The health system could be under pressure at winter approaches, with people reporting ‘flu-like symptoms that may or may not be Covid-19, as the two conditions sometimes appear to have similar effects, such as a fever, aches and pains, fatigue, and a cough.
As a result, health agencies in France are advising people to get a ‘flu vaccine - even if they usually would not do so - as a way of reducing the load on the healthcare system.
Since May, medical academy l’Académie de Médecine has even been advising that ‘flu vaccinations be made mandatory for “all carers and social workers in contact with vulnerable people, especially in elderly care homes, hospitals, and crèches”.
It also advised that doctors should be required to offer a ‘flu vaccine to all their patients.
And on August 19, seven pediatric health societies published an open letter, calling for all patients to vaccinate their children against both ‘flu and the rotavirus (which causes gastroenteritis in young children).
The ‘flu vaccine campaign will begin in mid-October.
Professor Daniel Floret, vice president of the technical vaccinations committee at health authority la Haute Autorité de Santé (HAS) told newspaper Le Monde: “[There is] a risk of overloading the health system, which is already under pressure from the Covid-19 epidemic.”
He added: “This year, I encourage more at-risk people to get vaccinated for ‘flu, and it seems that there has been greater take-up [so far] even among people who are usually reluctant or hostile to the idea.”
GP Serge Gilberg said: “The priority is to vaccinate people who might develop complications so that they do not clog up the hospitals at the very moment when we will need beds.”
Vaccine coverage
The HAS, which had been asked to consult on the issue by the ministry of health, said:“[It is very] important to improve vaccine coverage among targeted populations.”
In an email to Le Monde, the ministry of health said: “Within the context of Covid-19, vaccination is ever more important, and the people at risk of getting a severe form of the illness are the same for both infections.”
The main at-risk categories include people aged 65 and over, those with vascular or breathing problems, people with asthma or chronic diabetes, immune system issues, or neurological problems. Healthcare workers are also at high risk.
Overall, the “at-risk” groups number around 12 million people. The most at-risk can receive the vaccine for free from the Assurance Maladie, and can even be vaccinated at pharmacies. GPs can also prescribe a vaccine for anyone who is judged to need one.
Professor Floret said: “At-risk people must get vaccinated now more than ever, especially children who have serious conditions.”
Last year, the ‘flu vaccination coverage in France was at 46.8%, much lower than the 75% recommended by the World Health Organisation to offer widespread protection. Even among healthcare workers, the take-up has historically been low: 68% of doctors, 50% of midwives, 36% of nurses, and 21% for carers.
Professor Floret explained: “Many see ‘flu as a benign illness. And there is a lot of false information [out there] about ‘indesirable effects’ [from the vaccine]. However, the vaccine is very well-tolerated and contains no additives.”
Yet, even with the vaccine, there is no guarantee that a patient will not get ‘flu - the vaccine’s effectiveness stands at 60-65%, especially for older people, whose immune system responds less well.
However, virologist Astrid Vabret, at the CHU hospital in Caen, said: “The ‘ineffective’ argument does not hold up”, appearing to agree with Professor Sylvie van Der Werf, head of respiratory virus centre at the Paris medical research centre Institut Pasteur.
Professor van Der Werf said: “Some data shows that getting a vaccination reduces the severity of the illness even if you get it.”
Major ‘flu vaccination manufacturer Sanofi Pasteur - which accounts for 40% of the market in France - has started preparing for the winter vaccination demand earlier than normal, and is looking to provide 15-20% more doses than usual.
Professor van Der Werf said: “[Within the context of Covid-19] we have to be even more alert to other respiratory viruses such as ‘flu. ‘Flu vaccinations is one of the major means available to us.”
Competing epidemics
In France, between 2-8 million people suffer ‘flu each winter, with around 8,000-14,000 deaths from the illness per year, according to figures from the past three years.
During the 2018-2019 epidemic, which was judged to be of “medium” intensity, there were more than 65,000 emergency hospital visits reported, with 10,700 hospital admissions for ‘flu-related issues, and more than 1,890 admissions into intensive care, show figures from health body Santé Publique France (SPF).
Covid-19 is still spreading in France. Figures from SPF show that for the week of August 24-30, there were 36,785 new cases - a rise of 32% compared to the week before.
Overall, 30,661 people have now died.
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