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Illustration of a doctor. – Pixabay
- Caregivers and staff from medical and social facilities should be among the first to receive injections of an anti-Covid vaccine.
- But at the moment, many of them are suspicious and indecisive, which is not surprising as there are still a lot of questions about these vaccines.
- These health workers will be the first to convince if the government wants to be successful in its vaccination campaign, which could be based on their example and the trust they inspire in the population.
“Get vaccinated? I don’t know what will be in this vaccine, or the consequences it will have on my health. No, I will wait and let others serve as guinea pigs,” warns Morgane, 27, a nursing home nurse. who responded to our request for testimony.
This Monday, the High Authority of Health (HAS) defined the different phases of the vaccination campaign in France. Residents, as well as health workers from older nursing homes and those suffering from comorbidities, will be part of the first wave. Other caregivers could be part of phases 2 and 3 of the plan. Emmanuel Macron also made it clear that the Covid-19 vaccine would not be mandatory.
Not enough hindsight
When the first doses of vaccines arrive that have gotten the green light from the European Union, there could be a lot of educational work if the government wants caregivers to agree to get vaccinated. Lucas, a 25-year-old physiotherapist, “does not want to be vaccinated because of the rapid introduction of the vaccine, which does not yet allow us to see the long-term side effects.” Similarly, Mélodie, who works in nursing homes, questions the priority of the public. “I have no faith in the state and even less in pharmaceutical companies. Using our professional situation to invite us to act, I’m not a fan at all. Other branches, such as restaurateurs, are also at risk ”.
While some regret the pressures of their hierarchy, and sometimes even guilt, others qualify. “I’m for vaccines, my children and I are vaccinated,” explains Céline, 47. For Covid-19, when hindsight will be enough, I’ll think about it, but not for this year “. Annie, 48 and a home caregiver, tells a completely different story. “I want to get the flu shot, I’ve been doing it against the flu for at least thirty years. I find it normal to protect the residents. But I know, alas, that 90% of my colleagues won’t … They will be more likely to be vaccinated if the airlines dictate it, because holidays matter more than residents … “
Too many uncertainties to draw conclusions
As we have seen, acceptability does not seem to be won. Not surprisingly, given that very little is still known about these anti-Covid vaccines. Alexis Spire, a sociologist at the National Center for Scientific Research (CNRS), is leading a research project on caregiver trust in state institutions in times of Covid-19. For eighteen months and until September 2021, he investigates two hospitals in Ile-de-France and in the Grand-Est. “Most of what we have seen are not anti-vaccines,” he explains. In the interviews we had very few certain and definitive answers on the Covid-19 vaccine, it is too early because there are many uncertainties. To say today what is the acceptability of this vaccine seems to me very fragile. “
The flu vaccine, a revealing example
A great uncertainty would therefore remain. But the example of the flu shot seems revealing. “The problems are quite similar with Covid-19, Alexis Spire points out. Those who refuse to be vaccinated against the flu will also refuse to do so against Covid “. What to worry about. “Influenza vaccination rates among nurses are very limited, even in services in contact with people at risk, for example in geriatrics,” he analyzes. And it is lower among nurses and orderlies than among doctors and health managers. “
This is confirmed by the latest data from Public Health France. During the 2018-2019 season, 35% of caregivers in healthcare facilities were vaccinated (67% of doctors, 48% of midwives, 36% of nurses and 21% of nursing assistants). They were 32% in nursing homes (75% for doctors, 43% for nurses, 27% for nursing assistants and 34% for other paramedics). The problem of making the flu vaccine mandatory emerged in September 2020. “It is better to rely on incentive than constraint,” advises Alexis Spire.
Why do some caregivers refuse to be vaccinated?
How to explain that caregivers, who have a minimum of scientific background and spend their days in contact with patients, are so recalcitrant? Several explanations emerge from the interviews conducted by the researcher. “What emerges most often, and which is common to paramedics and doctors, is that they are not afraid of getting sick because they think they are immune from contact with the sick,” he explains. The second reason is that it would be absurd to want to inoculate a disease, especially since the vaccine is not always effective. Finally, a third justification, which goes back to nurses and nursing assistants: since the hospital encourages people to vaccinate, it is suspected that they want to limit sick leave ”.
Two main differences, however, prevent this relationship from being transposed to the coronavirus flu vaccine. The first is efficiency: we know that the flu shot, which must be repeated every year, is only 60 to 70 percent effective. The second point concerns safety: we do not know at all what the side effects of Covid-19 vaccines would be, unlike the one against influenza, known and mastered for decades.
A lever to restore trust
The game will be tight for the government. “There is a combination of two things in France: we are the champion country of distrust of political elites and vaccination,” continues Alexis Spire. Furthermore, contradictory injunctions since March in the face of the coronavirus have further fueled this mistrust. The French we interviewed, caregivers or not, can understand that there was a part of surprise, of unpreparedness in the face of the epidemic. What is very frowned upon is the lie and the fact that mistakes have not been recognized. This is why, in this rather tense context, the vaccination campaign cannot be conducted without or against caregivers.
Beyond the responsibility incumbent on them, there is also a question of exemplarity. “One of the findings of our investigation is that for there to be any form of trust in this vaccine, intermediaries are needed between the public authorities sending a message and the people who organized this campaign,” insists Alexis. Spire. Caregivers are very attentive to doctors, the heads of the clinics in their ward, with whom they are in direct contact. Convincing hospital doctors is key to reaching caregivers. Just how convincing primary care doctors is key to reassuring the general population. “
Especially since the government wants at all costs to avoid the fiasco of the vaccination campaign against H1N1 in 2009. The numerous stocks in fact had not found buyers … “We did it at the time of vaccinations and we have completely expelled general practitioners, recalls Alexis Spire. Vaccinating in the chain does not help alleviate fears … “
For general practitioners, the expectation is the same. “We can imagine that if we are not in maximum safety conditions and only 5% of caregivers are vaccinated, the population will not be vaccinated, warns Luc Duquesnel, general practitioner in Mayenne and president of the Les Généralistes-CSMF union. , that I put on a badge “your doctor is vaccinated”, that my colleagues do the same, just like the pharmacist, the nurse, that will have an impact, because the French trust us. “
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