4TH DOSE. Faced with this 7th wave of Covid-19 fueled by the highly contagious BA.5 sub-lineage, the authorities recommend the second booster dose. Does it concern all French people?
[Mis à jour le 12 juillet 2022 à 11h37] For a few weeks now, there has been talk of opening the “4th dose of vaccine” to people under 60, as former Minister of Health Brigitte Bourguignon said on June 27. A generalization that leaves part of the scientific community skeptical who, like the president of the Orientation Council for the vaccine strategy in France Alain Fischer, believes that “the need for an additional booster dose for adults in good health is less obvious” (comment reported by The Dispatch). In fact, at a time when the seventh pandemic wave invites itself into the suitcases of holidaymakers, the priority remains the protection of the most fragile.
If, since April 7, 2022, the injection of this second vaccine booster dose is only open in France to people aged 60 (and over), and this, three months or more after their first booster (or last infection Covid-19), vaccination is still slipping. In France, only 26.5% of people aged 60 to 79 and 33.7% of those over 80 went to a dedicated center… A coverage far too low to ensure the protection of the most vulnerable.
Faced with this growing reluctance, incitement calls are multiplying. On July 11, the European Union took the plunge by officially recommending the second booster dose for people over 60, instead of 80 so far. “I call on member states to immediately offer second boosters to all over 60s and vulnerable people, and call on all eligible people to come forward for a vaccination“, said European Commissioner for Health Stella Kyriakides in a joint statement from the European Center for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA). For its part, Public Health France believes that “vaccination coverage for booster doses remains notably insufficient”, the Ministry of Health insisting on the importance of “accelerating” the vaccination campaign to “spend a serene summer and autumn”. injection Could the recommendation be extended to other sections of the population?
What is the 4e dose of vaccine against Covid-19?
1st, 2e3e4e, booster dose… So many terms that are often mentioned when it comes to vaccination against Covid. But how to find your way there without getting lost? The 1st and the 2e dose were the starting point of the vaccination campaign, making it possible to complete its initial vaccination schedule. Then, for the most fragile and oldest people, a 3ethen a 4e dose of vaccine can be injected into them. On this subject, we also speak of 1st and 2e booster dose.
A 4e dose of vaccine against Covid-19, for whom?
“Only 26.5% of eligible 60-79 year olds and 33.7% of 80 and over” received their second booster dose, informed Public Health France July 7th. “The vaccination effort must be increased” in order to improve the vaccination coverage which remains “insufficient in certain territories such as the Antilles and Guyana and among the oldest”. The health agency also specifies that even though the latter had “the highest hospitalization rates”, only “a third of eligible 80 and over had received the second booster dose”. The government keeps the same speech: on July 5, the new Minister of Health Francois Braun insisting on the importance of getting vaccinated “when you are fragile”: “You have to do it now”, he said, at a time when “we have not reached the peak”. And to add: “50% of contamination occurs when the curve drops”.
The possibility of being administered a 4e dose of vaccine against Covid-19 dates back to early January, before being extended in mid-March. At this stage, this 2e recall is open to immunocompromised people, their relatives, and to those aged 60 and over since April 7th. However, it is necessary to respect a delay since its last injection before being able to claim to receive a new dose of vaccine: three months for immunocompromised people and those aged 80 and over; six months for people aged 60 to 79. In addition to older sections of the population, there are immunocompromised persons affected by the 4th dose, such as solid organ transplant recipients, recent bone marrowpatients on dialysis, patients with autoimmune diseases undergoing aggressive immunosuppressive treatment such as anti-CD20 or anti-metabolites, or patients with rare forms of primary immunodeficiency.
For the time being, the 4th dose of vaccine against Covid is not compulsory. But highly recommended for these populations. Jean-François Delfraissy, president of the Scientific Council, called on people over 60 and people with several risk factors to “get vaccinated with the 4e dose now without waiting for September/October”. “Because these vaccines exist, are effective against the BA.5 variant on severe forms”, he insisted. For epidemiologist Antoine Flahaut, there is no moreover “no reason to procrastinate to receive your vaccine if you are eligible for a booster” which specified to our colleagues from the HuffPost that there is “strong scientific data today showing that hospitalizations for severe forms of Covid-19 as well as mortality by Covid-19 are largely prevented by complete vaccination regimens (3 doses) associated with a second booster in the most vulnerable people”. Alain Fischer, the president of the council of orientation of the vaccine strategy, ensured that this recall represented “no danger”, trying to reassure the population on this vaccine “safe” and in his eyes necessary to “catch up with the level of protection obtained after the first reminder in terms of protection against infection but especially against serious forms” (comments made on France 2 at the end of June).
A 4e Will the dose of vaccine against Covid-19 be generalized?
This is the big question. The 4th dose allowing the increase in the rate of neutralizing antibodies, it allows a reinforcement of the immunity which can prove to be necessary for the elderly and more fragile for whom the protection guaranteed by the vaccine decreases after six months, against twelve months for the general population. While in its vaccination strategy, the government has gradually opened up access to vaccines by age group, will it be the same with the 4e dose (2e booster dose)? “We will probably come there” replied Brigitte Bourguignon on June 27, without however, at this stage, mentioning a precise timetable, criteria or even constraints on this subject. Remember that in January, the validity of the vaccination pass was conditional on the injection of a booster dose.
Another problem remains: territorial disparities in the vaccination process. At the dawn of the summer holidays, franceinfo noted, Friday, July 8, that obtaining an appointment was now a feat for a certain number of departments. In the short term, it is not uncommon to no longer have any vaccination slots available. If in large cities or in departments, such as Seine-Maritime, Pas-de-Calais, Var or Haute-Corse, it is not complicated to make an appointment, it is another pair sleeves in Drôme, Tarn, Landes or even Haute-Savoie and Côtes-d’Armor. In particular, the closure of vaccination centers and the departure on vacation of certain pharmacists and doctors, explains franceinfo.