▷ France vaccination programme: the controversy 🗼

France vaccination programme is a hot topic! It has been for a few years in France and it is reaching its pick with the mandatory vaccine against Covid-19.

Since the start, French people are not eager to be vaccinated against Covid-19. The French are rather sceptical. We need to be convinced.

Vaccination is a very sensitive subject that arouses a lot of emotions because it affects our bodies or those of our children. It is both a personal choice and a public health issue. It’s difficult to talk about it calmly.

So I’m going to try to explain where the French people distrust comes from in the most objective way I can.

France vaccination programme: The French scepticism

Is it safe?

In fact, “one in three French people do not believe that vaccines are safe,” says the American polling institute Gallup in a study carried out for the British medical NGO Wellcome. Out of 144 countries studied, France is even the most vaccine-sceptical of all. In this attitude of distrust, France is followed by Gabon, Togo, Russia and Switzerland.

7% was the world average for the question “Do you think vaccines are safe?“! Five times less than the French!

That’s a lot! This is certainly a reason there were worries around the reach of collective immunity in France.

But at the same time, their arguments to justify this refusal seem quite reasonable. They say they are afraid of the side effects of these vaccines, that the laboratories don’t have enough experience to measure the risks, and that they have doubts about their effectiveness.

The problem is that the French scepticism is not limited to the Covid-19 vaccine but this also englobes the France vaccination programme. 

What about Louis Pasteur’s heritage?

It may seem paradoxical because France is the country of Louis Pasteur, the rabies vaccine inventor who popularized the vaccination technique. France vaccination programme is also one of the national programmes with the most compulsory vaccines for children after Italy.

Since 2018, there are 11 mandatory vaccines in France. It passed from 3 to 11 without a real explanation. Whereas in Germany, there is one and in the UK none. Vaccines are only recommended, therefore parents are free to choose to vaccine their children or not.

Why do the French have this mistrust of vaccines? Do they no longer trust science?

This is a recent phenomenon that has developed over the last decade. Before the French were very much in favour of vaccination.

A long-standing fear

A bit of History

I’m not going to tell the whole history of vaccination but I can tell you that it has always had its detractors. And when you know how it works, it’s not surprising that people were afraid of it, especially at the beginning of the first experiments.

It’s true! Vaccination consists of injecting a virus and then being protected from it. Well, to be a bit more precise (and I’m not a scientist), you inject either a weakened or a dead virus so that the body learns to recognize the danger and create antibodies (immune proteins). These immune proteins then help to better resist the real virus later on.

It is a wonder how someone came up with such an idea!

The inventor of the vaccine is considered to be an English doctor, Edward Jenner at the end of the eighteenth century. For several centuries in Europe, there was a disease that was causing smallpox. It was a highly contagious and often fatal disease that mainly affected young children. 

But the French praise Louis Pasteur. About a century after Jenner’s discovery, Pasteur built on his research to further develop the method of vaccination with other diseases. He is best known for inventing the vaccine against rabies, a disease that was quite common in some wild animals and deadly to humans.

However, for both Pasteur and Jenner, it took time to convince their colleagues of the effectiveness of their method. 

Also, the Catholic institutions were quite reluctant to the vaccination too, but for the very principle of vaccination: injecting evil to do good. Yet Pasteur himself was a Catholic. But in the 19th century, Catholic institutions were not always convinced of the benefits of science.

As you can imagine, public opinion was also very doubtful! When doctors told their patients that they had to inject them with a small dose of a virus to protect them, the reactions were not always enthusiastic…

Finally, this was the best argument that convinced the sceptics: the effectiveness of vaccines. It’s thanks to vaccines that diseases like smallpox, diphtheria, polio and tuberculosis have completely or almost completely disappeared in rich countries. And to speed up their spread, some countries have even decided to impose them on their citizens. For example, France made the smallpox vaccine mandatory in 1902.

What about today?

But a century later, in some rich countries, doubts about vaccination are returning. The study by the British NGO WellCome shows that people in rich countries are the least confident about vaccines, especially in Europe. Since there hasn’t been a major epidemic in a long time (at least until covid came along), people don’t see the point of getting vaccinated. 

This is a phenomenon that researchers call the “laissez-aller effect” and in French, the expression “laisser-aller” is quite negative. It means a form of negligence.

On the contrary, in poorer countries where these contagious diseases are still very present, the level of confidence in vaccination is much higher. 

Even if you hear criticism of vaccines in rich countries, it’s still quite marginal, except in France! But in fact, this is a recent trend that appeared about ten years ago. So now we’re going to try to understand what happened.

And this mistrust partly explains why some diseases that had disappeared are now reappearing, like measles for example. Measles is also a disease that affects children and causes red spots on the skin. Thanks to the vaccine, measles had almost disappeared, but in recent years the number of cases has increased in some countries. For example, in France, there was a measles epidemic between 2008 and 2012. 

