{"id":3836,"date":"2021-04-24T15:12:30","date_gmt":"2021-04-24T13:12:30","guid":{"rendered":"https:\/\/sceaux-lagazette.fr\/?p=3836"},"modified":"2021-04-24T15:12:31","modified_gmt":"2021-04-24T13:12:31","slug":"immunite-collective","status":"publish","type":"post","link":"https:\/\/sceaux-lagazette.fr\/index.php\/2021\/04\/24\/immunite-collective\/","title":{"rendered":"Immunit\u00e9 collective"},"content":{"rendered":"\n

La vaccination a-t-elle permis de construire une immunit\u00e9 collective dans certains pays et peut-on l\u2019esp\u00e9rer pour bient\u00f4t en France ? Est-ce au contraire irr\u00e9aliste d\u2019attendre ce r\u00e9sultat dont certains pays avaient r\u00eav\u00e9 il y a un an ?<\/p>\n\n\n\n

Qu\u2019est-ce que l\u2019immunit\u00e9 collective ?<\/h2>\n\n\n\n

Selon Wikip\u00e9dia<\/a>, l’immunit\u00e9 collective (ou gr\u00e9gaire) est le ph\u00e9nom\u00e8ne par lequel la propagation d’une maladie contagieuse peut \u00eatre enray\u00e9e dans une population si une certaine proportion des individus est immunis\u00e9e, soit par vaccination, soit pour avoir d\u00e9j\u00e0 \u00e9t\u00e9 contamin\u00e9s.<\/p>\n\n\n\n

Au c\u0153ur de cette question, le taux de reproduction de la maladie, R0. Celui-ci repr\u00e9sente le nombre de personnes qu\u2019une personne atteinte va contaminer \u00e0 son tour, en moyenne, dans une population non immunis\u00e9e. Pour illustrer son impact, imaginons que R0 est \u00e9gale \u00e0 2 et que 100 personnes contamin\u00e9es arrivent dans une r\u00e9gion o\u00f9 personne ne l\u2019est. Elles en contaminent 200, qui en contaminent elles-m\u00eames 400 lors du cycle suivant. L\u2019\u00e9volution est exponentielle et lors du dixi\u00e8me cycle, 100 000 personnes sont contamin\u00e9es.<\/p>\n\n\n\n

Dans le cas du Covid 19, R0 est de 3,3 environ pour le variant classique, et peut-\u00eatre de 5 pour le variant anglais. Le cycle de contamination est d\u2019environ 1 semaine. Avec un R0 de 3,3, on multiplie le nombre de contamin\u00e9s par 390 en 5 semaines et par 153.000 en 10 semaines. Le 6 mars 2020, il y avait 613 cas identifi\u00e9s. Sans le confinement, l\u2019ensemble des Fran\u00e7ais auraient \u00e9t\u00e9 touch\u00e9s avant le 15 mai et on aurait compt\u00e9 probablement un million de morts (les h\u00f4pitaux \u00e9tant compl\u00e9tement d\u00e9bord\u00e9s).<\/p>\n\n\n\n

R0 est intrins\u00e8que \u00e0 une maladie. Par exemple, il est de 2 pour la grippe <\/a>et de 12 pour la rougeole, maladie tr\u00e8s contagieuse. Mais le coefficient de reproduction constat\u00e9 peut-\u00eatre diff\u00e9rente de ce R0, soit parce qu\u2019on a pris des mesures pour freiner la maladie (par exemple le port du masque et les gestes barri\u00e8res), soit parce qu\u2019une partie de la population ne transmet plus la maladie, parce qu\u2019elle a d\u00e9velopp\u00e9 des anticorps. Pour casser la propagation de l\u2019\u00e9pid\u00e9mie, il a \u00e9t\u00e9 n\u00e9cessaire de mettre en place un confinement, puis diverses mesures contraignantes. Pour pouvoir sortir de ces contraintes, il existe une solution : que le nombre de personnes ayant des anticorps soit suffisant pour atteindre l\u2019immunit\u00e9 collective et que le R effectif passe sous 1.<\/p>\n\n\n\n

Revenons au cas o\u00f9 R0 est de 2. Cette moyenne se maintient tant que les personnes que croise une personne sont \u00ab vierges \u00bb vis-\u00e0-vis de la maladie, qu\u2019elles ne l\u2019ont jamais rencontr\u00e9e et n\u2019ont donc pas d\u00e9velopp\u00e9 d\u2019anticorps. Si au contraire, une personne sur deux a d\u00e9velopp\u00e9 des anticorps (par la maladie ou par vaccination), alors le coefficient de reproduction, que nous appelons alors R, est divis\u00e9 par 2, ce qui le rend \u00e9gal \u00e0 1. Imaginons maintenant que les \u00be de la population ont d\u00e9j\u00e0 des anticorps, alors R n\u2019est plus que de 0,5.<\/p>\n\n\n\n

Imaginons maintenant dans cette situation que 100 personnes contamin\u00e9es d\u00e9barquent : elles vont en contaminer 50, qui en contamineront \u00e0 leur tour 25 etc. En une dizaine de cycle, apr\u00e8s qu\u2019une centaine de personnes ont \u00e9t\u00e9 touch\u00e9es, l\u2019\u00e9pid\u00e9mie s\u2019arr\u00eate d\u2019elle-m\u00eame. C\u2019est dans ce cas que l\u2019on parle d\u2019immunit\u00e9 collective : quelques individus sont touch\u00e9s, mais la maladie ne \u00ab prend \u00bb pas.<\/p>\n\n\n\n

