[Société] Why do people get fewer vaccinations in Reunion than in France?

“Vaccination coverage is on the rise, with nearly 50% of the eligible population having had a full vaccination schedule compared to 71.6% in the French capital.” The health bulletin issued by the regional health agency, this Tuesday, August 24, indicates that there is a large gap, specifically 21.78% (23.1% since Thursday), between Reunion and the city in terms of fully vaccinated people. But why is this?

To answer this question, we must first understand the calendar. In mainland France, the vaccination campaign began on December 27, 2020. With a priority audience: residents of a nursing home. In Reunion, the start was only launched on January 15, 2021, the time to ship the super-freezers and the first doses of the vaccine. Since the island’s population is much smaller than in France, at first few residents of Reunion were able to be vaccinated. This could explain, indeed, some of the delay in ignition.

Cassure, antivax, and false news

But there are several other factors that could explain the distrust of a part of the population towards vaccination. First, the context. Since 2009 and influenza A (H1N1), “there has been a break in adherence to vaccination. At that time, the message of the importance of universal vaccination was not understood, especially in the face of the reality of a less powerful and less dangerous epidemic than has been announced, in which anti-vaccines have played an important role”, says Professor Catherine Marimoto, Head of the Department of Public Health and Research Support at University Hospital Reunion Result: “The following years we observed more reluctance to vaccinate.”

Slowly but surely, in the wake of the rise of social media, anti-tax rhetoric has risen exponentially. “Anti-tax people are being expressed more and more, on networks, in the media, they are everywhere,” explains Professor Catherine Marimoto. “At the social level, the more educated we are, the more we are able to filter information and sources, and the less we say, the greater the risk of being influenced by fake news,” she continues.

However, according to INSEE study Published in April 2021, “Less than one in five citizens has a higher educational qualification, which is much lower than at the national level (30%). Conversely, nearly one in two (45%) has Few or no diploma, compared to less than one in three nationally (28%).Data that could help explain that a greater part of the population of Réunion, compared to the population of the French capital, shy away from needles.Even if it is true That anti-fax is not only found in the less affluent social classes.

A kind of distrust of government decisions

But not only this. “In some cases, there has been a loss of knowledge of major epidemic risks,” the specialist says. Young people, who are relatively more numerous in Réunion than in France, “lived in a world far from diseases, such as polio and childhood diseases. So they can be under the impression that there is little or no risk.” A sense of invulnerability doesn’t necessarily drive them to rush to vaccinations. “Since July in particular, the island has been relatively untouched by the waves of Covid,” recalls Professor Catherine Marimoto.

“There may be a drag associated with what’s coming from the city, and it’s not always well received,” develops Thierry Malbert, an anthropologist and research professor at the University of Reunion. There is a kind of mistrust in the decisions of the government. There has always been a certain opposition to the rule, especially with regard to things that are brutally imposed. There has to be acceptance.”

Acceptance is approached by many unvaccinated people. “There is a great pole of frequency,” Professor Catherine Marimoto analyzed. “A lot of people want latency and observing time. They need arguments. For example, when we talked about compulsory vaccination, it made a lot of people decide. The snowball effect is a bit slow but overall it happens.”

Poverty, priority and randomness

Others simply do not have the physical means to go to the vaccine. The head of the service says: “Globally people are poorer than in urban France (in 2018, according to INSEE, 39% of Réunion’s population lives below the poverty line in the capital), they are far from care and even further from prevention than public health. For some, there are many other priorities than traveling 20 km for vaccination.”

Evidence, among the four least vaccinated municipalities on the island (the last result made on 15 August), three are among the most affected by poverty (2018 INSEE Studiespublished in 2021). These are Salazie, Cilaos and Le Port.

The geography of the island – high/low tolerances, harshness and remoteness – doesn’t help either. “We know that to vaccinate people, you have to get as close to them as possible,” the health professional explains. A strategy currently being developed by the ARS and some municipalities, through ephemeral or vaccine centers. A strategy that can pay off.

Nature, belief and communication

“There are also different local beliefs compared to the capital, which may explain some of the reluctance to vaccinate,” Professor Catherine Marimoto recalls. “Faith is strong on the island,” continues Thierry Malbert, whose research focus revolves around culture, protection from COVID-19, and belief and ethics. Belief in religion can influence the chosen protection. There may be opposition to al-Qaeda.”

As for the vaccine, others prefer to rely on the virtues of plants and herbal teas. “The aspect of nature and the use of its products are very important in Reunion,” says the anthropologist.

“Finally, the lack of information on vaccines is a source of mistrust and hesitation,” notes the Regional Health Observatory of Réunion, in A study published in 2018. In terms of the campaign against Covid-19, communication was undoubtedly not optimal at first. “You have to convince so that people stick,” Professor Catherine Marimoto confirms. “Convince the attending physician and all health professionals of effective substitutions. Persuade the general public too.” For this, she advocates “education of proximity in order to bring people back to reality, to facts.”

For the latter, “The delay can be compensated. We are soon 50% of the eligible population vaccinated. We are not that bad. But we must continue. It is necessary to exceed 80% to avoid a resumption of the epidemic and above 90% to suppress the spread of the virus.” And there is no difference: This is as true of reunion as it is of mainland France.

Kilian Kerbert