08/01/2021

The Vaccine: Who’s Doing it Right?

Author

Fellow - Healthcare

In December, Institut Montaigne published a policy paper in French, in which the authors outlined the different options for France’s Covid-19 vaccination strategy, as well as the actors that needed to be mobilized in order for it to be successful. However, France is now trailing behind other countries in vaccination efforts: on January 7, only 45,500 people had been vaccinated in France, whereas Germany had already inoculated 500,000 people and Italy, 680,000. What practical examples could provide France with some much-needed inspiration?

The vaccination campaign in France: strategy and results so far

The French vaccination campaign started on December 28, 2020. It has been divided into three phases, due to run until late 2021. The target for January and February 2021 is to inoculate 1 million people, starting with all those living in retirement homes and the health professionals who care for them. The campaign is then supposed to shift to those over 75 years old and then to those over 65, to health professionals over 50 and to those who have prior health conditions, which make up another 14 million people. It is only in the spring that the rest of the population will become eligible for vaccination.

Vaccination has not been made compulsory in France and is only possible after a prior medical examination consented to by the patient, in which a clinical evaluation is conducted, and the patient informed of the advantages and risks of the vaccine. France is one of the only countries to have implemented medical examinations prior to vaccination, which in part explains the delays, according to doctors.

President Emmanuel Macron has made his impatience quite clear, stating that the strategy was not "up to the task". In response, Health Minister Olivier Véran announced on January 5 that the vaccination calendar would pick up speed and "match that of our neighbors in the next few days", provided that this target is still within reach. He also announced that access to the vaccine would be extended to doctors, firefighters, and home care staff over 50, and by the end of January, to people aged 75 or more who live outside retirement homes. All French citizens wanting to receive the shot will also soon be able to "register" for vaccination online, over the phone or through the national Covid-19 response application TousAntiCovid.

France is one of the only countries to have implemented medical examinations prior to vaccination, which in part explains the delays, according to doctors.

The United States: speedy mobilization of the armed forces along the entire supply chain

The American Department of Defense (DoD) is playing a key logistical role in the national vaccination campaign. It is responsible for buying and distributing the medical supplies that the DoD itself or federal agencies need.

The website of the federal government agency in charge of the coordination and supervision of all the government bodies linked to national security and the armed forces in the US, states that it had executed over 21,000 contracts pertaining to the purchase of over 2 billion dollars in medical equipment (testing kits, ventilators, drugs, masks, PPE, etc.). The DoD has promised to set up operation centers similar to the ones deployed during hurricanes, in order to supervise this massive supply chain.

The US has also launched Operation Warp Speed (OWS), which runs in parallel to these other efforts. The OWS’ objective is to supply American patients with 300 million doses of the vaccine by the end of January 2021. On the one hand, this should be done by spurring the vaccine research, production and distribution efforts and on the other, by accelerating therapeutic and diagnostics solutions for Covid-19. The OWS is a partnership between the various components of the Health and Human Services (HHS) Department, in particular the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority (BARDA), and the DoD.

The OWS works together with private companies and other federal agencies, most notably the Department of Agriculture, the Department of Energy, and the Department of Veteran Affairs. It coordinates all the actions taken by the HHS, including the NIH’s ACTIV (Accelerating Covid-19 Therapeutic Interventions and Vaccines) partnership or RADx (Rapid Acceleration of Diagnostics) initiative, as well as the BARDA’s work. Its action is focused on vaccine development (accelerating research and development phases), vaccine production (the federal government itself has invested in building the required production capacity) and vaccine distribution, for which it works closely with the Department of Defense.

The UK: widely mobilized medical staff ensuring the continuity of treatments

The British healthcare system, the National Health Services (NHS), has launched a large campaign titled "Your NHS needs you", to push health professionals to volunteer to participate in the vaccination program.

The NHS explains that it is currently recruiting thousands of new staff members in order to implement a large-scale vaccination program without this affecting other vital services. Priority in this recruitment is given to potential "vaccinators".

The Department of Health and Social Care recently changed the law in order to allow more people to receive a vaccination training. This applies to a large number of health professionals, scientists and dentists, as well as to people trained in first aid, like firefighters or volunteers for civil defense organizations. These flexible and paid assignments are thus open to a large number of professionals

The US has also launched Operation Warp Speed (OWS), which runs in parallel to these other efforts. Its objective is to supply American patients with 300 million doses of the vaccine by the end of January 2021.

The NHS also wishes to mobilize and train thousands of volunteers that could help guarantee the safety and orderly functioning of the reception and administrative services of the vaccination centers.

Germany: mass vaccination centers to reach the whole population

In Germany, the strict division of roles between the federal government and local authorities beckons a separation of vaccination tasks between the state and the Länder. This division of labor, unveiled in October, attributes to the federal government the responsibility of vaccine distribution to around sixty storage locations, distributed evenly around the country and for which hospitals and fire stations may be used.

The use of the vaccine supplies then falls on the Länder, which are in charge of the operational organization of the vaccination campaign, including the creation of staffed vaccination centers that are able to store vaccines at a low temperature. This division of labor makes it possible to manage the number of centers that need to be deployed locally, depending on the number of people that are first up for vaccination in each region.

In Germany, the strict division of roles between the federal government and local authorities beckons a separation of vaccination tasks between the state and the Länder.

Today, there are more than 400 vaccination centers stocked up with 136 million doses. In the Berlin region, a former terminal of the Tegel airport closed in November, was converted into a large vaccination center a month later. The target is to vaccinate 3000 to 4000 people per day in that center.

Italy: targeted communication to boost faith in the vaccine

Italy is also ahead of France in terms of the number of people who have received the shots. In mid-December, the government launched a wide-ranging communication campaign revolving around a video clip portraying a post-Covid Italian "rebirth". The campaign’s logo is a "primavera", or a primrose, which is also the world for spring in italian.

This video, which was ordered by the Ministry of Economy and Finances in order to launch the campaign, portrays the vaccine as the one tool that could enable a return to a "normality" and "real" life (we can see someone taking off their mask at the end of the clip). The video shows the new vaccination centers, designed by a famous Milanese architect to look like primroses.

The Italian communication around the vaccination campaign is an interesting example for France. It presents the campaign as a collective effort that requires everyone to be mobilized and suggests that getting inoculated is a civic act. It also seeks to instill hope and to remind us of what the world was like before, thereby suggesting to those most concerned with the vaccine’s potential risks that getting a shot is the only way to start anew and resume a normal life.

Copyright : Markus Schreiber / POOL / AFP