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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.
Objectif: L’hésitation vaccinale est fréquente en France, y compris chez les médecins généralistes. Nous avons cherché à comprendre le point de vue des médecins généralistes expriment des incertitudes sur les vaccins. Méthode: Nous avons réalisé des entretiens approfondis qui ont fait l’objet d’une analyse thématique. Résultats: Nous avons trouvé que, favorisée en partie par crises sanitaires et des controverses vaccinales - qui selon les participants ont été mal gérées par les autorités sanitaires - le contrat implicite entre les autorités de santé et les médecins généralistes a été rompu. Ce contrat implique que les autorités aident les médecins généralistes à appliquer les recommandations vaccinales, en répondant aux inquiétudes des médecins généralistes; en leur fournissant des informations et des conseils adéquats et à jour; et en les impliquant dans la prise de décision en matiére de vaccins. À leur tour, ceux-ci sont vacciner afin d’atteindre les objectifs de couverture vaccinale. Conclusion: La rupture de ce contrat implicite a suscité une rupture de confiance envers les autorités sanitaires et des vaccins qu’elles recommandent.
Acknowledgments
We would like to express our gratitude to those who participated in the study. We would also like to acknowledge the French National Research Agency for funding the study.
Disclosure statement
No potential conflict of interest was reported by the authors.
Compliance with ethical standards
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from the Aix Marseille University Ethics Committee (ref: 2016-05-12-002). Informed consent was obtained from all individual participants included in the study.
Notes
1. See Appendix A for a map of study sites.
2. This is the most recent available data.
3. National immunization schedule.
Additional information
Funding
Notes on contributors
Rose Jane Isobel Wilson
Rose Jane Isobel Wilson Medical Anthropologist specialising in vaccine hesitancy particularly among pregnant women and healthcare professionals.
Chantal Vergélys
Chantal Vergélys Sociologist specialising in risk perception.
Jeremy Ward
Jeremy Ward Sociologist specialising in sociological theory, qualitative social research, communication and media.
Patrick Peretti-Watel
Patrick Peretti-Watel Sociologist, research director at the French National Institute For Health & Medical Research (INSERM).
Pierre Verger
Pierre Verger Epidemiologist and Director of the Provence-Alpes-Côte d’Azur Regional health observatory.