for the remedy will begin another: the sprint for the vaccination.
The duration of immunity, a guarantee of effectiveness
To reach the finish line of collective immunity, health campaigns would have to go faster than the spread of the epidemic, on a global level.
“People travel, let's not forget that we don't live in an airtight bubble, and I don't know how long it takes to immunize the world…” recalls Benjamin Davido.
Another unknown complicates the equation: the duration of immunity guaranteed by the vaccine.
"Will it protect a few months, or a lot more?"
We still have no certainty, ”notes infectious disease specialist Dominique Salmon.
This data is also one of the most awaited by the scientific community, while the details of the clinical trial of Pfizer and BioNTech are due to be published shortly.
VIDEO. Vaccine against Covid-19: "Caregivers will have priority" according to an expert
Already, public health seems to be leaning towards a vaccination strategy based on "the recommendation", with priority given to certain populations.
“First the caregivers and people at risk,” says Dominique Salmon, then their entourage, and finally, the volunteers.