When Lack of Trust in the Government and in Scientists Reinforces Social Inequalities in Vaccination Against COVID-19
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Abstract
To assess whether lack of trust in the government and scientists reinforces social and racial inequalities in vaccination practices.
Design
A follow-up of the EpiCov random population-based cohort survey.
Setting
In July 2021, in France.
Participants
Eighty-thousand nine hundred and seventy-one participants aged 18 years and more.
Main Outcome Measures
Adjusted odds ratios of COVID-19 vaccination status (received at least one dose/ intends to get vaccinated/ does not know whether to get vaccinated/refuses vaccination) were assessed using multinomial regressions to test associations with social and trust factors and to study how these two factors interacted with each other.
Results
In all, 72.2% were vaccinated at the time of the survey. The population of unvaccinated people was younger, less educated, had lower incomes, and more often belonged to racially minoritized groups, as compared to vaccinated people. Lack of trust in the government and scientists to curb the spread of the epidemic were the factors most associated with refusing to be vaccinated: OR = 8.86 (7.13 to 11.00) for the government and OR = 9.07 (7.71 to 10.07) for scientists, compared to vaccinated people. Lack of trust was more prevalent among the poorest which consequently reinforced social inequalities in vaccination. The poorest 10% who did not trust the government reached an OR of 16.2 (11.9 to 22.0) for refusing to be vaccinated compared to the richest 10% who did.
Conclusion
There is a need to develop depoliticised outreach programmes targeted at the most socially disadvantaged groups, and to design vaccination strategies conceived with people from different social and racial backgrounds to enable them to make fully informed choices.
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SciScore for 10.1101/2022.02.23.22271397: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: 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 variable not detected. Randomization The EpiCov study consisted of a random sample of people aged 15 and over, excluding those living in institutional settings, selected from the FIDELI tax registry of the National Institute of Statistics and Economic Studies (INSEE), which covers 96% of the population living in France. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources …
SciScore for 10.1101/2022.02.23.22271397: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: 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 variable not detected. Randomization The EpiCov study consisted of a random sample of people aged 15 and over, excluding those living in institutional settings, selected from the FIDELI tax registry of the National Institute of Statistics and Economic Studies (INSEE), which covers 96% of the population living in France. Blinding not detected. Power Analysis not 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:Finally, suspicions of scientists colluding with big pharmaceutical companies, following comments made on social media, could also contribute to explaining this mistrust.[47] Our analysis nevertheless has some limitations. First, as any national population-based survey, the present study failed to capture highly vulnerable groups such as undocumented migrants and homeless people, who were particularly affected by the pandemic.[34] Secondly, our analysis was based on a survey conducted in July 2021. Until reaching a plateau in October 2021,[49] vaccination rates continued to rise particularly in connection with the mandatory anti-Covid-19 certification (requiring proof of vaccination, recent negative test, or proof of recovery to access specific places such as restaurants, theatres, trains, planes, etc.) introduced on July 21st 2021, which increased vaccine uptake.[2,50] Considering that the least privileged social groups are less impacted by the anti-Covid-19 certification, since they are not likely to routinely access such places, we could hypothesise that the social inequalities observed are still present today, even if their magnitude is less prominent. In addition, it was interesting to study the social inequalities in vaccination practises before the introduction of the mandatory anti-Covid-19 certification to be able to evaluate its effectiveness afterwards. The highly structuring effect of mistrust in the government and scientists remains to be understood in greater de...
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.
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