Covid-19: will a vaccine booster soon be necessary in France?

Like Israel, Germany or the United Kingdom, France plans to administer a third dose of vaccine against Covid-19 to the most vulnerable populations from the fall. The government is rejecting for the moment a recall campaign for the entire population.

Never two without three ? If some people, pushed by the implementation of the health pass, have just passed the course of the first injection of vaccine against Covid-19, others have already been fully vaccinated for eight months. For the latter, a new question arises as to their immunity: will they soon have to make an appointment to receive a third dose of serum?

During a speech on July 12, Emmanuel Macron had mentioned “a recall campaign, from the start of the school year, for the first vaccinated in January-February”. However, he did not specify whether this would concern vulnerable people or the entire population.

Asked on RTL Monday 2 August, Alain Fischer, the president of the Council of orientation of the vaccine strategy, has, in turn, recommended the administration, “from the beginning of the autumn, of a third dose of vaccine, confined this time to the people fragile “and” the oldest “. A position that joins the opinion issued by the Scientific Council on July 6. This advisory body had indeed advised “to anticipate now a booster vaccination in people over 80 years living in nursing homes or at home, as well as in immunocompromised patients in the broad sense.”

“An immune boost” for vulnerable people

“In the case of some vaccines, it is necessary to have regular boosters because our immunity weakens over time. This is why, for example, we should be vaccinated against the flu every day. years “, recalls, with France 24, Daniel Floret, specialist in vaccinology and vice-president of the technical commission of the vaccinations at the High Authority of Health, questioned by France 24.

“But for the moment, we lack data to determine the duration of protection of vaccines against Covid-19”, he continues. “Today, what we are sure of is that a third injection would cause an immune boost. But is it useful immediately? There is nothing to guarantee it.”

“On the other hand, in the case of immunosuppressed people, for example, who suffer from cancer or transplant recipients, several studies have shown that the lifespan of their antibodies developed after vaccination was short”, continues Daniel Floret.

A German study, published at the end of July in the scientific journal “The Lancet”, thus highlighted that people who have undergone a kidney transplant, and fully vaccinated, had an antibody level more than two times lower than a control group, also vaccinated. Same observation in another study, carried out on 20 patients undergoing immunosuppressive therapy.

“For these very vulnerable people, this immune boost can therefore be justified”, believes Daniel Floret. “It is also in this kind of case that France has already recommended a third dose.” In France, some immunocompromised people have indeed already received two doses plus a booster.

In the case of the elderly, a study published in the journal “Clinical Infectious Disease” in April shows, in the same way, a drastic drop in immunity after a few weeks in a group of people over 80 years of age vaccinated, unlike a younger group. “A booster strategy by a third mRNA dose in this population therefore seems justified,” thus decides the Scientific Council.

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The example of Israel closely scrutinized

Based in particular on these studies, several countries have already announced the establishment of a recall campaign for vulnerable groups. In Hungary, a third dose can thus be administered since August 1. Germany has announced that it will offer it from September 1. Across the Channel, the United Kingdom will open access to a recall from September 6.

So far, only Israel, where 62% of the population is fully vaccinated, has already passed the milestone. Since August 1, all people over 60 vaccinated “before February” are invited to receive a third dose. “Vaccines protect against mortality just like the flu vaccine, which must be redone from time to time,” pleaded Prime Minister Naftali Bennett.

A third dose for the whole population?

On the other hand, it is out of the question for the health authorities to generalize this third dose to the entire population. “For the youngest, it is necessary to see what will be the data of the persistence of immunity. For the moment, those which we have today are quite good”, assured, Monday, Alain Fischer.

For its part, Pfizer / BioNtech pleads for a third dose. In a statement released Thursday, July 8, the laboratory explained that a booster dose administered six months after the second dose would elicit antibody levels “five to ten times higher” than those seen after just two injections.

“Even if the protection against severe cases of the disease remains high for six months, a decline in its effectiveness against symptomatic cases over time and the emergence of variants is expected,” explained the group.

And it is indeed the variants, in particular the Delta, considered to be more contagious, which could change the situation. “The emergence of variants adds a lot of complexity. But for now, a third dose for the entire population would remain a premature decision,” Judge Daniel Floret.

Another sign could also prompt the government to change its mind: a growing epidemic among vaccinated people. However, for the moment, according to DREES, the statistical service of social ministries, for the period from May 31 to July 11, unvaccinated people represented 85 % of hospitalized patients in France. In addition, 78% of deaths from the virus were among unvaccinated people and 11% of those people who received a single dose of the vaccine.

“It’s not the priority”

Other scientists argue, for their part, the need to continue to massively vaccinate the population to achieve collective immunity before considering the administration of an additional dose. “It is really not the priority”, judges the epidemiologist Catherine Hill, with France 24.

“For now, we still have a large part of the population that is not vaccinated while we are facing a significant wave of contamination, especially in the West Indies. The real priority is to improve vaccination coverage Population.”

A finding shared by the WHO, which fears that this will further reinforce inequality in access to vaccines, while the Covax program is slipping. “The priority must be to vaccinate those who have not received any dose and protection”, implored Didier Houssin, president of the emergency committee of the organization.

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