towards a fifth dose in the fall for people at risk of severe forms

In the fall, people at risk of developing serious forms of Covid-19 will, in all likelihood, have to lend their shoulder to a new injection. In a document made public on Wednesday May 25, the High Authority for Health (HAS) recommended this strategy to anticipate “the probable resurgence of a variant”.

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

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This recommendation is taken in a period of relative calm. The number of new infections, in fact, continues to decline, with 24,231 cases of SARS-CoV-2 contamination on May 24, a drop of 25% compared to 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 be vigilant, Wednesday morning, on RTL: “There is always this risk, and I ask the most fragile people to continue to have barrier gestures, to protect themselves, to get vaccinated. »

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

Three scenarios

“In the fall, we can have an epidemic that comes back again”, added the minister, even if, according to her, “the worst is behind us”. In fact, the HAS is considering three scenarios for the coming months, 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 maintained immunity against severe forms. “In this case, the booster campaign would only be offered to immunocompromised people, to boost their immunity”, explains Elisabeth Bouvet, president of the technical commission for vaccinations of the HAS.

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At the other extreme, the pessimistic scenario predicts the emergence of a new, more virulent variant, not covered by current vaccines. “We would then have to vaccinate the general population, with new adapted vaccines”, adds the infectious disease specialist. Even if it is not the most likely, the HAS notes that we should prepare for it.

But the scenario “most likely” is the one where “the impact of the circulation of the virus, which is still active, would be less thanks to long-lasting and sufficient immunity, making it possible to limit serious forms and deaths”. The variant in question, here, would be close to Omicron. The epidemic waves would then be less and less serious, with peaks of transmission “seasonal, during cold periods”, says Elisabeth Bouvet.

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