Why don't health care workers in France trust the COVID-19 vaccine?

Dear Editors,

The emergence of vaccines, particularly with the development of messenger RNA technology, is a new hope in the battle against COVID-19 [1]. Unfortunately, it seems that there is a lot of mistrust of the vaccine among health care workers. This situation is particularly acute in France. In April 2021, only 51% of the French medical health workers had received a first dose of vaccine, and only 25% had received both doses [2]. These data are in contradiction with a survey of 2512 caregivers carried out in in March/April 2020 showing that 81.5% of them said that they wanted to get vaccinated [3]. How can we explain this mistrust of vaccination that is still so pervasive in emergency departments and among health workers fighting against COVID-19 after a 1-year battle? [4]

Since the first COVID-19 cases, disinformation has spread widely through traditional media and social media, called an “infodemic” by the World Health Organization (i.e., excessive amounts of misinformation and rumors that make it difficult identify reliable sources of information) [5]. Moreover, social media and media gave the opportunity to the conspiracy plot and some eminent famous physician “experts” gave their opinion against the government’s strategy [6]. The mistrust of French population has begun to increase as a result of ethical questions or scientific debates about effectiveness of medicines (i.e., hydroxychloroquine, Zinc) as many contradictory studies (not randomized controlled trials) have not given a strong strategy for treating patients [7]. The pandemic has broken the barrier between medical and policy as expressed in recent studies [8].

The main concern of French-speaking health care workers (France, Belgium and Quebec) about the COVID-19 vaccines seems to be the ability to develop them in one year, especially those based on genetic technology [4]. On the other hand, in Europe and particularly in France, a negative attitude towards vaccines has existed and has persisted for many years [9]. An anti-vax community has developed with influential health professionals in their ranks. Thus, each publication on vaccine side effect or policy decisions to stop the use of some vaccines (e.g., AstraZeneca) feeds suspicion, even among health professional [8, 10]. This is probably one of the reasons why, although vaccination may be thought to play a fundamental role in the prognosis of the population, and even if it is strongly recommended, it is not mandatory.

Thus, we could sum up that, in France, health workers’ mistrust of the immunization process is secondary to political issue, new vaccines and low-level scientific debates. We think that French experience of vaccination is not isolated, and no country is immune from a rise in mistrust. In the face of uncertainty about the evolution of the pandemic, pedagogy and transparency of information must be the key points of a global treatment strategy. In the case of health workers, because they are recognized to be at high risk of infection in the workplace, vaccination rate of these personnel must be exemplary [11]. Therefore, their personal and professional responsibility is at the forefront.