About fifteen nursing homes will first receive the vaccine against Covid-19. While waiting to receive the doses, the teams are organizing themselves to obtain the residents’ consent and schedule pre-vaccination consultations with general practitioners.
In the “Les Rives d’or” retirement home in La Couture-Boussey, in the south of the Eure, the common room has been transformed into a pine forest. A desire to fill the void with nature and maintain a festive spirit in this period which does not lend itself completely to it. Because since the first confinement, this space is hardly used any more. The 82 residents take their meals on the upper floors, and only come down to enjoy the magnificent park that surrounds the building. “Of course, this year has turned everything upside down, agrees the director, Chantal Trocherie, who sees dozens of boxes of chocolate piling up on her desk, recognition of the families to a team mobilized at 100%. We are used to doing a lot of events, we had to cancel some, life is not quite the same, we think of Covid permanently. »
“A tedious set-up”
The vaccination campaign is therefore welcome in the establishment, which has not experienced a single case since the start of the epidemic. Even if, tempers Chantal Trocherie, « it will not be the return to normal life immediately, we are telling our residents that. But there are things that we will be able to reconsider, such as bringing them down, in small groups, to restaurants. “
The residence “Les Rives d’or” hopes to be ready to receive the vaccine doses the week of January 15th. This gives the team two weeks to organize everything. “Vaccination itself is not stressful. We are used to the flu shot. But it is the setting up that is long and tedious. ” The nursing home first set up a steering committee, then began to collect consents, either from residents, or from tutors or trusted persons, for seniors with cognitive disorders. « Then, we will have to organize the pre-vaccination consultations, and when we know the overload of general practitioners, we say to ourselves that it will be difficult to plan everything in such a short time … »
It is only at the end of this preparatory phase that the regional health agency (ARS) will be able to send the doses of vaccine, to be administered less than five days after leaving the super-freezer which keeps them at -80. ° C. « There, the vaccination can be done by our nurses. »
So far, the team has done half the census. And the feedback is rather positive, enthuses Chantal Trocherie. Madeleine, 91, is one of those who gave their consent right away. “You have to be vaccinated to avoid contagion, to have the hope of living normally. ” The retiree is not afraid of side effects, but still awaits the consultation with the doctor to see if there is any contraindication, “Because I was bitten by a hornet a few years ago and I developed a big allergy”. René, 78, one of the youngest boarders, is also starting. “Even if I would have preferred a 100% French vaccine, but hey, I won’t wait a year, now is the time to do it! “
This is exactly what Dr Patrick Gence thinks. He has just retired from his practice, but remains the coordinating doctor of the “La Villa Saint-Michel” nursing home in Charleval, in the north of Eure. « For weeks now, each consultation systematically ended with the same question: “And you doctor, what do you think of the vaccination against Covid-19?”. It is now that we are talking about it, the campaign must be able to start quickly so that it can spread quickly. We must not hang around too much, otherwise we will fail! »
So at “La Villa Saint-Michel”, the team wasted no time. The nursing home is fortunate to have a coordinating doctor only attached to this establishment, and the small number of residents – 37 – greatly facilitated the procedures. “We quickly obtained the consent, but it took longer for residents placed under the supervision of associations. “ As a result, “La Villa Saint-Michel” is one of the three pilot sites in the Eure department for the launch of the vaccination campaign. « As soon as the ARS gives us the green light, we will communicate the number of doses to them and we will be delivered, via the pharmacy, explains Doctor Patrick Gence. If all goes well, it should be done from January 5th or 6th. Due to the small number of residents, everyone will be vaccinated on the same day. »
“Take the time to explain”
Of the 37 residents, 22 gave their consent. Like Chantal Trocherie, the director of Villa Saint-Michel, Noura Minot, is pleasantly surprised by the enthusiasm. Returns like these, Jean-Marc Venard, regional delegate of Synerpa – national union of private retirement homes which represents around a hundred establishments in Normandy – has received many in recent days. “I had several colleagues on the phone and so far, everything is going very well. Many nursing homes have organized meetings between residents and coordinating doctors or even epidemiologists from the ARS, to dispel doubts. The directors of nursing home sent out newsletters to inform the families… It was all very well understood. When you take the time to explain and put things in scientific perspective, it’s pretty well accepted. “
The vaccination schedule
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The vaccination campaign began on Sunday, December 27 in France. In Normandy, it is this week that the first doses will be administered to residents of nursing homes. For the launch of this phase, around fifteen residences or long-term care units (USLD) with public or private status (three per department) were selected. This pilot phase should run until January 17 before extending to all nursing homes and USLDs in the region from January 18. Facilities will be supplied with vaccines throughout this first stage, which will last six to eight weeks, with the vaccine requiring the administration of a second dose twenty-one days after the first injection.
