France sets out future Covid-19 vaccine priority plan
France has started to plan a vaccination strategy for Covid-19 - deciding who will qualify for the jab first, depending on their job, age, and vulnerability level - even though no vaccine is yet available to the public.
A report by 15 key members of health care advisory bodies le Conseil Scientifique, le Comité Analyse, Recherche et Expertise (CARE) and the vaccination committee le Comité Vaccin Covid-19 was published online on the ministry for health website on Friday (July 24).
The full report can be seen below (in French, from newspaper Le Monde).
The document details who will qualify for the vaccination first, and highlights people due to their job, risk category, age, or the presence of any chronic illnesses. More than half of the French population would qualify.
More than 6.8 million people are at especially high risk, the report said, including 1.8 million healthcare professionals, such as doctors, surgeons, dentists, pharmacists, midwives, nurses and carers.
Five million other professionals would also be included due to their contact with the general public; shop workers, school staff, transport staff and hospitality workers; those working in smaller spaces such as abattoir staff, taxi drivers, migrant workers and construction teams.
Around 23 million people could be considered vulnerable due to their age (over 65), or a chronic condition (cardiovascular illness, hypertension, diabetes) or obesity. These people would be considered “as a first priority”.
Around 250,000 other people in a “precarious state” would also be considered as a priority.
The report also lays out a list of people who would take “second priority” - around five million people.
These would include people who live in departments - including in French overseas territories - at risk of a lack of intensive care beds, people living in closed, at-risk sites (such as prisons, disabled care units and psychiatric hospitals), and people with a “strategic” job, such as police, the military, and firefighters.
No vaccine yet
The report acknowledges that there is no vaccination currently available, as 148 development projects are underway - including 17 at the clinical trial stage and 131 at pre-clinical stage.
Most recently, a trial at Oxford University in the UK (with pharmaceutical company AstraZeneca) was reported to have “triggered an immune response”, and appeared to be safe, with few serious side effects.
A similar trial in China, supported by CanSino Biologics, has also suggested similar results. Both have been described as “promising” and “hopeful”.
The authors of this new report said: “The number of vaccinations that will be ordered is still unknown, but we expect to have tens of millions of doses (potentially of 2-5 different products) available between the last trimester of 2020 and the first trimester of 2021, which could be deployed in case of a second wave of Covid-19.”
Yet, they called for caution. The report said: “It is imperative to give ourselves the necessary time for a rigorous evaluation on the effectiveness and safety of the possible vaccines, before using them on a wider scale.”
Some have suggested that “infectious challenges” could help the process. This would consist of a medically-supervised infection of people who had been vaccinated - as part of a proper trial.
However the report authors rejected this idea on a scientific and ethical basis.
The effectiveness of a potential vaccine has also been called into question when it comes to elderly people, who may be less immune to the virus even after vaccination, due to the ageing of their immune system.
The report added also that any vaccine would need to be free - or at least, paid for by the State - in order to ensure wide scale take up among the population.
It said: “[We call for] transparent communication on procedures that would allow the speeding up of the vaccination coming to market, without compromising on safety, on the [existing] scientific uncertainties and recommendations.
“[This would] benefit, in a participatory, open and transparent way, a “citizens forum”, which would notably include patient associations”, the report said. So far, patient associations have not been widely consulted in the fight against the virus, it added.
The report comes after a nationally-representative poll found that one in three people "would not get a Covid-19 vaccination" even if it were to become available, in line with the general view that the French are often sceptical of vaccines.
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