Covid-19: Towards a new autumn vaccine booster for the most vulnerable

PARIS: Given the “very likely” scenario of an imminent resumption of the circulation of Covid-19 in France, the health authorities are recommending a new vaccination for all those at risk, this time including those with comorbidities, in the autumn.

People over the age of 60 and those with a weakened immune system could already receive a second booster vaccination. From now on, other French people at risk for severe forms of the disease, such as diabetics, the overweight or even those with psychiatric disorders, would be eligible.

The aim is to “anticipate”, “limit the impact of a future wave, especially on the most vulnerable”, reduce mortality “related to Covid-19 and the spread of the epidemic, maintain the capacity of the health system and meet the vital operational needs of the Landes”, said the High Authority for Health in a press release on Wednesday.

Because even if the epidemic seems to be stabilizing in France, “it is very likely that the spread of the virus will periodically increase again,” emphasizes this health authority, which advises the government.

Of the three scenarios for the next few months described by the World Health Organization, from the most optimistic to the most pessimistic, it assesses the middle one as “the most likely”: a “lesser” impact of the epidemic “thanks to an immunity durable and sufficient to prevent serious forms and deaths limit”.

However, as the proportion of people with reduced immunity increases, “periodic transmission spikes could occur” that would require a “periodic” reminder for those most at risk, the HAS explains.

For autumn, the new anti-Covid vaccination campaign could be coupled with that against seasonal flu “for mobilization and logistical reasons”.

The HAS also recommends that “vaccination of healthcare professionals be reviewed, particularly in light of future data on vaccine efficacy against asymptomatic forms of the disease.”

The type of vaccine to be preferred for each population group may be determined later, once new anti-Covid vaccines, for example aimed at several variants at the same time, are authorized in France.

“Lots” of uncertainties

It is now up to the government to decide whether to follow the HAS recommendation, which it is not obliged to do.

If she feels that “the worst is behind us” for the Covid-19 epidemic, new Health Minister Brigitte Bourguignon invited on Wednesday to “vigilance” in the face of a possible return or “a small outbreak” in the autumn.

In this phase, the Borne government invites the “weakest people to continue to make barrier gestures, to protect themselves, to be vaccinated,” she added in her first interview in her new role at RTL.

Until then, the vaccination rate will stagnate with the second anti-Covid reminders reserved for the over 60s and the immunocompromised. For the past month, around 25,000 injections of this “fourth dose” (more often in some immunocompromised) have been given every day.

Around 20% of those over 80 received this new “boost”. Among the 60 to 79 year olds it is even less, around 7%.

“Things are better, there is a downward trend, so gestures are fading and people may think less about using the vaccine,” the minister noted. “We need to bring this issue back to the table.”

And, stresses the High Health Authority, it is necessary “to continue efforts today to vaccinate those at risk who are not vaccinated or who have not yet had their first booster shot”.

This applies in particular to a portion of the French aged 80 and over: almost a quarter had no first memory.

A possible fourth dose of vaccine for the entire population is not currently on the agenda.

However, as there are “many” uncertainties about the turn the epidemic will take, particularly under the influence of more severe or transmissible variants, the HAS believes it is “necessary to be ready to anticipate the pessimistic scenario” that will require a fourth dose would… for all adults.

Sublineages (BA.4 and BA.5) of the Omicron variant are currently being monitored as they are suspected of being more transmissible but do not appear to be more serious at the moment.

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