Home vaccination for the elderly, a 'big concern' for geriatricians

According to August 10 data provided by Public Health France, vaccination coverage has continued to increase very slightly among those aged 80 and over.

Geriatrician Olivier Guerin, in an interview with geriatrician Olivier Guerin, geriatrician Olivier Guerin, insists on a bad pupil of vaccination for more than 80 years living at home, France should choose a more “regional” approach against Covid-19 and “go to The door of the most vulnerable people.

“It is a subject of great concern” for this professor at CHU de Nice, president of the French Society of Geriatrics and Gerontology (SFGG), who is also a member of the scientific council for Covid-19. We have known him since April. The curve began to stagnate in those most at risk because age was still the main risk factor, all variables combined. “

According to August 10 data provided by Public Health France, vaccination coverage continued to increase very slightly among those aged 80 and over: 83.3% for a single dose and 79.1% for a full vaccination. Vaccination coverage was 91% (single dose) and 87% (full vaccination) for residents of nursing homes or long-term care units (USLDs).

This population is among the most vulnerable groups, and who are primarily interested in the vaccine booster dose (the third dose) announced by the government as of mid-September, facing “a difference with other European countries: the English, Spanish and Portuguese account for more than 95% of that number.” Target Al-Omari,” Professor Guerin notes. “We are lower quality when we encounter a delta variant that is more contagious and dangerous.”

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For this specialist, “the explanation is complicated: there is a relatively small percentage of people who do not want to be vaccinated but the vast majority of them have difficulty getting vaccinated, and it is very close to the at-risk population.”

“We see here a limit to our primary care system based on a liberal model,” notes Olivier Geranne, who notes that “the countries that have succeeded in having an effective strategy are those in which the primary care structure is regional: the GP is in charge of a plot (a block of land). From homes, a rural area…) with everyone in it. It is not the French system where the patient chooses his doctor and the doctor chooses his patient, which excludes all who are furthest from care because of fragility and all kinds of vulnerabilities.”

Heat Wave Records

However, “you have to go to the door and vaccinate them at home, which requires getting to know them and having the right organization. This is a fundamental problem if we are to avoid hospital saturation, and for the people involved, we have dangerous forms” of Covid-19. Olivier Guerin asserts that SFGG holds the same discourse about the seasonal influenza vaccine.

The solution should be “mixed” and highly dependent on the local authorities. Example: “CCAS (Community Centers for Social Action) has records, particularly heatwave records, that identify our most vulnerable and most dangerous elders.” This practitioner considers it essential that health insurance be authorized by the CNIL (National Commission on Informatics and Liberties), in an opinion issued on July 7, to pass on the names of their patients who are not immunized against Covid-19 to the treating physicians.

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He also notes that My Health 2022 established the Regional Occupational Health Communities (CPTS) and carried “the idea of ​​bringing together actors with a real public health project in a given area.” This localization was the beginning of a profound and very cultural reform of the primary health care system. But ‘we were chosen by Covid’.

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