to a fifth dose in the fall for people at serious risk of seriousness

In the fall, people who are at risk of developing severe forms of Covid-19 will most likely have to lend a shoulder for a new injection. In a document released on Wednesday, May 25, the Haute Autorité de santé (HAS) in fact recommended this strategy for anticipation “The likely resurgence of a variant”.

Among the audiences concerned is immunocompromised people and their entourage as well as people aged 65 and over or with comorbidities (cardiovascular disease, hypertension, obesity, chronic respiratory disease, chronic kidney failure, chronic liver disease, cancer or malignant haematological disease, psychiatric disorders…). That is, according to HAS estimates, more than 25 million people in France. A new injection, for these populations, would most often be a third booster – a fifth dose.

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This recommendation is a reward in a period of relative calm. The number of new infections, in effect, continues to decline, with 24,231 cases of SARS-CoV-2 infection on May 24, a 25% drop from the previous week. However, the circulation of the virus remains at a high level, and the Minister of Health, Brigitte Bourguignon, urged the most vulnerable to watch, on Wednesday morning, on RTL: “There is always this risk, and I urge the most vulnerable to continue to have barriers, to protect themselves, to be vaccinated.” »

In a vaccination center in Sarrola-Carcopino (Corsica), on January 8, 2022.

Three scenarios

“In the fall, we may have a recurring epidemic,” added the minister, although she said “The hardest part is behind us.” In fact, HAS predicts three scenarios for the coming days, based on the assumptions described by the World Health Organization (WHO). The first, optimistic, is that of a return to normal, with future less severe variants and a maintained immunity against severe forms. “In this case, the recall campaign would have proposed only for people immunity, to relax immunity”, explains Elisabeth Bouvet, chair of the HAS vaccination technical committee.

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At the other extreme, the pessimistic scenario envisages the emergence of a new, more virulent variant, not covered by current vaccines. “The general population will have to be vaccinated with new adapted vaccines”, adds the infectiologist. Although not the most likely, HAS notes that preparations should be made.

But the script “Most likely” is the one where “The impact on the circulation of the virus, which is always active, would be more due to a lasting and sufficient immunity, which would allow the limitation of serious forms and decays.” The variant in question here would be close to Omicron. The epidemic waves would then be less and less severe, with peaks in transmission “Seasonal, during cold periods”, precisely Elisabeth Bouvet.

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