How France is confronting its big anti-vaxx problem

Getty Images / WIRED

As it emerges from its second Covid lockdown, France is preparing to roll out one of the biggest vaccination campaigns in its history. The country has been badly battered by the pandemic, tallying 59,000 Covid deaths and 2.39 million cases so far, and the vaccine would finally offer a way out of the ordeal. Yet, Paris will now have to grapple with another alarming reality: France has become one of the most vaccine-sceptical countries in the world.
“I’m not going to get vaccinated against the coronavirus, unless they make it mandatory. It doesn’t seem reasonable, when you look at how quickly these products have been manufactured.” Catherine, a 55-year-old French woman who is crossing Paris’s Luxembourg Gardens on her way to work, is absolutely sure: “I’m healthy, I don’t fall into the age groups at risk…I don’t need the shots.” Patrick, who is exercising just a few meters away, has a similar view: “I’m quite wary, usually it takes several years to create a new vaccine. This seems rushed, we have no long-term perspective on secondary effects,” says the 34-year-old engineer. “I think it’s too soon to vaccinate the population.”

Advertisement

An Ipsos survey gauging the attitudes of 15 countries in October found that only 54 per cent of French respondents would be willing to get a Covid vaccine jab, compared to 64 per cent in the US and 79 per cent in the UK. This attitude is in line with the population’s broader distrust of vaccines in general. In 2018, in a wide-ranging Gallup study of 144 countries, the French were found to be the most prone to believe that vaccines aren’t safe – an opinion shared by about one third of respondents.
Like the rest of the EU, France is awaiting the go-ahead of the European Medicines Agency to make the new vaccines available, but the country has already pre-ordered up to 200 million doses. The campaign may kick off as early as in the last days of December, starting with the elderly in care homes. The government has decided to leave the shots optional, and is in desperate need to boost the population’s trust.
The pillar of its strategy will be general practitioners: a lesson learned the hard way from France’s past failures, particularly the 2009 vaccination campaign against the H1N1 virus. Back then, the logistical details were decided by administrative authorities such as the prefects, and family doctors felt left out of the effort. Gyms across the country were converted into big testing centres, but remained largely empty. By the summer of 2010, barely 8.5 per cent of the population had been vaccinated, well short of the 75 per cent target. The campaign cost €600 million (£540m), but its main result was that, as a health policy expert told a parliamentary inquiry, it “stirred up tensions between doctors and public authorities.”
This time, things are going to be different. Jacques Battistoni, president of France’s biggest union of general practitioners, says that while the details are still being hammered out, local doctors expect to have a much bigger role not just in answering their patients’ questions and reassuring them, but also in deciding where and how people will receive the jabs.

Advertisement

“In the early stages, vaccines will go to the most vulnerable groups, elderly people that we know well and see regularly,” says Battistoni. “So we will have to find places where they can get the shots easily.” These will likely include public spaces selected in coordination with local authorities, doctors’ offices big enough for the task, but potentially also the patients’ homes.
The government is aware that communication will be essential. Once the rollout begins, multiple public bodies will monitor the new vaccines closely, with the Agence Nationale de Sécurité du Médicament issuing weekly public reports. Vaccine recipients will get full medical check-ups beforehand, and will be contacted systematically after the jabs to inquire about their health. The agency is also improving an existing online platform where doctors and the general public can flag side effects, making it simpler to use.
Following what is becoming a pattern in France during this crisis, Paris has also picked a highly respected but previously little-known figure to be the “public face” of this new phase. Last spring, before becoming prime minister, Jean Castex had been appointed “Monsieur Déconfinement,” in charge of overseeing the lifting of the first national lockdown; now, immunologist Alain Fischer has been tasked with advising the government and helping reassure the population, getting the message across that safety and transparency are the authorities’ top priorities.
“Monsieur Vaccin”, as French media are already calling him (reportedly to his chagrin), featured prominently in the government’s press conference to present the vaccination campaign earlier this month. He will help coordinate a variety of committees, made up of experts but also local officials and normal citizens, in a bid to better adapt the state’s response to people’s fears.