As a reminder, the national vaccination campaign takes place in three main stages. The first was to concern only elderly people residing in establishments, as well as professionals working there and at high risk of developing a serious form of Covid-19 (over 65 years of age and / or pathologies).
Faced with criticism of the slowness of the implementation, the government has decided to speed up the vaccination schedule, and to allow caregivers aged 50 and over to also benefit from the vaccine as of Monday, January 4. Then, from February, vaccination centers will open in town to first welcome seniors over 75, then people aged 65 to 74. Finally, the opening of the vaccination campaign to the entire population, with priority given to people over 50, security and education personnel and vulnerable people, is maintained in the spring.
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Doctor Jean-Philippe Leroy, doctor at Rouen University Hospital, is an expert in vaccines, having already taken care of the vaccination campaign against meningitis in Dieppe, or against the H1N1 flu. He is intervening today to fight against Covid-19.
How is the vaccination campaign organized in Normandy?
Dr Jean-Philippe Leroy: “Between two and three nursing homes per department are expected for the start of the campaign which should take place from January 5, 6 or 7. It’s quite complicated … Before starting, you have to plan the pre-vaccination consultation, which makes it possible to check that the patient does not present any contraindication (major allergies, pregnancy, etc.) and obtain consent. I want to clarify that this is not an informed consent as we have heard in the media: informed consent is a term that is used when it comes to registering of patients in a clinical trial. There, it is a question of a consent for access to traditional care, which is obtained orally before each medical act or vaccination. “
You say starting up is complicated… Why?
“The situation from one establishment to another is very different. Throughout Normandy, there are nearly 400 nursing homes. Some no longer have a coordinating doctor, others no longer have a coordinating nurse, some residents have not had an attending physician for years … For more than a week, a communication system has therefore been set up. place so that each establishment can identify its needs to set up vaccination, and report on the consents that have been obtained. Everywhere, general practitioners and their representatives are mobilized to fill the gaps. “
Is it also because residents are reluctant to get vaccinated?
“What is it that makes Germany at 42,000 vaccinations and France at 112?” It’s obviously not just a question of logistics [chiffres donnés le 30 décembre, NDLR]. We absolutely have to get the message across! We can’t wait. I remind you that 44% of patients who died from Covid-19 come from nursing homes. When you are very old and live in a community, there is a real risk of catching Covid-19 and dying from it. People have lost sight of the reality a bit: 300 deaths a day, that’s the tragic reality. When you have a vaccine that is 95% effective, it’s a gift, you have to take it! When you take the time to explain it, families understand it. “
All the same, there is a mistrust: the French find that the research has gone too quickly, that there is a risk of side effects… What do you answer them?
“Why was it so fast?” Because we quickly got the genetic sequence of the virus. It’s not fishy, it’s just luck, that of malaria has only been known for four or five years when the disease has been around for a long time. The messenger RNA vaccine like the one from Pfizer / BioNTech was quick, because instead of putting viruses in culture to extract an attenuated or inactivated protein or virus and then inoculating it to activate our immune defenses, the idea is to let our cells manufacture themselves the molecule against which our organism will learn to defend itself. It is therefore shorter! Regarding side effects, we know that all vaccines that are very effective have side effects, such as pain in the muscles, headaches, even diarrhea. Now you have to know what we are talking about: the trial found that 51% of people who received the vaccine complained of fatigue. Among the people who received the placebo (salt water), they were 23%… ”
2,000 doses arrived
In Normandy, how will the vaccine be delivered?
“In each department there is a super-freezer, which allows the vaccine to be stored at -80 ° C. Each super-freezer is associated with a list of establishments that will receive the vaccine in thawed doses, to be stored in the fridge between 2 and 8 ° C and to be administered within a maximum of five days. So far, 2,000 doses have arrived. But this is not the only means of supply. Establishments that are not attached will be directly supplied by specialist deliverers from national centers, according to their requests. So the more requests there are, the more vaccinations there will be! “
Interview by CB
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“A vaccine that is 95% effective is a gift, you have to take it”
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