Vaccination, who’s next? In a notice she published on March 2, the High Authority for Health (HAS) extends the list of people to be vaccinated as a priority against covid-19.

The authority therefore recommends vaccinating, with the same priority as those over 75 and over 65 suffering from high-risk pathologies, three new categories of people: those with Down’s syndrome, those who have had a transplant. organ and kidney patients on dialysis. And this whatever their age. Until now, these pathologies were considered a priority criterion, but only in the elderly.

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Dementia, psychiatric disorders, stroke …

But that’s not all. The HAS is also adding new pathologies to the list of those which give rise to priority vaccination according to age groups. These are psychiatric disorders, dementia, chronic liver disease – especially cirrhosis -, and a history of stroke.

They join in this list obesity, cancers, obstructive pulmonary disease (COPD), respiratory failure, heart failure and “complicated high blood pressure“.

“People deemed vulnerable by their doctor”

Finally, in addition to the pathologies formally listed and regardless of age, the HAS recommends giving priority for vaccination to “people deemed particularly vulnerable by their doctor and with rare and serious pre-existing conditions or severe disabilities that predispose them to a particularly increased risk of dying“of the covid.

She cites severe immune deficiencies, hematologic malignancies and rare diseases as examples.

Beware of the accumulation of pathologies

A “special attentione “should also be brought to people with several of these pathologies,”who are among the people to be vaccinated as a priority“.

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In fact, studies show that the combination of three comorbidities leads to almost the same level of risk of dying.“only if you are in the upper age group but without pathology.

Age, the first risk factor

Even if certain comorbidities represent a risk of serious forms and death, age remains “the predominant factor in the occurrence of severe forms and death“, recalls the HAS in its opinion.

To quantify this risk, the HAS relied on two French studies: the study Epi-Phare conducted by the Health Insurance and the ANSM drug agency, and a study carried out by the Bordeaux medical information department. They both confirm that the risk increases with age.

Thus, 50-64 year olds have “three times more likely to die“of covid than 18-49 years. This risk rises to seven times more for 65-74 years, 10 times more for 75-80 years and 16 times more beyond 80 years.
It remains to be seen whether the speed of supply of anti-covid vaccines will be sufficient to rapidly vaccinate all these priority people. “As of February 9, 2021, only 20% of people aged 80 and over and 17% of those aged 75-79 received their first injection“indeed deplores the HAS in its report.