The social specificities of hostility toward vaccination against Covid-19 in France

Abstract

Equal Access to the COVID-19 vaccine for all remains a major public health issue. The current study compared the prevalence of vaccination reluctance in general and COVID-19 vaccine hesitancy and social and health factors associated with intentions to receive the vaccine. A random socio-epidemiological population-based survey was conducted in France in November 2020, in which 85,855 adults participants were included in this study. We used logistic regressions to study being "not at all in favor" to vaccination in general, and being "certainly not" willing to get vaccinated against Covid-19. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against COVID-19 (OR = 1.88 (95% CI: 1.79–1.97)). We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, were more likely to refuse the COVID-19 vaccine (from OR = 1.22 (95% CI:1.10–1.35) for respondents without diploma to OR = 0.52 (95% CI:0.47–0.57) for High school +5 or more years level). People from the French overseas departments, immigrants and descendants of immigrants, were all more reluctant to the Covid-19 vaccine (first-generation Africa/Asia immigrants OR = 1.16 (95% CI:1.04–1.30)) versus OR = 2.19 (95% CI:1.96–2.43) for the majority population). Finally, our analysis showed that those who reported not trusting the government were more likely to be Covid-19 vaccine-reluctant (OR = 3.29 (95% CI: 3.13–3.45)). Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.

When mistrust in the government and scientists reinforce social inequalities in vaccination against Covid-19

“…[7] This could relate to the fact that members of the working classes have a perception of their body and their health that is more distant from medical diagnoses and recommendations than the upper class. [33] Racialised minorities, who had greater reluctance towards receiving a Covid-19 vaccine in France and in many countries[13,31] also appeared to be less likely to be vaccinated, as found in British and US surveys. [6,8,20,34] Numerous studies have shown that racialised minorities[24,35] have less confidence in the healthcare system and in caregivers than the mainstream population.…”

“…Secondly, it is interesting to note that social differences in vaccination practices overlapped with the social distribution of vaccine reluctance observed in France eight months earlier, except for gender differences. [13] Indeed, women were no less likely to be vaccinated than men, although they were more reluctant to get vaccinated in France, as in many countries, before the vaccine was made available to all. [31] Faced with the reality/possibility of prevention, it is as if their gendered reflexes as guardians of the family's health came into play.…”

“…But in a context where governments have taken the lead in managing the pandemic crisis, it is all the more important to analyse vaccination practices accompanied by consideration of the trust that people place in the government. Many studies have shown the implications of political mistrust in Covid-19 vaccination intentions [13,14], but only a few have analysed its implications in vaccination practises. These studies were conducted in the US and showed that in counties with a high percentage of Republican voters, vaccination rates were significantly lower [15,16].…”

When Lack of Trust in the Government and in Scientists Reinforces Social Inequalities in Vaccination Against COVID-19

“…In a context where governments and scientists have taken the lead in managing the pandemic crisis, it is all the more important to analyse vaccination practices along with consideration of the trust that people place in the government (12)(13)(14)(15). Many studies have shown that COVID-19 vaccination intentions are related to trust in the government (11,(15)(16)(17)(18)(19)(20). One study, in the UK, simultaneously considered trust in the government and in scientists: COVID-19 hesitancy was associated with low trust in scientists and doctors but the correlation was weaker with trust in government (16).…”

Perception and Coverage of Conventional Vaccination among University Students from Rouen (Normandy), France in 2021

“…In France, a new program of primary prevention interventions among HCS started in 2019, called "Service Sanitaire des Etudiants en Santé", and has been shown to improve misconceptions and hesitancy surrounding vaccines [25]. Our study showed that female students have better VC than male students, while Bajos et al highlighted a gendered reluctance toward vaccination in general (but even more so, regarding vaccination against COVID-19) [26]. This could be explained by better follow-up by a healthcare professional due to the prescription of a contraceptive method [27].…”