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Une bonne couverture vaccinale grippe pour l’hiver 2021-2022 est indispensable !

 
 

Des signaux précoces en faveur d’une recirculation des virus respiratoires saisonniers cet hiver

Durant l’hiver 2020-2021, la circulation des virus respiratoires épidémiques a été limitée du fait de la circulation intense du SARS-CoV-2 et des mesures barrières mises en place. L’absence de contact de la population avec ces virus pendant toute une saison est à l’origine d’un phénomène de « dette immunitaire » fragilisant de nombreuses personnes, de jeunes enfants en particulier, peu ou non immunisés. Dans ce contexte, une certaine incertitude sur le niveau de circulation des virus respiratoires pour la saison 2021-2022 existe.
Or, depuis plusieurs semaines, alors que la pandémie de Covid-19 décroit, les virus respiratoires saisonniers font leur réapparition. La situation actuelle, favorable sur le front du Covid-19 pourrait permettre la circulation des autres virus, du fait de l’absence de compétition virale, du relâchement du respect des gestes barrières, et de la reprise des échanges internationaux.
Santé publique France et les systèmes de surveillance rapportent déjà une circulation précoce du virus respiratoire syncytial (VRS), et un rythme de détection des virus grippaux équivalent de celui observé au cours des hivers précédant la pandémie de SARS-CoV-2 (2018-19 et 2019-20).

La grippe saisonnière : un risque important pour les personnes vulnérables et une charge pour le système de soins

Après 18 mois de pandémie Covid-19, il est important de rappeler que la grippe saisonnière affecte chaque année entre 2 et 6 millions de personnes en France, entraînant l’hospitalisation et le décès de plusieurs milliers de personnes, essentiellement dans le groupe d’âge des personnes de 65 ans et plus.L’absence exceptionnelle de circulation des virus grippaux à l’hiver 2020-2021 a pu s’accompagner d’une baisse de l’immunité collective contre la grippe, tous âges confondus, ce qui pourrait accroitre le risque épidémique par rapport aux années précédentes.

Utiliser au mieux tous les outils de prévention disponibles

Les mesures barrières, comme le lavage régulier des mains, le port du masque chirurgical et l’aération des pièces, doivent être maintenues pour réduire le risque de transmission.
Par ailleurs, la vaccination grippe permet de réduire le risque de formes sévères de la maladie, de décompensation de maladies chroniques (pulmonaires, cardiaques, diabète…), mais aussi de complications cardiovasculaires (infarctus du myocarde, accidents vasculaires cérébraux), notamment chez les patients porteurs de maladies chroniques. La campagne de vaccination qui commence est ambitieuse ; elle vise à augmenter la couverture vaccinale des plus fragiles afin de réduire le poids de la grippe.
Cette année, en plus des vaccins tétravalents « classiques » utilisés depuis plusieurs années, un nouveau vaccin, 4 fois plus dosé, est disponible et réservé aux personnes de 65 ans et plus. Comme les autres vaccins contre la grippe saisonnière, ce vaccin haute dose est un vaccin inactivé, injectable, contenant quatre souches de virus grippal : deux de type A (H1N1pdm et H3N2) et deux de type B (lignées Yamagata et Victoria). Ce vaccin, comportant une dose plus importante en antigènes, a fait la preuve, auprès des personnes âgées, qu’il est plus performant en termes d’efficacité, tout en restant bien toléré. Ce vaccin n’est pas soumis à une prescription médicale obligatoire et peut être injecté par tous les professionnels de santé habilités à vacciner dans le cadre de la campagne de vaccination.

Une campagne nationale qui démarre le 22 octobre pour une population à remotiver

Entre l’absence de circulation de la grippe l’an passé, et l’administration de 2 à 3 doses de vaccin Covid-19 en moins d’un an, il existe un risque de lassitude de la population vis-à-vis des vaccins en général.
Pour contrer ce risque, il est nécessaire que les professionnels de santé s’impliquent dans un travail de conviction pour renforcer la couverture vaccinale vis-à-vis de la grippe en France, tout particulièrement pour les personnes ciblées par les recommandations. Une priorisation vers ces populations des vaccins disponibles a été prévue jusqu’à fin novembre.
La Haute Autorité de Santé (HAS) a récemment rappelé que l’absence d’épidémie de grippe en 2020-2021 ne devait pas entraîner une baisse de la couverture vaccinale des personnes ciblées par les recommandations cette année. Les campagnes de promotion de la vaccination contre la grippe doivent conserver l’objectif d’une couverture vaccinale d’au moins 75 % dans tous les groupes cibles pour lesquels cette vaccination est recommandée. Parmi ces groupes cibles figurent aussi les soignants, pour lesquels les objectifs de couverture vaccinale grippe devraient être fixés à la même hauteur, voire à des niveaux supérieurs pour les Etablissements Médico Sociaux hébergeant des personnes fragiles.
Enfin, la HAS confirme, pour éviter tout retard à la vaccination grippe et simplifier le parcours vaccinal, la possibilité d’une administration concomitante ou sans délai particulier des vaccins Covid-19 et grippe (dans deux bras) dès lors qu’une personne est éligible aux deux vaccinations.

Pour la campagne 2021-2022, trois vaccins grippe sont disponibles : Vaxigrip Tetra®, Efluelda®, et Influvac Tetra®. Il s’agit de vaccins tétravalents inactivés :
– Entre 6 mois et 3 ans, le vaccin Vaxigrip Tetra® doit être utilisé préférentiellement (Influvac Tetra® a une AMM pour cette tranche d’âge mais les étapes administratives pour le remboursement ne sont pas encore franchies).
– A partir de 3 ans, les vaccins Vaxigrip Tetra® et Influvac Tetra® peuvent être utilisés indifféremment selon les recommandations de la Haute Autorité de Santé.
– Pour les 65 ans et plus, les vaccins Vaxigrip Tetra®, Efluelda® et Influvac Tetra® peuvent être utilisés indifféremment, selon les recommandations de la Haute Autorité de Santé.

Source : https://solidarites-sante.gouv.fr/IMG/pdf/dgs-urgent_110_-_articulation_campagne_grippe_covid.pdf

Contacts
Société de Pathologie Infectieuse de Langue française (SPILF) – https://www.infectiologie.com/fr/contact.html
Société Française de Microbiologie, groupe grippe (SFM) – 09 63 04 70 73 – secretariat@sfm-microbiologie.org
Société Française de Gériatrie et Gérontologie (SFGG) – contact@sfgg.org
Société de Pneumologie de Langue Française (SPLF) – 01 46 34 03 87
Société Française de Cardiologie (SFC) – 01 43 22 33 33
Société Francophone du Diabète (SFD) – 01 40 09 89 07
Collège de la Médecine Générale (CMG) – 01 47 45 13 55
Société Française de Pédiatrie – sfp@sf-pediatrie.com
Société Francophone des Sciences Pharmaceutiques Officinales (SFSPO) – 01 43 31 06 49 – contact@sfspo.org
Société Française de neurologie (SFN) – sfneurologie.org@gmail.com
Société Française de Santé Publique (SFSP) – accueil@sfsp.fr

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