Advertisement

One of these advisory bodies will be formed by some 30 people selected at random among the public – a mechanism that has already been tested recently, to help devise France’s next steps to tackle climate change. Greater involvement of the civil society has been one of president Emmanuel Macron’s mantras, although observers are divided over the extent to which proposals coming from the bottom are translated into actual policy – with critics saying this is just a gimmick.
Winning people over will be no easy task: distrust of public authorities is in a way part of the French national character. According to data from Sciences Po university, which tracks public mood and compares it to other countries, over the past decade the percentage of people saying they have faith in the government has never been higher than 33 per cent. The figure was 27 per cent this year, 14 points lower than in the UK.
Public policy blunders bear some responsibility for this state of affairs. Many experts agree that a turning point in the French anti-vaxxer phenomenon was the campaign against Hepatitis B in the ’90s. A vaccine had been available for years, but in the country immunisations were lagging and the disease was on the rise. In 1994, the government decided to launch a mass vaccination of all newborns and kids entering middle school. France’s vaccination rate quickly became one of the highest in the world (about one third of the population), but the debate about side effects also grew in intensity. In 1998, amid largely unfounded concerns of a link with multiple sclerosis, then-health minister Bernard Kouchner “temporarily” stopped the vaccinations in schools, while still recommending them for newborn babies.
The stated goal had been to reassure the public, but the government’s position appeared inconsistent, and the result was the opposite. Provisional measures became permanent, and the campaign lost steam. While no convincing evidence of a connection between Hepatitis B vaccines and multiple sclerosis was ever found, mistrust among the French remained sky-high for decades. In a study carried out between 2012 and 2014, some 80 per cent of respondents said they worried about it or were outright against it. When the vaccine was finally made mandatory three years ago, such concerns emerged again in the public debate – albeit they never threatened to jeopardise the reform.
Closer to home, the way French authorities have handled the ongoing Covid-19 crisis has sometimes compounded people’s scepticism. The messaging on face-masks, in particular, has been perceived by many as confusing and insincere. In the early spring, as Covid cases surged, the country’s stocks quickly ran low. Masks became hard to find and often insufficient even for hospital personnel. It was then, following a pattern seen in other countries – notably the US – that the French government claimed that face coverings were “totally useless” for the general public and should only be worn by health professionals and people who had tested positive for the virus. Over the following months, though, as the problem of shortages was gradually resolved, the line changed. In April, top officials started encouraging wearing masks for all those who “wished to,” making them mandatory on public transport and some schools the following month, at the end of the first lockdown. Face coverings later became compulsory in all indoor public spaces, and ultimately, over the summer, in many outdoor areas as well.
While the changes in the official stance partially reflected the advice given by French and international scientific bodies, including the WHO, the result was to sow doubt among the population that the original recommendations had simply been a ruse to stave off mask shortages.
The government’s efforts to win the public over may also be hampered by the increasing polarisation of the current political environment. According to a poll published last week by broadcaster BFMTV, far-right and (to a lesser extent) far-left voters are much more likely to reject the vaccine than supporters of the centrist La République en Marche – the party founded by President Emmanuel Macron. “Part of the population may reject the jabs just because they don’t see them as an anti-Covid vaccine, but as a pro-Macron one,” says Laurent-Henri Vignaud, a historian of sciences and co-author of a book on vaccine-scepticism.
People on the extremes of the French political spectrum are also more responsive to conspiracy theories, which play a major role in the anti-vaxxer discourse. In a survey released in 2019 by research institute Ifop, 43 per cent of respondents agreed with the statement that “the Health Ministry is in cahoots with the pharmaceutical industry to keep the truth about vaccines’ harmfulness from the public”; that figure jumped to 53 per cent among supporters of the far-left France Unbowed, and 61 per cent among those of the National Rally – Marine Le Pen’s anti-immigration party. This year, another Ifop poll found that far-right voters are also much more likely to believe that the novel coronavirus was intentionally engineered in a laboratory. France is by no means a unique case: in 2015 a much-cited studyalso showed a strong correlation between radical political beliefs and “conspiratorial mindsets” in the US and in the Netherlands.
Like in most countries, social media is making the problem worse. According to the Institute for Strategic Dialogue, a think tank, anti-vaccine views feature prominently in France’s most popularCovid-related posts on Facebook and Twitter. Two out of the top five most-shared Facebook posts commenting on France’s second wave conveyed anti-vaccination messages. In the same period, the five French Twitter accounts with the highest number of posts about the pandemic all contained disinformation and unfounded speculation.
Despite all these challenges, some experts believe the threat posed by anti-vaxxer sentiment in France should not be overblown. After all, in 2018 the number of compulsory vaccine jabs for newborns went from three to 11 without major backlash. For most key vaccines, immunisation rates among babies are over 90 per cent.
The hope is that the new anti-Covid shots will pave the way to a return to normalcy and ease the pressure on health facilities overburdened with Covid patients. However, many frontline professionals are under no illusion that this will happen in the short term. Guillemette Frémont works in a hospital just east of Paris – an area where Covid has hit hard. She warns that, even once vaccination starts, the crisis will be far from over, with multiple new waves of the virus to be expected. She finds French people’s wariness of vaccines difficult to understand: “As a doctor and infectious disease specialist, I have always been puzzled by it.”
To defeat the nation’s rampant scepticism, transparency from the top will be paramount. “The government must avoid repeating the same kind of mistake it made with masks, by all means,” says Laurent-Henri Vignaud, the historian. “It has a catastrophic impact.”
More great stories from WIRED
🏥 The devastating human cost of a mental health data breach
🇷🇺 Russia’s vaccine has attracted criticised. Here’s what is really happening with the Sputnik V vaccine
🍿 The Netflix Christmas Cinematic Universe is being torn apart

Advertisement

🔊 Listen to The WIRED Podcast, the week in science, technology and culture, delivered every Friday
👉 Follow WIRED on Twitter, Instagram, Facebook and LinkedIn

Like this article?

Share on facebook
Share on Facebook
Share on twitter
Share on Twitter
Share on linkedin
Share on Linkdin
Share on pinterest
Share on Pinterest

Leave a comment

Why You Need A Website

Now