On the occasion of the annual Public Health Days this week, experts raised awareness of this reality in order to deal with it. In the dock, we identified in particular the mass of misinformation that has spread on the planet faster than the virus. This phenomenon has even been called an “infodemic” by the World Health Organization.
Among the adverse impacts observed closely during the current health crisis is this growing distrust of vaccines. Vaccine hesitancy, which existed before the pandemic, took on a whole new dimension over the course of the vaccination campaign against the SARS-CoV-2 virus and the booster doses that followed.
During a conference held Thursday morning, the scientific advisor specializing in immunization at the National Institute of Public Health of Quebec, Ève Dubé, described vaccine hesitancy as “a serious public health problem”.
A distinction must be made here between vaccine hesitation and refusal of vaccination or even anti-vaccine activism. These convinced resistance fighters remain only a small minority of the population, shows Ms. Dubé’s research, but the hesitant who are getting their ears out or who are slow to get their dose are more and more numerous.
In the eyes of Dr. Paul Le Guerrier, who led the workshop, this relative mistrust is not temporary. “I believe that vaccine hesitation is here to stay,” said the man who is medical manager of the immunization and vaccination teams against COVID-19 at the public health department of the CIUSSS du Centre-Sud-de-l. ‘Island of Montreal.
A slow crumbling
In addition to the surge of malicious misinformation and misleading information circulating on the internet and social networks, several other factors have contributed to the erosion of general trust in health institutions.
First, many communities already have a deep distrust of anything that represents authority, whether it be the state, law enforcement or health institutions. This is particularly the case for groups that have been victims of discrimination or trauma related to colonization.
As for the factors directly related to the management of the pandemic, the confusion in certain public messages would have perplexed part of the population, acknowledged the communications advisor to the Ministry of Health and Social Services, Viviane St-Gelais, in a presentation on Wednesday afternoon.
“We should have better prepared the public for the fact that the recommendations could change quickly from one day to the next according to the evolution of knowledge”, she conceded, targeting more precisely the case of wearing a mask.
At the start of the pandemic, public health had completely rejected the idea of asking people to wear a mask. Then, this measure later became mandatory. According to Ms. St-Gelais, Quebec should have foreseen the possibility of a change and qualified its message.
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Another aspect that has damaged the bond of trust is the feeling of betrayal that people would have felt after the arrival of the vaccine. While the end of the health crisis was promised as soon as the vaccine arrived, the wave of the Omicron variant hit the health system hard and forced the imposition of new restrictive measures. It was also realized that the vaccine did not prevent contracting the disease, but limited the risk of serious complications.
According to researcher Ève Dubé, people “felt cheated” by the “end of the pandemic” speech that accompanied the start of the vaccination campaign. Thus, many vaccine-supporters began to develop an onset of hesitancy.
Then, over the doses and reminders, a weariness won another part of people in favor of vaccines. The ranks of the “hesitant” have thus been swelled.
It is now feared that this hesitation, which would affect approximately 14% of Quebecers, will undermine the long-term work behind the other routine vaccines given to children and adolescents. These fears are all the more serious since people aged 34 and under are the most hesitant, according to data from Ms. Dubé.
Possible solutions
Most stakeholders agree that the solution begins with the long term. According to the journalist specializing in science at the newspaper Le Soleil, Jean-François Cliche, the best remedy for misinformation remains good information. However, this implies presenting complete and above all not simplistic information.
“The complexity, the nuance, that can be explained,” he argues, throwing some of the blame on the media, which sometimes sensationalizes by only showing disaster scenarios drawn from studies that are not at all alarmist.
Other researchers, such as Professor Arnaud Gagneur, from the Faculty of Medicine at the University of Sherbrooke, recommend a personalized approach. Although such an individualized approach may seem counter-intuitive in a population medicine context, Professor Gagneur drew inspiration from the motivational approach, which above all makes it possible to listen to the concerns of a refractory person and then help him solve her own problem.
His research project is now being deployed across Quebec under the EMMIE program. This program is aimed at new parents, in the maternity units of hospitals. We then take the time to talk with them about everything related to the vaccination of children.
So far, the results show a significant gain in the vaccination coverage of children and above all a lasting impact on parents’ perception of the benefits of vaccination.