Covid is a bit ahead. As anticipated this summer, when early signs of a slight epidemic recovery were reported, the virus seems to be starting to circulate quite widely before the first frosts of autumn. Proof that Sars-CoV-2, if sensitive to climate and temperature, does not behave quite (or not yet) like a purely seasonal virus.
Unfortunately, it is not easy to be much more precise than that. Epidemic surveillance has eased considerably since March, with the cessation of the count of hospitalizations, then in June with the abandonment of the daily rise of positive tests. Even if Covid remains a notifiable disease, it is difficult to have a very clear vision of viral circulation at any given time.
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The incidence is thought to have increased by about thirty percent since last week. It is to be taken with great caution but the virus is circulating, each of us can see cases around him, "said Friday the Minister of Health, Aurélien Rousseau. The latter therefore took the decision to bring forward to 2 October the launch of the vaccination campaign, two weeks earlier than planned, thus complying with an opinion of the Committee for Monitoring and Anticipation of Health Risks (Covars) recommending "access to the vaccination booster as soon as possible".
Initially, the campaign was to be done in a group with influenza, from October 17. "The idea was to do both injections at the same time during the same consultation, for purely logistical reasons," recalls Odile Launay, professor of infectious diseases at Paris-Cité University. Immune-wise, it doesn't change anything. The vaccine is neither more nor less effective. But when we see the current epidemic recovery and the reluctance related to the fear, unfounded, of adverse effects reinforced by a double injection, the Covars judged that there were probably more advantages than disadvantages to dissociate the two campaigns." Fears that the start of the school year will give a new boost to the epidemic have also played a role.
Vulnerable audiences
Vaccination will be done with Pfizer's "updated" vaccine in the spring and targeting Omicron. The subvariants currently circulating are all from this family. "The immunological data we currently have are relatively reassuring about the effectiveness to be expected from these new vaccines against circulating variants," explains Professor Jean-Daniel Lelièvre, an expert in vaccination at Henri-Mondor Hospital in Paris. They should offer a level of protection close to 80% to 90% against severe forms.
Some 2.5 million doses are currently available, assured the Minister of Health, adding that in total there would be "13.5million doses" by November. For the most sensitive audiences, doses will be available at the end of September at the hospital. Pharmacies can already order the doses that will be made available in the first week of October. Two other vaccines adapted to Omicron are being evaluated and should also be available in the future, one from Moderna (also RNA like that of Pfizer), the other from Novavax (a more conventional technique with recombinant proteins); pending the arrival of this second product, people over the age of 18 who are unwilling or unable to receive RNA vaccine may be offered Sanofi VidPrevtyn Beta.
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The anti-Covid vaccination campaign is primarily aimed at vulnerable populations and those who work with them (relatives, caregivers...): people over 65, patients with comorbidities, pregnant women, nursing home residents. The ministry recalls that a minimum period of six months must be respected with the previous injection. The vaccination can be administered by a doctor, a nurse, a midwife or in a pharmacy, or even on site in a nursing home.
From 17 October, the start date of the flu vaccination campaign, both injections can be given at the same time. The Covid vaccine will be completely free, the flu vaccine only for target audiences. If vaccination against Covid is open to all, "for young adults in good health, unless you want to protect a fragile loved one, there is no real need to be vaccinated," says Jean-Daniel Lelièvre. But for the most fragile, on the other hand, a booster with the new vaccine is particularly recommended: "The protection conferred by RNA vaccines is of relatively low duration," says Odile Launay. However, the vaccination campaign in the spring met with very low adherence. Many frail people have not had a recall for at least eight months, and are currently particularly vulnerable.
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