Science

The vaccination card, essential tool or policy? The Caumes-Fischer face-to-face

It is an understatement to say that this measure divides. In parliament, on the street and also among the experts who follow the Covid-19 epidemic as closely as possible. This week, no later than the next, the health pass should become “vaccinal”. The National Assembly has just voted on the text, and now there is only one step left, its validation by the Constitutional Council, which has taken over the opposition. If this body decides favourably, it will no longer be possible to benefit from a simple negative test to go to a restaurant, take a plane or visit a museum: it will be necessary to have been vaccinated, and in certain cases to have benefited from its reinforcement (7 months maximum after the second dose), or have recovered from Covid. Professor Alain Fischer, chairman of the Council for Vaccine Strategy Guidance, remains an ardent supporter of “going towards” to convince opponents of vaccination, but still sees it as a useful move. A great defender of vaccination, the infectologist Eric Caumes, sees above all in this reform “political food”. They detail their arguments for L’Express.

No / “It’s politics, not public health”

By Pr Eric Caumes, infectologist, head of service at the Hôtel-Dieu

I was in favor of the health pass, but I am against the vaccination pass for the general population. It’s humanly divisive, terminologically inappropriate, and unnecessary given Omicron’s uncontrollable circulation and lower gravity. The proof: Despite a vaccination coverage of almost 80%, there were more than 300,000 new cases per day, including those double or triple vaccinated. And the resuscitators did not explode. What was understandable with Delta is no longer understandable with Omicron. Vaccines certainly protect against severe forms, but little against infection. This pass is intended to force the recalcitrant to get vaccinated, except that a single injection is not enough, a second will be needed twenty-one days later: with this delay, the wave of Omicron will almost be over. In Paris, the peak has probably passed and will pass elsewhere in mid-February.

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And then ? Will the vaccine be even less effective with the next variant? Above all, it should be called an immune pass, a more appropriate term since it can be validated by people infected for less than six months. Why lean on the divisive term of the passage of vaccines that directs many people? Because what serves as a compass for the government is “fuck the unvaccinated”? But “bothering” people is not a public health policy, it is a political policy facing the presidential elections in three months and the legislative ones in four. This monopolizes the debate when there are other topics. Rather, we should focus on people who are not fully vaccinated and those who are frail and have not yet received their third dose.

In light of the Omicron wave, we should think about changing the paradigm instead of pitting people against each other. I’m afraid we are more interested in politics than public health.

YES / “It is essential to accelerate with the booster dose”

By Pr Alain Fischer, pediatrician and immunologist, chairs the Vaccine Strategy Guidance Council

Every time incentive measures have been announced or put in place, we have seen an acceleration of vaccination. The latest decisions – the deactivation of the sanitary pass if the withdrawal has not been carried out on time, and then its transformation into a vaccination pass – are also bearing fruit. Combined with the effort of health services, communities and associations to “go to” the most precarious, these announcements have made it possible to relaunch primary vaccinations: in mid-January around 50,000 to 60,000 per day were registered, which is far from being negligible. .

In addition, it is absolutely essential to streamline the administration of reminders. The pressure that will be exerted on people who may arrive late should push them to regularize their situation, because it can be imagined that they are not opposed to vaccination. Antibody levels decline over time, and with just two doses, these people are in the same situation as the unvaccinated against infection. It also decreases protection against severe forms. The curves prepared by Guillaume Rozier on his Covid Tracker site based on data from the Ministry of Health are eloquent: doubly vaccinated people aged 60-79 are five times more likely to be hospitalized after becoming infected than those who have benefited from the booster.

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However, 24% of those over 65 have not yet received this third dose, while more than 80% of them are already eligible for it. A strong incentive is all the more legitimate since the reminder acts in seven days. In the context of the Omicron wave, this is really the key factor to prevent these people at risk from having a hospital stay and, therefore, to limit the saturation of our health establishments in the coming weeks.

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