Covid-19 risks ruining the progress made in the vaccination of infants in France. According to the National Agency for the Safety of Medicines (ANSM), sales of vaccines intended to protect children before 2 years of age have been in free fall since the establishment of containment. Its Epi-Phare report, published on April 21, shows that the delivery of penta and hexavalent vaccines, which immunize against diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae meningitis , is down 23% . That of the measles and rubella vaccine is 50% lower in the week of March 23-29, compared to what was expected. It is likely that this trend continued in April, according to experts.
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"It is very worrying ," says Professor Pierre Bégué, pediatrician and member of the National Academy of Medicine, who was alarmed by these data in a press release published on Tuesday. Any delay in vaccination exposes infants to frequent illnesses that can be serious at this age, such as whooping cough or meningitis. This, while these very young children are very little affected by the Covid-19. ”
Postponing these vaccinations also risks creating flaws in group immunity, and allowing epidemic flushes. A particularly acute risk with measles, says Dr. François Vié Le Sage, pediatrician: "Collective protection is a bulwark for babies under 1 year and immunocompromised children, who cannot be vaccinated and are at risk of complications . " However, unlike respiratory viruses, measles circulates more in spring and summer.
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In an opinion delivered in April, the French National Authority for Health considered it "essential" to maintain compulsory vaccinations for infants despite confinement. For these injections (scheduled for 2, 4, 5, 11, 12 and 16-18 months), pediatricians and general practitioners are encouraged to receive the child accompanied by a single parent, spacing the consultations to avoid waiting , ventilating and disinfecting the treatment room between each family. The fear of being infected has nevertheless led many parents to cancel their appointments. "Some practitioners have also chosen to postpone vaccinations until later ," notes Dr. Vié Le Sage. As for general practitioners, who carry out more than half of the vaccinations, they found themselves caught up in the care of the Covid-19 patients. ”
BCG, a possible weapon against the virus
According to the Academy of Medicine, the fear of parents of weakening the immune system of their child in the middle of an epidemic of coronavirus can also explain this collapse of vaccination. "There is no scientific data suggesting an interference between vaccination and coronavirus infection in infants," replied Professor Daniel Floret, vice-president of the technical committee on vaccinations. On the contrary, immune stimulation by a live vaccine, such as BCG against tuberculosis or MMR against measles, could trigger broader protection than that intended. "It has been observed in Africa that oral vaccination campaigns against polio cause a drop in mortality greater than what could have been expected," said the pediatrician. Studies in progress in adults also intend to assess the possibility that BCG could help fight the infection.
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Last year, the Ministry of Health welcomed an improvement in vaccination coverage linked to the extension of the obligation for children born in 2018 - even if the number of protected infants remained below 95% required to obtain group immunity against measles. In its press release, the Academy of Medicine also recalls that compulsory vaccination at 5 months against invasive meningococcal C infections has significantly reduced the number of cases in young infants. It was before the Covid-19 epidemic.
