Science’s COVID-19 reporting is supported by the Heising-Simons Foundation.
All across Europe, coronavirus vaccines are in scarce supply. But in France, they are also surprisingly unwanted: Recent polls suggest just 57% of the country intends to get vaccinated, whereas in the United Kingdom, 89% wants to get a shot for COVID-19. With persistent, world-leading rates of vaccine skepticism, France is adopting a new tactic to boost trust. A 35-member citizens’ vaccine panel, built from a random but demographically representative slice of the country, met for the first time last month in an effort to steer government strategy on COVID-19 vaccinations. The panel is one of an increasing number of citizen assemblies that have been set up across Europe to grapple with thorny questions at the intersection of science and society.
The panel’s first advice is due in a progress report on 23 February. Alain Fischer, a pediatric immunologist at the College of France and president of the government’s vaccine strategy board, hopes the group can identify the information the public wants and how it should be presented, so it can be “understood by everyone, regardless of their knowledge of vaccines.” He also expects the panel to provide practical tips, such as how to provide vaccinations in remote rural areas. “Citizen panelists usually have a good grasp of the issues,” he says. Some critics, however, say the government already receives plenty of citizens’ input, and they question the need for the new body.
Heidi Larson, who directs the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, says the memory of past health scandals accounts for some of the French wariness about vaccines. In the 1980s, HIV-contaminated blood transfusions are thought to have infected hundreds of people with hemophilia, while the anti-diabetes drug Mediator may have killed hundreds of people before regulators finally took it off the market in 2009. “This is partly why the French people’s default position is distrust,” Larson says.
Her project’s 2016 study of vaccine confidence showed France ranked last among 67 countries, with 41% of respondents saying they believed vaccines were unsafe. Larson says the findings helped the French government realize how big the problem was, and since then, trust in vaccines has risen a bit. Her project’s latest polling, from December 2020, shows France fifth out of 32 nations for vaccine antipathy. “The French are incrementally more confident, but they are still at the low end in international comparisons,” Larson says. The government has “made a significant effort in communication, but needs to focus more on the listening side of the dialogue.”
Citizen groups offer a chance for this listening—or at least the appearance of it. Fischer notes how an earlier group contributed to the debate before parliament passed a law that, starting in 2018, boosted the number of required vaccinations for infants from three to 11. The group agreed the vaccinations were “indispensable,” and, because immunity was dropping, they could be made mandatory, provided that pediatricians and the public were well informed, Fischer says. “There had been huge opposition to the idea,” he says. “But 3 years later, protests are now barely a murmur and children are being inoculated as required.”
The new vaccine panel is designed to be more than an ad hoc gathering. Its members match French society by age and education level and include a representative contingent of people with skeptical views of vaccines. Run by the Economic, Social and Environmental Council (CESE), an assembly of organizations from civil society, the panel can call for presentations by any experts it wants, and it will remain in business until the end of the vaccination campaign. It follows last year’s 150-strong Citizens Climate Convention, which was also organized by CESE, and which generated dozens of recommendations, some of which will be included in a law expected to pass later this year. “We have certainly gained in notoriety,” says CESE President Patrick Bernasconi.
To Cédric Villani, a mathematician and independent member of parliament, the panel is “just one too many.” Already, says Villani, who is also president of the Parliamentary Office for Scientific and Technological Assessment, “There are about a dozen official bodies managing the COVID-19 pandemic in France, several of which have a citizen’s component.” But Larson says it is an important gesture. “Efforts to engage citizens should never be mocked.”
Even without the efforts of the vaccine panel, French sentiment about vaccines appears to have shifted, at least for COVID-19. The latest figure for the proportion who intend to get vaccinated, 57%, is 17 points higher than it was in December 2020, according to an Ipsos poll.
But Pierre Verger, an epidemiologist, vaccine hesitancy specialist, and director of the Southeastern Health Regional Observatory in France, says skepticism still runs deep—even among the experts themselves. A recent unpublished survey of 1000 French doctors, conducted by Verger’s observatory and the health ministry, suggests 25% are uncertain about or hostile to COVID-19 vaccines. “The media has gone overboard reporting that the French have changed their mind on vaccines,” he says. “There has been an improvement, but not nearly as much as reports suggest.”