While the vaccination against Covid-19 in companies was not envisaged before the spring, with the entire population, the Ministry of Labor is accelerating the schedule. The General Directorate of Labor (DGT) informed the occupational physicians that they could, from Thursday 25 February, launch the campaign using the AstraZeneca vaccine for a first category of staff: employees aged 50 to 64 “With comorbidity” (complicated hypertension, unbalanced diabetes, obesity, cancers under treatment, etc.). This age group has a total of nearly 8 million employees, according to INSEE.
Vaccination can only be organized on a voluntary basis and with strict respect for confidentiality “Vis-à-vis employers”, indicates the DGT. Companies must inform all employees of the possibility of being vaccinated, including those who are on short-time work or telework, but no “Individual notice” can not be “Transmitted under cover of the company manager”.
“Transversal” organization
The choice is at the initiative of the employee. “People over 50 affected by the targeted pathologies will have to take the approach themselves to get closer to OSH [service de santé au travail] for vaccination. “ And non-vaccination cannot become a reason for exclusion from the company: “No decision of incapacity can be (…) taken from the sole refusal of the employee to be vaccinated ”, specifies the DGT.
All businesses are affected. The occupational health services present throughout the territory are located either within a company or in external centers. For example, the business service for occupational health (SEST) in Ile-de-France, which has 6,500 member companies for 100,000 employees, is deployed in nine centers in Ile-de-France, Hauts-de-Seine in Val-de-Marne.
The vaccination campaign is preferably considered « in the service premises [de santé au travail] and not in premises located within companies “, writes the DGT, which conceives that the organization is “Transverse” with available doctors who would vaccinate all volunteer employees, “Rather than asking each doctor to manage the demands of the workers in the workforce he is responsible for”. It is the occupational physician who will tell the employee which center to go to.
Procurement
There remains the question of vaccine availability. “For the moment, we have no visibility on the supply”, notes Pascaline Cristofini, in charge of the organization of the vaccination campaign for the SEST of Ile-de-France. Occupational physicians must report to a pharmacy of their choice, which they inform each week of the number of doses desired.
The maximum expected delivery is a ten-dose vial of AstraZeneca vaccine for the week of February 22, “Then two or three bottles maximum the following week”. That is ten appointments maximum per occupational physician the first week and thirty the following. Once supplied, the doctor will have six hours at room temperature to vaccinate ten patients or forty-eight hours if he can keep the doses between 2 and 8 ° C.
Beyond supply, respect for medical confidentiality and the constraints of teleworking, “The start-up will also depend on the companies”, notes Pascaline Cristofini.
Who are the employees suffering from “comorbidity”
About fifteen criteria are taken into account to qualify the comorbidity of employees who will be able, from February 25, to request to be vaccinated by the occupational health services. Here is the list:
– Cardiovascular pathologies: complicated arterial hypertension (hypertension) (with cardiac, renal and vascular complications), history of cerebrovascular accident, history of coronary artery disease, history of cardiac surgery, NYHA stage III or IV heart failure;
– Unbalanced or complicated diabetes;
– Chronic respiratory pathologies liable to decompensate during a viral infection: obstructive pulmonary disease, severe asthma, pulmonary fibrosis, sleep apnea syndrome, cystic fibrosis in particular;
– Obesity with body mass index (BMI) ≥ 30;
– Progressive cancer under treatment (excluding hormone therapy);
– Child Pugh score stage B cirrhosis at least;
– Congenital or acquired immunosuppression;
– Major sickle cell syndrome or history of splenectomy;
– Motor neuron disease, myasthenia gravis, multiple sclerosis, Parkinson’s disease, cerebral palsy, quadriplegia or hemiplegia, primary cerebral malignancy, progressive cerebellar disease.
– Cancers and malignant haematological diseases during treatment with chemotherapy;
– Severe chronic kidney disease, including dialysis patients;
– People with solid organ transplants;
– People transplanted by allogeneic hematopoietic stem cell transplantation;
– Chronic poly-pathologies with at least two organ failure;
– Certain rare diseases and particularly at risk in the event of infection (list drawn up by the health sectors of rare diseases);
– Trisomy 21.
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