► How do we choose vaccines?
The European Commission has volunteered to negotiate, on behalf of the 27, privileged access conditions to future vaccines with the pharmaceutical companies that develop them. As early as June, the European executive put forward criteria for the selection of vaccine candidates, explaining being ” willing to enter into negotiations with all producers who have started or have a firm intention to start clinical trials again in 2020 ».
Many parameters guided the Commission’s choices, from the rigor of the scientific approach and the technology used to the speed of large-scale supply, including of course cost, but also supply capacity and production within the Union. Result: since the summer, Brussels has signed advance purchase agreements with AstraZeneca, Sanofi-GSK, Johnson & Johnson, Pfizer-BioNTech and CureVac, to secure 1.8 billion doses. An agreement with Moderna is expected to follow and talks are underway with Novavax.
→ ANALYSIS. Covid-19: The challenges of vaccine production and distribution
As part of this common strategy, the states have undertaken not to engage in parallel talks to those of the EU, with the same companies approached by Brussels. However, they can negotiate with other vaccine manufacturers.
► How many doses will France have?
There is no question for the Commission to “make people jealous” in the distribution of doses, once they have been authorized by the European Medicines Agency. She therefore opted for a simple and politically acceptable formula, which Ursula von der Leyen summed up at the end of October: “ The Member States will all receive vaccines at the same time and under the same conditions, depending on the size of their population in relation to the total population of the Union. »
According to Eurostat figures, with its 67.098 million inhabitants on January 1, 2020, France accounts for 15% of the population of the Old Continent. It should therefore benefit from 15% of the vaccines negotiated by the EU.
If the vaccines in the five contracts negotiated by the Commission manage to meet the standards of quality, safety and efficacy required to be authorized (an extremely optimistic scenario), France will have 270 million doses (15% of the 1, 8 billion potentially available, including the doses actually pre-ordered, but also any additional doses). Or 270 million doses for France, which would represent 4.03 doses per person. For comparison, the Duke Global Health Innovation Center calculated that in the United States, 3 doses per capita might be available, compared to 5.3 per capita in Australia.
→ EXPLANATION. Covid-19: should the secrecy of vaccine contracts be lifted?
No question either for the Commission to walk on the beds of the States: it underlines that the policies of vaccination (for example, to choose who will have in a priority way access to these new vaccines) ” remain in the hands of the Member States ».
► When could vaccination start in France?
If the arrival of a vaccine becomes clearer, the question of the timing remains uncertain. With caution, as the United States announced possible injections as early as mid-December, Andrea Ammon, the director of the European epidemic agency, said on November 11 that the first vaccinations would take place in the region. European Union in the first quarter of 2021. Since then, countries are organizing themselves like Germany, which detailed its vaccination plan on November 19. In France, the Haute Autorité de santé (HAS) published interim recommendations on November 9 which were submitted for public consultation. Its final opinion on the implementation of the vaccination should be made public in early December.
However, in France, as in Germany, the date of the first vaccinations remains subject to the decision to place the candidate vaccines on the market of the European Medicines Agency. A green light is expected in December. The French will then need a little more patience to get bitten.
« After the European authorization, the French procedure comprises three stages, explains Professor Jean-François Bergmann, former vice-president of the marketing authorization commission at the National Medicines Safety Agency (ANSM). The vaccine must go through the technical committee on vaccinations, the transparency committee and finally, the economic committee for health products, which sets the price. “A circuit usually lasting several months which could, according to Jean-François Bergmann, be significantly accelerated.
→ PORTRAIT. Stéphane Bancel, a Frenchman in the race for the vaccine against the Covid
« During this time, we can organize the logistical means so that everything is ready at the end of the procedure., he adds. We can expect the start of vaccinations for February 2021. ” Not sure that our European neighbors are doing really better: “ Certainly thes Germans appear to be more logistically advanced and their process to market is faster than ours, but the timing difference should not be too great. »
► Who will be vaccinated first?
The vaccine strategy in France is not yet complete, but a targeted vaccination campaign seems to be, at first in any case, the most probable scenario. The oldest people, those at risk of developing serious forms of Covid-19 as well as caregivers must be given priority, according to the High Authority for Health.
This choice is justified by an ethical principle of solidarity with the most vulnerable people and those most exposed to the disease. But the uncertain timing of the delivery of the various vaccines also comes into consideration because the first available doses will not allow everyone to be vaccinated. “Stocks will not be built up overnight and will depend on production capacities and marketing authorizations”, confirms Jean-Paul Ortiz.
The High Authority for Health also specifies that it may have to change its opinion on priority audiences depending on the types of vaccines available. Because all will not have the same priorities: some could be less effective on the elderly for example. This is what the first results of the ongoing clinical trial on Pfizer-BioNTech vaccine seem to demonstrate.
Another unknown to date, the distribution of doses according to the territories. “It has happened before that a vaccination campaign has focused on a region. For example, the one that was carried out in Seine-Maritime after a meningitis epidemic in 2003, remembers Bruno Lina, virologist and member of the scientific council. Nothing would justify this for the Covid, because all regions are affected by the virus. “
AstraZeneca vaccine 70% effective
The British laboratory AstraZeneca and the University of Oxford announced that their vaccine against Covid-19 is 70% effective. A rate that could reach 90% in some cases, which would place it at the same level as those of Pfizer / BioNTech or Moderna.
AstraZeneca announces that 3 billion doses will be available in 2021. Pfizer and its partner BioNTech want to produce 1.3 billion doses by the end of 2021.
A total of 60,000 people around the world are participating in clinical trials large-scale phase III, last step before commercialization. These clinical trials are being conducted in the United States, Japan, Russia, South Africa, Kenya and Latin America.