Does the program in medicine teach not to vaccinate in the midst of an epidemic?

Around vaccines, rumors are going well. In particular on social networks, where everything can be advanced and resumed, without necessarily providing proof. “In the medical school curriculum, it is taught that you should not vaccinate in the midst of an ‘epidemic’ !!”.

This publication, supported by more than 6,000 people and published by L’Infirmier, a particularly active account on the pandemic, therefore suggests that vaccination is incompatible with a period of intense circulation of a virus or bacteria. And that this is contained in the curriculum taught to medical students, without any further details.

No information is provided on vaccination (against Covid or routine vaccination), nor on the education in question. Because if there is a common program, it is declined in several ways by the teachers in the faculties. So the existence of a single program in medical school does not mean anything. To see more clearly, we interviewed several protagonists, directly concerned by the question: all deny this assertion, distorted in any context, and insist on the need on the contrary to continue a vaccination schedule during an epidemic. In addition, none of the different immunology courses that we were able to consult contraindicated to vaccinate during an epidemic.

Contacted initially, the president of Anemf, the National Association of Medical Students of France, assures that he has never seen such a principle taught in current programs. The astonishment is the same in the teaching world. “The notion that one should not vaccinate during an epidemic has never been taught in the medical faculty of Sorbonne University. This makes no sense and goes against all the principles of prevention that we teach”, assures us the dean of the faculty of medicine of the Sorbonne, Professor Bruno Riou, for whom this type of speech “is not based on any scientific basis and could have deleterious effects during the health crisis we are going through”.

Professor David Boutoille, president of the College of Infectious and Tropical Diseases University College, also refutes an assertion “out of context as often for dubious aims”: “On the contrary, it is essential to continue the vaccination schedule during the current period, so that children or anyone else needing vaccinations do not run the additional risk of developing other infections.”

In Africa, for example, where severe infectious diseases continue to spread due to the low vaccination coverage, health organizations are encouraging the continuation of so-called routine vaccinations in children for public health reasons. Gavi, the Vaccine Alliance, looked at their benefit / risk balance for children during the Covid-19 epidemic. It clearly appears that the continuation of the vaccination is advantageous. “In our ‘worst’ scenario, we found that immunizing as usual would prevent an estimated 700,000 child deaths. Measles and pertussis are believed to be the cause of most of these deaths.”, according to the body responsible for financing the immunization of millions of children in poor countries. In his “best scenario”, here too the benefit is greater than the risk of contracting the disease, with 3,000 children saved by vaccination.

But let’s come back to France, where there may however be a very particular case of postponement of a vaccine during an epidemic: “What the students are taught is that, in a patient with a full infection, it is better to postpone a vaccination, not because it is dangerous but because the immune response is poorer on the part of a system. immune system already busy fighting an ongoing infection. This only applies to a clearly symptomatic patient “, details Professor David Boutoille. Concretely, the patient will have to wait for his immune system to be strengthened to be vaccinated and not for the end of the epidemic.

This is particularly the case for children, in whom vaccination may be delayed for these reasons, as Professor Bruno Riou suggests. This recommendation, made for many years, is justified to avoid a risk of coincidence, which would attribute to the vaccine a symptom related to the only disease and not to the vaccine itself. But these instructions, which mainly had the effect of delaying routine vaccinations in infants, were changed in 2019 to be limited to severe infections. According to the 2021 vaccination schedule, “the existence of a febrile illness or of a moderate to severe acute infection does not contraindicate vaccination but may lead to it being postponed by a few days”.

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