Abstract
ABSTRACT Purpose: Vaccine hesitancy is common in France, including among general practitioners (GPs). We aimed to understand vaccine hesitant GPs’ views towards vaccines. Method: We conducted in-depth interviews that were thematically analysed. Result: We found that, facilitated by health scandals and vaccine controversies—that according to participants were not effectively handled by health authorities—the implicit contract existing between health authorities and GPs has been ruptured. This contract implies that health authorities support GPs in making vaccine recommendations by addressing GPs’ own concerns, providing them with adequate and up-to-date information and advice, and involving them in vaccine decision-making. In turn, GPs encourage vaccination to reach vaccine coverage targets. Conclusion: The rupture of this implicit contract has led to a breach in trust in the health authorities and the vaccines that they recommend.
Highlights
For the majority of those in high and middle-income countries, vaccination is part of an established health care routine
● general practitioners (GPs)’ reluctant trust in the health authorities in France—This theme relates to the reluctant trust GPs had to cultivate for health authorities and their advice—despite the perceived impartiality of the latter, as well as various health scandals— in order to carry out their work
● GPs’ adoption of socially constructed knowledge —Participants often relied on socially constructed knowledge relating to their own experiences, as well as those of colleagues to inform their views of various vaccines and whether they recommended them to patients
Summary
For the majority of those in high and middle-income countries, vaccination is part of an established health care routine. Many countries are experiencing a reduction in vaccine confidence. The 67country survey conducted by Larson et al in 2016 found that the global average of safety and effectiveness-related vaccine scepticism was 13% and 9% respectively. Respondents from France (45%), Bosnia & Herzegovina (38%), and Japan (31%) reported the highest rates of safety-related scepticism, and Bosnia & Herzegovina (27%), Russia (20%), and Italy (19%) had the highest rates of effectiveness-related scepticism. The European region had lower confidence in the safety of vaccines than other world regions. This region accounted for seven of the ten countries with the lowest levels of safetybased confidence issues, including France, Greece, Slovenia, and Italy. Vaccine confidence has significantly decreased in Poland, Sweden, Finland and Belgium. Vaccine confidence has significantly decreased in Poland, Sweden, Finland and Belgium. (Larson, de Figueiredo, et al, 2018)
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