'I Think I Made The Right Decision I Hope I'm Not Wrong'. Vaccine hesitancy, commitment and trust among parents of young children.

During the last decade, public health research has emphasised the growing public disaffection with vaccination. This contemporary vaccine hesitation (VH) refers to a delay in acceptance or refusal of vaccines, as well as agreement despite doubt and reluctance. We investigated VH among French parents of young children, with an emphasis on two key features of VH: trust towards physicians and commitment to vaccination issues. We targeted two populations with contrasting socioeconomic profiles, using in-depth interviews (n = 25). Most parents exhibited some kind of VH, with differentiated attitudes across vaccines, including acceptance despite enduring doubts, especially for vaccines already provided to older siblings ('vaccine inertia'). Despite the rise of the Internet and social media, our participants still strongly relied on face-to-face interactions with peers and significant others. Most participants trusted their own physician but this was the result of a selection process: they had engaged resources to find a physician they could trust. Participants with contrasted socioeconomic profiles struggled with the same dilemmas, and they committed themselves to the same quest to find the 'right' physician. Nevertheless, parents with a higher socioeconomic status were able to engage more resources and use a wider repertoire of actions, and they also displayed greater health literacy.

Flu vaccination among patients with diabetes: motives, perceptions, trust, and risk culture - a qualitative survey.

BACKGROUND: Vaccination against seasonal influenza (SIV) is recommended for patients with diabetes, but their vaccination coverage is unsatisfactory in France and elsewhere. This qualitative survey of people with diabetes sought to explore 1) the extent to which SIV-related behaviour is more or less automatic; 2) reasons they choose/reject SIV; 3) their trust/distrust in authorities, science, and medicine. METHODS: We conducted semi-structured in-depth interviews of 19 adults with diabetes in 2014. We recruited them through physicians or patient associations and implemented an analysis of thematic content. RESULTS: Eight patients were vaccinated against flu in the preceding flu season and 11 were not. SIV uptake and refusal were stable over time and justified by multiple arguments. Coupons for free vaccines and regular doctor visits contributed to the habit of vaccination. Vaccination decisions were frequently anchored in past experiences of influenza and its vaccine. Patients often justified non-vaccination with attitudes of trivialisation/relativisation of influenza-associated risks and the perception that these can be controlled by means other than vaccination (e.g., through the avoidance of exposure). Some misbeliefs (e.g., SIV causes influenza) and doubts about SIV effectiveness and safety also existed. Several patients reported increased mistrust of SIV since the A/H1N1 pandemic in 2009. Patients trusted their doctors strongly regardless of their SIV behaviour, but unvaccinated patients had little trust in the government and pharmaceutical companies. Some discordances were found between perceptions and behaviour (e.g., remaining vaccinated despite doubts about SIV effectiveness or remaining unvaccinated despite feelings of vulnerability towards influenza complication), suggesting the existence of some vaccine hesitancy among patients. CONCLUSION: This study among patients with diabetes suggest that SIV uptake is stable, thanks to a favourable environment. Nonetheless, SIV refusal is also stable over time. Unvaccinated patients used multiple arguments to justify SIV refusal, including compensatory health beliefs. Physicians should take every opportunity to recommend SIV. The necessary individualised patient education regarding SIV requires better physician training in patients priorities. While almost all patients strongly trust their doctors, unvaccinated patients distrust distal stakeholders: it is absolutely essential to restore trust in them and to develop new more effective influenza vaccines.

[Risk perception of the general public of cell phone towers and cancer: trend and associated factors, 2005-2010]. / Antennes-relais et cancer: évolution et déterminants du risque perçu par le public, 2005-2010.

The purpose of this study was to assess risk perception related to living near a cell phone tower based on data from two national telephone surveys conducted in France in 2005 and 2010. In 2005, 48.5% of French people aged 16-75 years considered that living near a cell phone tower increases the risk of cancer, compared to 68.9% in 2010. In addition, the number of ?don't know' responses decreased. The increase in risk perception was far greater than the increase in perceptions related to other potential environmental factors of cancer (nuclear power plant, air pollution, chemically-treated food). In 2005, the perceived risk of cancer due to exposure to cell phone tower radiation was correlated to gender, level of income, size of town and sensitivity to other environmental causes of cancer. However, these correlations were weaker in 2010. This risk perception may reflect non-specific fears and a lack of trust in the authorities, but is also rooted in a local context.

Vaccine hesitancy among general practitioners in Southern France and their reluctant trust in the health authorities.

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.