The damaging effects of the French government paternalism

From first in class to dork

Until the beginning of the 2000s, France vaccination programme was very successful. France was one of the good students in terms of vaccination. Only between 8 and 10% of the population expressed reluctance (and today this rate has tripled to 33%!). In fact, in the 20th century, there was a strong consensus around this issue. The French accepted vaccination as a practice of modern medicine that saved millions of lives. 

In 2009, there was a major turning point, the French government ordered tens of millions of vaccines against the swine flu, also known as influenza A (H1n1). But it quickly became clear that this flu was much less dangerous than expected. And only 8% of French people got vaccinated since the swine flu.

The government was seen as having massively overordered with public funds. This raised questions against financial interests.

At that point, rumours started to spread that the French government had ordered all these vaccines just to enrich the pharmaceutical companies. This accusation of collusion between the state and large industrial groups, particularly in the pharmaceutical field, is not new. But the extent of the waste really upset the French, especially in the context of the economic crisis at the time.

More health scandals…

In the ’80s and ’90s, the tainted blood affair of people contaminated with HIV and Hepatitis C had heavy consequences on French people trust in the institutions. Long trials revealed medical, industrial and administrative failures.

But also the Médiator scandal, the anti-diabetes medicine that started to be marketed in 1976 and appeared to have important cardiac risks. Médiator was withdrawn from the Belgian market in 1978, from the Swiss market in 1997 and from the Spanish market in 2003. Médiator was withdrawn from the French market only in November 2009 and approximately 200,000 patients were still under treatment.

A study published in 2011 estimated that there had been between 500 and 2000 deaths linked to Médiator in France. A lawsuit was opened against the Servier laboratory and the National Agency for the Safety of Medicines. This case was highly publicised and increased the French people distrust in the government.

And this is the heart of the problem, if some French people have doubts about the safety of vaccines, it’s partly because they no longer trust their government. 

… no nurrish fear but also the extremes

At least, this is the conclusion of a study published last November, a study by the very serious Fondation Jean Jaurès. This study tried to establish the profile of the French people who refuse to be vaccinated against Covid-19. 

The study shows that women under 35 are generally more afraid of vaccine side effects than men. This seems quite logical as it is the age of higher fertility.

However, the main common point of these French people who don’t want the vaccine against covid is their political preference. People who refuse the vaccine against Covid-19 are generally voters of populist parties, either of the extreme right or of the extreme left. 

At first sight, it may seem strange since they have completely opposite ideas. But they have one thing in common: they are both anti-system. They believe that the traditional parties of the left and right have plunged France into a deep crisis, a crisis that Emmanuel Macron’s party has only made worse. So naturally, people who no longer trust the state, well are more easily seduced by these arguments. 

So the author of this study, Professor Antoine Bristielle, thinks that this mistrust of the new vaccine is, first of all, a problem of trust between the French and their government. 

The governement counter-productive paternalism

Unfortunately, in France, polls show that for the last twenty years, the French have been trusting the government less and less. And this problem is worsened by the paternalistic attitude of politicians, especially the current president. Instead of being educational, explaining the situation to the French and letting them choose, the government imposes measures. 

For example, in 2018, the number of compulsory vaccines of the France vaccination programme for children to enter childcare was increased from 3 to 11. France became one of the countries with the highest number of compulsory vaccines, and without really explaining the reasons to parents. 

Like a parent saying to their child: “Do what you are told and don’t ask questions!” The best way to get the French to distrust and demonstrate. 

This paternalistic attitude rarely gets good results. And this is confirmed now with the Covid-19 pandemic. 

It’s up to the government to reassure and convince the French, to explain to them how this vaccine works, why the studies that were done by the laboratories are reliable, why the production was faster than expected. But unfortunately, this effort of pedagogy has been made in France very late in this war of opinion, which lead to the spread of conspiracy theories.

Theories that were emphasized by the social media algorithms since this type of content get clicks and views, watch time and of course money for the platforms and the media…

But I want to be optimistic!

Overall the perception of vaccination has improved in France over the past two years despite what we can see on the media as per the State of Vaccine Confidence in the EU+UK 2020 report done for the European Commission.

In-short

So, I hope that now you understand a little bit better why the French people are so divided on the France vaccination programme in general, and the Covid-19 vaccine in particular. This impacts every family, every group of friends…including mine! 

In the current context, it seems impossible to convince the most radical anti-vaccinators. Authoritarian and paternalistic management of the crisis is clearly increasing the distrust that gives fuel to the conspiracy theorists. 

What is the solution to this scepticism? There is no vaccination against conspiracy theories. In my opinion, an early-stage transparency campaign and education campaign would have avoided the lack of trust French people have. 

French people need to understand and trust, then to act. And I worry about the impact of the implementation of the health pass that only divides my people. I’m sure there were other ways to reach collective immunity in France.

But let’s focus on the positive! We are soon reaching collective immunity and let’s hope and this effort will weaken this virus enough to allow all of us to go back to a more normal life!

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