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

  1. Nathalie Bajos
  2. Alexis Spire
  3. Léna Silberzan
  4. for the EPICOV study group

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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.

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  1. Version published to 10.1371/journal.pone.0262192
  2. ScreenIT

    SciScore for 10.1101/2021.06.07.21258461: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The survey was approved by the CNIL (French independent administrative authority responsible for data protection) on April 25th 2020 (ref: MLD/MFI/AR205138) and by the “Comité de protection des personnes” (French equivalent of the Research Ethics Committee) on April 24th.
    Sex as a biological variablenot detected.
    RandomizationA random sample of 135,000 people aged 15 and over, drawn from the tax database of the National Institute of Statistics and Economic Studies (INSEE), which covers 96% of the population living in France but excludes people living in institutional settings, participated in a first wave of the study in May 2020.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Like all national surveys conducted in the general population, our analysis showed limitations. First, the study could not reach highly vulnerable groups such as the undocumented and the homeless, who were particularly affected by the pandemic [42], especially in France [43]. Furthermore, our analyses did not consider which sources of information people used to learn about vaccination issues. Misinformation campaigns in the media and on social networks could have influenced vaccination intentions [44,45]. However, the impacts of these discourses were not homogeneous and it could be hypothesized that their effects varied according to social background and gender, somehow reinforcing the results we have obtained. Finally, it is important to note that the survey was conducted shortly before the vaccines were actually made available in France in early January 2021. Attitudes toward vaccination might have changed according to available information on each prototype vaccine and might as well have changed over time [46]. As the number of vaccinated individuals increased, knowing vaccinated people in one’s environment might encourage reluctant individuals to follow suit. However, the scarce studies on the evolution of vaccination intentions over time showed that it was mainly those who were hesitant who were likely to be vaccinated [47]. In the case of France, available data showed that the share of clearly reluctant individuals, those on whom we focused our analyses, remained relati...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.06.07.21258461v1 on medRxiv