Quand aura-t-on une immunit\u00e9 collective pour le Covid ?<\/h2>\n\n\n\n

L\u2019immunit\u00e9 collective s\u2019obtient quand le taux de reproduction effectif, R, est inf\u00e9rieur \u00e0 1, sans mesures de protection. Appelons T la part des personnes immunis\u00e9es (car vaccin\u00e9es ou ayant d\u00e9j\u00e0 eu le Covid). Quelle est la valeur de T actuellement\u00a0? On a au moins 25% des Fran\u00e7ais qui ont d\u00e9j\u00e0 eu la maladie et 20% qui ont \u00e9t\u00e9 vaccin\u00e9s. Si on admet qu\u2019un quart des vaccin\u00e9s avaient d\u00e9j\u00e0 \u00e9t\u00e9 malades, on a un T un peu sup\u00e9rieur \u00e0 40%, ou plut\u00f4t, qui le sera dans une quinzaine de jours, le temps que les derniers vaccin\u00e9s d\u00e9veloppent une immunit\u00e9.<\/p>\n\n\n\n

Cette valeur de T ne permet pas encore d\u2019avoir une immunit\u00e9 collective, mais elle participe \u00e0 freiner la diffusion de la maladie, puisqu\u2019elle fait baisser R. Mais pas suffisamment : pour \u00e9viter que la maladie se diffuse plus rapidement, il faut continuer les mesures qui la freinent, comme le port du masque, l\u2019a\u00e9ration des logements ou la fermeture des restaurants.<\/p>\n\n\n\n

Mais T augmente r\u00e9guli\u00e8rement. La circulation du virus se traduit actuellement par pr\u00e8s de 1% des Fran\u00e7ais contamin\u00e9s chaque semaine. Trois millions de Fran\u00e7ais ont re\u00e7u leur premi\u00e8re dose dans les deux derni\u00e8res semaines. En tenant compte du fait que certains des vaccin\u00e9s avaient d\u00e9j\u00e0 \u00e9t\u00e9 contamin\u00e9s, on peut estimer que T augmente de 2 % par semaine.\u00a0 Et donc qu\u2019il atteindra un taux de 80% dans 20 semaines (\u00e0 taux d\u2019augmentation constant). Cela apporterait l’immunit\u00e9 collective (voir note) mais cela suppose qu\u2019une part suffisante de la population accepte de se faire vacciner, ce qui n\u2019est pas assur\u00e9 pour l\u2019instant.<\/p>\n\n\n\n

Mais les nouveaux variants ?<\/h2>\n\n\n\n

Les calculs pr\u00e9c\u00e9dents supposent que la vaccination ou le fait d\u2019avoir d\u00e9j\u00e0 eu le Covid prot\u00e8gent de celui-ci. Or, on a pu observer que le variant br\u00e9silien affecte des personnes ayant d\u00e9j\u00e0 eu la maladie, et que le vaccin ne prot\u00e8ge pas forc\u00e9ment de tous les variants. Ce sont ceux-l\u00e0 qui vont se propager en priorit\u00e9 quand on aura atteint l\u2019immunit\u00e9 collective pour le variant anglais ou le variant classique.<\/p>\n\n\n\n

Il faudra donc se faire vacciner de nouveau d\u2019ici six mois ou un an avec un vaccin modifi\u00e9. Il est probable que d\u2019ici l\u00e0 les capacit\u00e9s de production auront augment\u00e9 notablement et que le rythme de vaccination sera nettement plus rapide. On comprend aussi qu\u2019il faut aussi vacciner la plan\u00e8te enti\u00e8re pour \u00e9viter que de nouveaux variants plus dangereux apparaissent : plus le virus se reproduit, plus il est probable que de nouveaux variants apparaissent.<\/p>\n\n\n\n

\n\n\n\n

Note: Pour les amateurs, rappelons qu’il existe une relation alg\u00e9brique entre le R le taux r\u00e9el de reproduction, R0 le taux intrins\u00e8que \u00e0 un virus et T le pourcentage de personnes immunis\u00e9es exprim\u00e9 sous forme d\u00e9cimale. On a R=R0(1-T)<\/strong>. Ce qui donne 1-T < 1\/R0, ou encore T= 1\u20131\/R0. Donc si R0 = 3,3 (variant classique), on obtient T= 0,7. Et si R0=5 (variant anglais), cela donne T = 0,8. Ce qui revient \u00e0 dire que l’immunit\u00e9 collective est atteinte \u00e0 partir de 70% de la population pour le virus classique et \u00e0 partir de 80% de la population pour le variant anglais. <\/p>\n","protected":false},"excerpt":{"rendered":"

La vaccination a-t-elle permis de construire une immunit\u00e9 collective dans certains pays et peut-on l\u2019esp\u00e9rer pour bient\u00f4t en France ? Est-ce au contraire irr\u00e9aliste d\u2019attendre ce r\u00e9sultat dont certains pays avaient r\u00eav\u00e9 il y a un an ? Qu\u2019est-ce que l\u2019immunit\u00e9 collective ? Selon Wikip\u00e9dia, l’immunit\u00e9 collective (ou gr\u00e9gaire) est le ph\u00e9nom\u00e8ne par…<\/p>\n","protected":false},"author":11,"featured_media":3838,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[53,60],"tags":[],"class_list":["post-3836","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-analyses","category-sante","entry","simple"],"yoast_head":"\nImmunit\u00e9 collective - La Gazette<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sceaux-lagazette.fr\/index.php\/2021\/04\/24\/immunite-collective\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Immunit\u00e9 collective - La Gazette\" \/>\n<meta property=\"og:description\" content=\"La vaccination a-t-elle permis de construire une immunit\u00e9 collective dans certains pays et peut-on l\u2019esp\u00e9rer pour bient\u00f4t en France ? 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