Anne-Marie Moulin is a doctor, specialist in tropical diseases, philosopher and director of research emeritus at the CNRS (SPHere laboratory of philosophy and history of science – Paris-I-Panthéon-Sorbonne). She has been conducting research on immunology and vaccination for several decades, combining history and philosophy. She is the author of The Vaccination Adventure (Fayard, 1996) and in 2016 was part of the steering committee for citizen consultation on vaccination, created as part of the consultation organized by the Minister of Health at the time, Marisol Touraine, on maintaining compulsory vaccination in a context of reduced vaccination coverage. In the article “Vaccine hesitation or the impatience of global health”, published on the Life of Ideas site on May 4, 2021, it takes a critical look at the recent concept of “vaccine hesitation”, on which international public health actors rely to probe vaccination intentions.
Where does the concept of vaccine hesitancy come from?
It has imposed itself since the early 2010s to replace what historians until then called “resistance to vaccination”, and public health professionals, “acceptability”. It was very quickly adopted by all players in global health, including both international institutions such as the World Health Organization and philanthropic foundations, including the Bill and Melinda Gates Foundation. Vaccine hesitancy can be studied from all possible angles, depending on age, sex, profession, country or type of vaccine. The interlocutors are probed on their confidence in the efficacy and harmlessness of vaccines, and, in short, the concept of “vaccine hesitation” has reshaped the conceptual and epistemological horizon of the relationship to vaccination and vaccines.
The term was coined in 2016 by American anthropologist Heidi Larson, following an international survey to assess public perception of vaccination. We find this term in December 2021 in issue 116 ofNews and file in public health, review of the High Council for Public Health (HCSP), devoted to the crisis due to Covid-19.
Why do you criticize this concept?
Global health actors have seized on it because it is a watered down term, which, at the start, avoided the stigmatization of antivax, an easy expression, which meets with a soft consensus and eludes angry questions. But it amounts to sticking together very different motivations, and, ultimately, in the context of the Covid-19 pandemic, it will be taken up by the French government, for example to explain the laborious start of the vaccination campaign at the end of the year 2020. Later, it will lead to a global stigmatization of people who are not vaccinated without worrying about the diversity of citizens. However, it would be good for the executive to remember that citizens are different individuals, and that any generality amounts to transforming the country into barracks and bringing people to heel.
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