While the resurgence of Covid-19 cases is being felt in France, due to the circulation of the BA.4 and BA.5 sub-variants, a report by the Parliamentary Office for Scientific and Technological Choices highlights the need for the State to communicate transparently about the possible side effects caused by the vaccine. Senator and co-rapporteur Sonia de la Prôvoté sees regional pharmacovigilance structures as the best way to combine political considerations and scientific truth.
The Express: The Opecst report indicates that the pharmacovigilance system worked well during the Covid-19 crisis. What was his exact role?
Sonia de la Provôté: Pharmacovigilance is based on a network specific to France. Regional centers are responsible for collecting, recording and evaluating data transmitted to it by health professionals or directly by the citizens concerned. In the case of Covid-19, they have, for example, collected testimonies from people mentioning possible side effects linked to vaccination. These centers identify emerging, frequent or serious signals, and send their reports to the National Agency for the Safety of Medicines and Health Products.
This system, recognized at the international level, works well because it plays both the role of support and the word of truth. Pharmacovigilance is a device capable of reconciling citizens with science, making it more accessible and reassuring. Faced with the unknown that is the appearance of a virus, it is necessary to propose structures of trust. Especially since pharmacovigilance centers have autonomy from political power. Our report encourages the State to put more financial resources into it.
You write that “scientific truth must triumph”. In the case of Covid-19, was the political dimension not too significant?
We are, in fact, talking about the elements of pure politics which have had certain consequences in the field of health. It must be understood that health policy is based on a mixture of two considerations. For example, the fact that for years Governments successive closed beds in the hospital conditioned the choice to resort to confinement fairly quickly. The brutality of the epidemic in its early stages undermined hospital capacities as a whole, and from the moment when Covid-19 patients became “priority”, other care had to be deprogrammed. Health policy inevitably generates tensions among those who feel victimized by measures that are nevertheless presented as protective.
Politics includes a large human dimension, and the field of Health must grasp the collective, the individual, and the consequences of collective choices on individuals. Around the Covid, other health topics have emerged, some even born of the policy put in place. We are in charge of taking stock, not of criticizing the choices, but it is certain that when a new virus arrives, the State will have to better understand the general consequences of its decisions.
The government has insisted on seeking herd immunity when it has proven impossible to achieve. Has this choice of communication served the cause of vaccination?
The progress in the knowledge of this virus has been long, it is still in progress. It is necessary to be interested in the various stages of knowledge, and the measurements which were associated with it. At the beginning, we observed a contagious virus on a population without immune defense capacity. Serious side effects were therefore very numerous, resulting in hospitalizations and deaths. Then came the vaccines, and with them an argument: if the population is vaccinated, we will achieve herd immunity. This hope turned out to be chimerical, the scientists understanding that the vaccine certainly protected the population very well but did not prevent the transmission of the virus, because of its multiple mutations. Being increasingly contagious, it undermined the goal of herd immunity. What prevents the virus from circulating are barrier gestures and confinement, not vaccination.
However, the communication on collective immunity continued, while the real objective was to limit the serious forms. In addition, the immunity conferred on vaccinated persons is short-term. The political power should have explained more that the goal was to protect as much as possible while living with the virus rather than to make people believe that it could be eradicated by getting vaccinated.
Likewise, do you think that communication on the adverse effects linked to the vaccine should have been better considered?
When there have been cases of thrombosis or even myocarditis, the State has communicated. We cannot blame him for opacity on these rare but very serious cases of bad reactions to the vaccine. On the other hand, there was no active communication on how to declare the side effects experienced. We come back to the importance of pharmacovigilance. In fact, people can transmit their testimony to health professionals or directly on the portal of the National Agency for the Safety of Medicines and Health Products. But it’s not instinctive, so the government should have explained how to do it. I do not remember having seen an advertising campaign to that effect. Transparency requires balanced communication between vaccine policy objectives and vaccine side effects, otherwise the state may lose the trust of its citizens. Vaccine hesitancy can arise from a lack of honest communication, even if it is not voluntary.
There have also been blunders, like this TV spot saying something like if you’re feeling achy, you’ve done too much sport, when in reality everyone knows the vaccine can cause side effects. such as high fever or pain at the puncture site. Citizens may feel cheated, and the benefits of vaccination are obscured.