AstraZeneca vaccine against Covid-19: what to do with millions of unused doses?

The Prime Minister, Jean Castex again stepped up to the plate this Saturday.

“Above 55 years old, the authorities are all unanimous, in France as elsewhere, that there is no danger.

I urge you to get vaccinated with all vaccines, in particular with AstraZeneca, ”he said after visiting a vaccinodrome in La Défense, near Paris.

Like the host of Matignon, the Ministry of Health is struggling to convince that there is no problem with the adenovirus vaccine in France.

Wednesday May 5, it is Gabriel Attal, the spokesperson for the government, who stuck to it, demanding that we also speak of "those who are vaccinated with AstraZeneca".

They are 30,000 on average each day over the past week, against 76,000 in mid-April.

Deliveries, they follow the opposite curve and France has now received almost 7.5 million doses, of which more than 3 million are awaiting a volunteer.

“People eligible for AstraZeneca need to be vaccinated.

Otherwise, we will lose lives, "urged Professor Alain Fischer, the" Mr. Vaccine "of the government, this Friday in Paris.

To read also Alain Fischer in front of our readers: "The objective, to remove the mask by the end of the summer"

The Ministry of Health clings to the hope of a flashback: “We will have to come back to a much larger consumption.

I remember the blessed days when we used over 100,000 doses of AstraZeneca per day.

Adherence to this vaccine must be increased.

“However, the serum is now only accessible to over 55s (like Janssen, but which has the merit of requiring only one dose).

However, the supposed side effects and the suspicions of less efficacy on certain variants lead the overwhelming majority of French people who have the choice to turn to messenger RNA (mRNA) from Pfizer and Moderna.

Anyone over 60 has the option, provided they find an appointment.

From this Monday, this will also be the case for all over 50s.

Open it to people under 55?

Since the opening of mRNA vaccination to people with a chronic pathology, those aged 55 to 60 are, in theory, still only eligible for AstraZeneca.

However, a simple phone call to the Stade de France vaccinodrome is enough to verify that a 57-year-old obese or diabetic person can also benefit from a niche there.

To find potential candidates, it would therefore be necessary to broaden the target.

A possibility put on the table last week by Olivier Véran.

"We are awaiting the exit of the work of the High Authority of Health (HAS) which was seized by the Minister to know if it is possible to open the vaccination with AZ to the less than 55 years old, specifies one avenue de Segur.

This is a really interesting trail, there is no reason not to explore it.

Several Länder in Germany do this.

"

Read also AstraZeneca and Janssen vaccines: why France risks having too many doses in stock

The HAS, which had advised to reserve the vaccine to the oldest, confirms its referral to us on a double question: "Can we consider the vaccination of under 55 years with AstraZeneca and if so what information to provide? to patients so that they are aware of the risk and can make an informed decision?

The body itself intends to rely on the work of the Temporary Scientific Committee (CST) of the National Agency for Health and Medicines (ANSM), which is studying the links between thrombosis and vaccines.

"The HAS is an independent scientific authority and does not take into account economic or organizational factors," she warns.

As soon as we have data that allows it, we update our reviews.

"

A disputed discharge

“The decision goes far beyond pharmacovigilance. Some countries leave the AstraZeneca vaccine for everyone, while others like France reserve it for certain age groups, or even stop it like Denmark… recalls Tabassome Simon, head of the clinical pharmacology service at the hospital Saint-Antoine (Paris). The benefit-risk ratio remains in favor of the vaccine, but the trade-off depends above all, of course, on the availability of other vaccines, the incidence of the virus, the benefit / risk ratio of the product, depending on the age groups considered. . The risk of thrombosis is very rare, but the older the age, the higher the ratio between the benefit of the vaccine and the risk of thrombosis linked to the vaccine. "

By evoking a possible rejuvenation of the target, Olivier Véran evoked the signing of a discharge, as in Germany. What made tick in the medical sphere. "I find it strange that we are asking for a discharge," explains Professor Régis Aubry, member of the National Consultative Ethics Committee. Our role is to explain the interest, the benefit and the risk when proposing an act. Then the patient can accept or refuse. For no other decision we do not sign a waiver, it would be a way of not assuming responsibility for the health system. It is up to the authorities to take the responsibility to authorize or not. Then the ability to refuse is the power of the patient. "

Concretely, in case of opening, the question will arise for everyone to wait a few more months to benefit from Pfizer or Moderna, or to immediately obtain AstraZeneca. "The risk of falling ill and its consequences in the period without a vaccine are much greater than the risk of having a serious adverse effect linked to the vaccine," insists Professor Tabassome Simon. Moreover, if we want to stop the viral circulation, we must achieve collective immunity as quickly as possible. With the highly contagious variants, such as the one from Great Britain dominating in France today, it is necessary to reach 80% of the vaccinated population to stop the circulation of the virus. The AstraZeneca vaccine is very effective against this variant. We therefore have every interest in getting vaccinated as soon as possible. "

Unable to cancel orders

The demand is there anyway.

If his friend Loïc prefers to wait, admitting “being afraid”, Dominique, a 48-year-old Parisian, sees the benefit very well, and the risk very little.

He admits that when it comes to vaccines, he "takes it all".

"There is a greater risk of taking a wrong turn by eating sausage than of dying from thrombosis while being vaccinated," he says.

We don't know what will happen in three months, let's go now!

The sooner the better to protect myself from a serious form and get rid of it.

I want to travel, go to the movies and finally see my parents, whom I haven't seen since the summer of 2019. ”The market therefore exists, even if the time between the two doses of“ AZ ” (twelve weeks, against six for Pfizer and Moderna) limits the time savings for a complete vaccination.

Last solution to overcome stocks of AstraZeneca ... resell them or give them away but not cancel the orders, which should bring the total to 44 million doses by the end of 2021. The European Commission recently confided to the Parisian that its states “own the vaccines and decide how to use them.

[They] have the option of donating or reselling these doses to other countries ”.

What France has not considered for the moment, unlike South Africa which separated from its stock in March.

If France decided to do without adenovirus vaccines altogether, it would have to wait until August to receive enough doses to immunize 60% of its adult population (the declared adherence rate), depending on the pace of supply. planned from Pfizer and Moderna.