Wednesday , January 27 2021

How to vaccinate a nation of skeptics

A Covid-19 vaccine is getting closer, and governments are scrambling to meet the financial and logistical challenge of immunising their populations in a short space of time. Hopes for a pickup in global economic growth next year depend on it.
But the bigger challenge may end up being psychological: How to convince people to actually take the shot. Achieving herd immunity may mean at least 80% of people will need the vaccine, leaving little room for error.
Polls suggest it’s France, the birthplace of vaccine pioneer Louis Pasteur, that will be the country to watch. A recent Ipsos survey found that only 54% of French adults would be willing to get a Covid-19 vaccine when it’s available, the lowest score of 15 countries. (The US was second-to-last.)
While France has its share of anti-vaxxers, the main reasons for skepticism are questions about efficacy and a fear of side effects, rather than outright opposition. France is also vulnerable for other reasons: It’s a highly-medicalised society where antibiotics have tended to be over-prescribed, pushing people towards natural remedies. Even 26% of French doctors think some recommended vaccines are useless. Vaccine hesitancy isn’t new, but it’s complex.
We don’t know how the holdouts will really react when immunisation campaigns begin, but it’d be reckless to assume they’ll automatically get in line. France’s child vaccination coverage is above 90%, like many rich countries, but that’s largely because 11 of them are required by law and conditional for access to schooling. There’s little appetite to make a Covid vaccine No. 12 on the list in case it fuels a backlash. So people will have the power to refuse it, and a likely need for a two-shot course raises the risk of dropouts.
Communication will be key. Fear of side effects runs deep among the vaccine-hesitant and it’s very hard to dislodge misinformation. When Gerard Araud, a former French ambassador to the US, recently tweeted his support for vaccination, he was flooded with so many anti-vaxx responses that it became impossible to answer them all. It’s the social media equivalent of “Gish Gallop.”
President Emmanuel Macron hopes creating a committee of scientists to focus on vaccine take-up and recruiting members of the public to spread the word will help. But support should also be enlisted from the medical community at large. Family doctors are the “last mile” of vaccination, and they need to be advocates. That’s made a big
difference in uptake of
the human papillomavirus (HPV) vaccine that protects against cervical and other forms of cancer.
Even something as simple as an HPV fact sheet was enough to increase intent
to vaccinate from 49% to 70% in one group, according to research cited in Jonathan M Berman’s book “Anti-Vaxxers.”
The most effective nudges will be community-based. Rather than lecture skeptics and risk hardening their opposition, it’s better to focus on positive kinds of peer pressure: The altruism of saving others, the benefits of not being ill and the role modeling parents can do by getting vaccinated themselves.

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