If Denmark is seeking to sell its doses of AstraZeneca vaccine, Africa is preparing to recover a good package, thanks in particular to France. By mid-June, our country should deliver 500,000 doses, as part of the Covax aid program. Some see it as a way to get rid of an impossible to sell stock, because of the strong mistrust of the French vis-à-vis the Anglo-Swedish vaccine. The most cynical evoke a poisoned gift: why send such a vaccine to treat relatively young populations when in our country, its injection is not recommended for those under 55?
The sending of AstraZeneca doses to the south of the Mediterranean nevertheless makes sense, recall two former military doctors. “We will not be able to get out of the pandemic if we content ourselves with vaccinating the populations of rich countries,” explains Jean-Marie Milleliri, epidemiologist and specialist in health systems for the WHO. For now, on the African continent, injections are lagging behind. With the exception of Morocco where 13% of the population received a first dose, vaccination rates, country by country, remain between 0 and 4%. Many African states depend on deliveries of AstraZeneca vaccines produced in India, but due to a meteoric resumption of the epidemic, New Delhi shut down the export tap at the beginning of April, so any other source of supply is useful.
Chinese vaccines too ineffective
“Sending doses from France is a good initiative,” says Jean-Louis Koeck, professor of the chair of applied medical biology at the Val de Grâce school and founder of the MesVaccins.net platform. Developing countries have less access to vaccination. But above all, they mainly have Chinese vaccines available, the efficacy of which leaves much to be desired “. Even Gao Fu, the director of the Chinese Center for Disease Control and Prevention, admitted recently: the protection induced by these anti-Covid weapons is “low”. Studies carried out in Brazil and Chile suggest an efficiency close to 50%. “In these circumstances, it is better to have the AstraZeneca vaccine available”, assures Jean-Louis Koeck.
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Seen from Paris of course, the decision to use AstraZeneca in Africa may seem questionable. “But in France, we have four vaccines available. The context is therefore very different. Denmark, for its part, may well do without AstraZeneca: it has access to other effective products and has far fewer cases of Covid. -19 than us. In each country, the decisions depend on the vaccines available, the epidemic level, the structure of the population … The situations are unequal “, summarizes Jean-Louis Koeck. In addition, African countries have set up, with the assistance of the WHO, technical committees for immunization, the purpose of which is to advise governments. “It is therefore not for us, the French, to give our opinion on how to proceed. Each country is sovereign over the use of the doses it receives” confirms Jean-Marie Milleliri. Côte d’Ivoire, for example, has extended the use of the AstraZeneca vaccine to the entire population.
The fear of variants
However, access to doses, as important as it is, does not guarantee the success of a campaign. The technical vaccination committees will have to remain vigilant in the coming months, in particular to monitor the evolution of the variants. “This remains the main element of uncertainty”, recognizes Jean-Louis Koeck. What strains are circulating? What is their incidence rate? How are they progressing? It is difficult to answer these questions given the limited resources of African countries in molecular epidemiology. “For the time being, the circulation of variants towards the north of the continent seems weak. But we do not have a lot of data”, confirms Jean-Marie Milleliri. According to some specialists, the number of Covid-19 cases officially listed on the African continent would be far below reality. So much so that the numbers would have to be multiplied by ten or fifteen!
On the spot, the authorities will also have to face the mistrust of the populations. As in Europe, some citizens do not want to be vaccinated. This can be explained by the fact that there are few cases of Covid listed: why, indeed, get vaccinated if you do not feel the danger? But news from Europe also plays its part. “In Côte d’Ivoire, for example, the doubts born in Europe and North America on the safety of the AstraZeneca vaccine following thromboembolic accidents will only add to the mistrust of populations who are well informed of the international news “, urges Jean-Marie Milleliri. It should not be forgotten: on social networks, information circulates even faster than the virus.
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