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

Abstract

Objective To assess whether mistrust in the government and scientists reinforces social and racial inequalities in vaccination practises Design A follow-up of a random population-based cohort survey. Setting In July 2021, in France. Participants 80,971 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 mistrust 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 racialised minorities, as compared to vaccinated people. Mistrust of 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. Mistrust was more prevalent among the poorer which consequently reinforced social inequalities in vaccination. The 10% poorest who did not trust the government reached an OR of 16.2 (11.9 to 22) for refusing to be vaccinated compared to the 10% richest 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.

The French Covid-19 vaccination policy did not solve vaccination inequities: a nationwide longitudinal study on 64.5 million individuals

“…These accessibility issues may also explain the association we find between lower vaccination rates and living in a district with a high proportion of immigrants, which may for instance reveal language barriers. These associations of lower vaccination rates with more poverty and with higher proportions of immigrants in the district of residence are compatible with the results of a survey conducted in July 2021 in France (Bajos et al 2022) on close to 81000 participants, which indicated that unvaccinated respondents were more likely to have lower income and more likely to belong to racialised minorities than vaccinated respondents…”

“…K. Ward et al 2022; Lindholt et al 2021). A survey conducted in July 2021 in France confirmed that trust in the government and trust in scientists were associated to higher odds to be vaccinated (Bajos et al 2022). Votes for Mr Asselineau – which represented a minority of cast votes in 2017 in France (less than 1% overall) – can be interpreted as mistrust in the government (or more generally, against the establishment): This candidate for instance proposed that France exits the European Union, leave the Euro zone and reinstall the Franc currency; he was a proponent of hydroxychloroquin and ivermectin during the Covid-19 pandemic, and publicly expressed doubts about the safety of available Covid-19 vaccines.…”

“…In addition, although the different indicators are analysed independently in our study, their combinations may affect vaccination rates. For instance, the effect of mistrust in the government on vaccination refusal was shown to be even stronger among individuals from lower social classes than from higher social classes (Bajos et al 2022). Finally, our data do not inform directly on the reasons for non-vaccination – e.g., whether it is hesitancy, refusal, or accessibility issues, which is why our approach is complementary to qualitative surveys.…”