As the days go by, the list grows. After the very elderly and those suffering from serious illnesses, it is ultimately all those aged at least 65 and those with co-morbidities who could be invited to receive a third dose of the Covid-19 vaccine this fall. Or rather a booster dose, some of these people having received only one (in case of past infection or with the Janssen vaccine) or three (in case of severe immunosuppression). This is in any case what the High Authority of Health (HAS) recommends in a new opinion, made public this Tuesday and that Le Parisien was able to consult in preview.
The HAS thus offers "the administration of a booster dose for people 65 years of age and over, as well as for all people with comorbidities increasing the risk of serious forms and death due to Covid-19".
These comorbidities are, in particular, trisomy 21, diabetes, obesity (BMI greater than 30), cancer, heart failure, or even psychiatric disorders.
Monday evening, Olivier Véran had anticipated this recommendation, indicating that he had asked his services to prepare for a booster injection for - in particular - those 65 and over.
This HAS opinion should therefore be followed by the government.
Olivier Véran (@olivierveran): "I asked my services to set up the 3rd dose program for those who fall under it" pic.twitter.com/oauFzi6aA4
- BFMTV (@BFMTV) August 23, 2021
To arrive at this position, the HAS examined numerous recent observational studies, in France but also in many foreign countries.
Despite their "methodological limitations", they "suggest a decrease in the efficacy over time of all vaccines, in particular against the Delta variant".
A booster dose “will very probably provide a boost effect without any particular tolerance problem”, but subject to “validation by the European Medicines Agency of the possibility of administering a booster dose”.
"Probably necessary" to broaden the target soon
On a practical level, the HAS recommends allowing a minimum period of 6 months to pass between the last injection and the administration of a booster dose.
These will therefore begin this fall.
Whether the person was initially vaccinated with Pfizer, Moderna, AstraZeneca, or Janssen, they should receive an mRNA vaccine (Pfizer or Moderna either) as a booster.
These new injections against Covid-19 could take place "concomitantly with the seasonal flu vaccination once a person is eligible for both vaccinations", in order to simplify the process.
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Until then, the scientific agency was fairly cautious, for lack of scientific data on the decline in immunity conferred by vaccines over the months. In mid-July, she estimated that studies should first be conducted because they are "essential to define, if the administration of a booster dose is necessary, the target populations as well as the optimal time and type of treatment. vaccines to be used ”.
Less than a month later, on August 12, the Ministry of Health had further advanced, announcing that nursing home residents, over 80 years old, people with very high-risk disease of severe form and those who are immunocompromised will be invited to receive a booster dose (usually a third dose) from mid-September. While it is necessary to anticipate the practical and logistical aspects, this device was valid subject to the recommendations of the health authorities.
It is interesting to note that the HAS considers “probably necessary” to widen the target population by these booster injections, but without being able to specify the modalities and the timetable at this stage. Finally, all this should not make us forget that "the priority for the next few weeks is to do everything possible to increase vaccination coverage, in particular in the age group over 80 years for which full vaccination coverage. is still insufficient ”. Only 8 in 10 of these older residents have received at least one dose of the vaccine to date.