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Abstract Background Vaccination is expected to change the epidemiology and management of SARS-CoV-2 epidemics. Methods We used an age-stratified compartmental model calibrated to French data to anticipate these changes and determine implications for the control of an autumn epidemic. We assumed vaccines reduce the risk of hospitalization, infection, and transmission if infected by 95%, 60%, and 50%, respectively. Results In our baseline scenario characterized by basic reproduction number R0=5 and a vaccine coverage of 70–80–90% among 12–17, 18–59, and ≥ 60 years old, important stress on healthcare is expected in the absence of measures. Unvaccinated adults ≥60 years old represent 3% of the population but 43% of hospitalizations. Given limited vaccine coverage, children aged 0–17 years old represent a third of infections and are responsible for almost half of transmissions. Unvaccinated individuals have a disproportionate contribution to transmission so that measures targeting them may help maximize epidemic control while minimizing costs for society compared to non-targeted approaches. Of all the interventions considered including repeated testing and non-pharmaceutical measures, vaccination of the unvaccinated is the most effective. Conclusions With the Delta variant, vaccinated individuals are well protected against hospitalization but remain at risk of infection and should therefore apply protective behaviors (e.g., mask-wearing). Targeting non-vaccinated individuals may maximize epidemic control while minimizing costs for society. Vaccinating children protects them from the deleterious effects of non-pharmaceutical measures. Control strategies should account for the changing SARS-CoV-2 epidemiology.

In this study, Tran Kiem et al. examine the contribution of different age groups to COVID-19 transmission. Using data from the French epidemic in summer 2020, they report that while individuals aged 80 years and older are more at risk, pandemic control in the absence of vaccines required measures targeted at all age groups.

To combat the COVID-19 pandemic, many European countries have developed a public health strategy involving the use of digital contact tracing (DCT) applications to improve timely tracking and contact tracing of COVID-19 cases. France’s independent COVID-19 Control and Society Connection Council (CCL) was established by law in May 2020 to issue advice and recommendations on the national epidemic digital systems. In this paper, we present the recommendations by the CCL, with the objective to increase the uptake and utility of French DCT applications. As the country's most vulnerable population has been subjected to greater virus exposure, a stronger impact of the lockdown, and less access to preventive and health care services, the CCL is particularly aware of health inequalities. The French DCT app TousAntiCovid had been downloaded by 13.6 million users (ie, 20% of the French population) in March 2021. To promote the use of DCT apps, the CCL has recommended that communication about the app’s individual and collective objectives be increased. The CCL has also recommended the introduction of clear, simple, accessible, incentivizing, noncoercive information within the digital tools. In addition, the CCL has recommended improving public health policies to address the needs of the underprivileged. The CCL calls for promoting population empowerment with the use of digital tools, improving public health culture for decision-makers dealing with health determinants, taking social considerations into account, and incorporating community participation.

In France, economics gradually became more relevant to health issues in the past few decades. This resulted from a social process in which the medical profession played a crucial role. Over the years, physicians tried to guide and, at times, to inhibit the soar of health economics. This article shows how physicians strived to control the development of health economics from the 1950s to the 1990s. In the post war period, a new set of expertise significantly called “medical economics” was developed by physicians within the administration, which later gained larger autonomy from the medical world in this field. In the 1970s, health economics gained autonomy as a specialized field in higher education institutions, more easily in economics than in medicine. From the 1980s, when the financial control of health expenditures became inescapable, health technology assessment procedures were for a time oriented to predominantly medical approaches, at the expense of rather economic ones, at that time overshadowed. This genealogy finally typifies the development of health economics in France, and the specific relationship between this field and the medical watchdogs.

This article seeks to apprehend the institutional dynamics, individual courses and the intellectual productions which contributed to the formation of "medical economics". To study together the social use of the economic arguments and their specifically intellectual properties, the concept of "cognitive reason" was introduced. It is then possible to seize empirically various reasonings, which are by nature more difficult to observe than other social phenomena more directly accessible. The work of the economist can then be compared to a production process of rationalization and use of cognitive reasonsing.