A vaccination operation under the towers of Noisy-le-Sec, in Seine-Saint-Denis – Christophe ARCHAMBAULT / AFP
- Vaccination delays in Seine-Saint-Denis are noticeable in each age category.
- Additional doses are allocated to the department and the “going to” strategy is favored.
Thirty vaccination centers installed in the 40 municipalities of Seine-Saint-Denis, a bus that crisscrosses the roads of the department several times a week to educate residents, barnums mounted at the foot of the towers to pick up those who are standing on the further from traditional circuits… Despite the voluntarism of the public authorities, the figures are struggling to take off. While nationally, more than 34% of the population has received at least one dose of the precious serum, this rate is only 23% in Seine-Saint-Denis.
And demographics alone cannot explain this delay. Admittedly, this department is the youngest in France while the vaccination strategy favored the oldest until Monday – it was therefore, initially, less endowed than others – but this vaccination deficit is found in all age categories. Among those over 75, the rate of people having received a dose is 8 points lower than the national average (71.2% against 79%). Among 65-74 year olds, it is even 12 points below (64.2% against 76%).
The expression of socio-economic difficulties
“These figures would have been even lower without all these local actions, assures Stéphane Troussel, the president of the PS of the department, but it is obvious that the precariousness, stronger here than elsewhere, takes away from the course of care. And that, in times of Covid-19 or not. Each year, the vaccination rate for seasonal flu is in this department, the poorest in France, 10 to 15 points lower than the national average. “We unfortunately know that taking care of one’s health, in a preventive or curative manner, is directly linked to socio-economic factors”, continues a source within the Regional Health Agency. And the density of general practitioners and specialists, lower in this department by 30% than the national average, could not facilitate the work of information and guidance.
However, all the actors, local as sanitary, refuse to see inevitability in these figures. Friday, the director of the ARS, the prefect and the 40 mayors of the department met by videoconference to organize the response and adapt the vaccine strategy to the specificities of this territory. The opening of vaccination dates without appointment exclusively reserved for residents of Seine-Saint-Denis and the extension of the opening hours of several centers, especially in the evening, have been decided. And to keep pace, 15,000 additional vaccine doses were allocated last weekend and throughout June, 120,000 doses will be injected each week.
A tailor-made plan
Above all, all agreed on the need to promote operations “to go to”: in short, it is not the population that goes to the vaccine, but the vaccine that goes to the population. Throughout the month of June, the barnums at the foot of the towers will be multiplied, the mobile teams will be reinforced to go and vaccinate in social residences or associations. From Thursday to Saturday, they will be deployed in Sevran in a food distribution center. “Local centers are essential but insufficient, insists Stéphane Troussel. Even by setting up telephone switchboards very early on to allow those who do not have the Internet or cannot read to make an appointment, we realize that this is not enough to reach the most vulnerable. Discussions are also underway with social landlords to organize campaigns directly with tenants.
There remains the issue of trust. Institutional communication to reach populations far from the traditional health system is reaching its limits. To try to better apprehend this reluctance, the department has just launched a “flash” survey on the arguments which hit the mark with those who have just been vaccinated. The ARS, for its part, is working on more targeted arguments to seek new audiences at risk. “For example, we have noticed that the vaccination rate of obese people is far below the national average *,” explains one. We tried to understand why – some did not know that they were part of the eligible populations, others did not know that their overweight was due to obesity – and developed more precise arguments. If this is not case by case, this ultra-proximity campaign is in any case akin to lace.
* 37.4% in Seine-Saint-Denis against 47.6% on average in France.