Vaccine passport: why so much doubt?

Accord­ing to a sur­vey by the Eco­nom­ic, Social and Envir­on­ment­al Coun­cil ¹, 67% of French people are “highly unfa­vour­able” to the adop­tion of a “vac­cine pass­port”. How do you explain this opposition?

Étienne Min­vi­elle. The pass­port offers a way to reopen places that are cur­rently closed and to start trav­el­ling again. But many people see it as a form of infringe­ment of indi­vidu­al freedoms and a poten­tial source of inequal­ity. The pass­port is sup­posed to be an incent­ive for vac­cin­a­tion, yet access to vac­cines is still prob­lem­at­ic. So, to gen­er­al­ise a vac­cine pass­port now would be giv­ing freedoms to those who lucky few who have been able to bene­fit from it so far. 

Hence, this would cre­ate inequal­it­ies on both nation­al and inter­na­tion­al levels, likely to fuel bit­ter­ness of non-vac­cin­ated indi­vidu­als and sus­pi­cions of enti­tle­ment. The crisis is put­ting social cohe­sion to the test, and the reluct­ance to put this pass­port into cir­cu­la­tion is a testi­mony to this.

Who are those who oppose this passport?

There is wide­spread fear of sur­veil­lance among most French people and the pass­port, since it increases trace­ab­il­ity, increases this fear. Many people also have doubts about the risks and effect­ive­ness of vac­cines. We can see this clearly with the con­tro­versy sur­round­ing AstraZeneca’s doses: people are wor­ried about the lack of hind­sight and fear poten­tial side effects.

But it’s not just the clin­ic­al sphere that is con­cerned. Many people under­stand the med­ic­al benefit/risk ratio but are still scep­tic­al about the inten­tions of those who are push­ing for vac­cin­a­tion. There is a social – almost iden­tity-based – rejec­tion of polit­ic­al and med­ic­al elite. This scep­ti­cism can bor­der on con­spir­acy when cit­izens come to ima­gine col­lu­sion between elites and phar­ma­ceut­ic­al labor­at­or­ies. We are there­fore see­ing the emer­gence of a form of res­ist­ance, based on the rejec­tion of the dis­course of the elite, of which the first and fore­most is the government.

There is wide­spread fear of sur­veil­lance among most French people and the pass­port, since it increases trace­ab­il­ity, increases this fear.

How can those people be con­vinced of the effect­ive­ness of vaccines?

For people who have doubts about the clin­ic­al effect­ive­ness of vac­cines, med­ic­al staff simply need to explain the clin­ic­al res­ults, which prove that vac­cines are not dan­ger­ous. In the case of AstraZeneca, for example, no link between the vac­cine and throm­bos­is has been demonstrated.

For those whose doubts are based on socio-iden­tity cri­ter­ia, the mis­take is to believe that words by doc­tors and author­ity fig­ures are enough ². The vac­cin­a­tion of elites can even send a neg­at­ive sig­nal: the fact that Jean Cas­tex was vac­cin­ated with a dose of AstraZeneca can be inter­preted as proof of his links with the labor­at­or­ies. The response is there­fore not be clin­ic­al, rather it is social. 

We need to devel­op a dif­fer­ent kind of com­mu­nic­a­tion, based on influ­en­cers play­ing the role of “trus­ted third parties” [Pres­id­ent Mac­ron prom­ised fam­ous you­tubers McFly and Carlito to take part in one of their videos if they made a music video on pre­vent­ive meas­ures that reached 10 mil­lion views]. The vac­cin­a­tion of rap­per Booba (sug­ges­ted in a post on his Ins­tagram account) is in this sense not entirely anec­dot­al, not least because he is fol­lowed and listened to by a some of these con­spir­acy the­or­ists. The mixed reac­tion of his fans on social net­works shows the lim­its of this meth­od: people are not fooled, and often per­ceive this com­mu­nic­a­tion as an attempt at manipulation.

So, there is no mir­acle solu­tion for con­vin­cing people who doubt?

It is extremely dif­fi­cult to con­vince people who do not want to be con­vinced. To take just one example, one study showed that par­ents who were reluct­ant to vac­cin­ate their chil­dren became even more scep­tic­al when they were presen­ted with data that shattered the myth of aut­ism risk due to vac­cines ³. Although coun­ter­in­tu­it­ive, this pos­i­tion does not reflect a lack of intel­li­gence. It demon­strates that sci­entif­ic evid­ence is rejec­ted when it dis­turbs beliefs.  It is there­fore not the con­clu­sion that counts, but who pro­duces it.

The trans­mis­sion of inform­a­tion is not just a sender/receiver rela­tion­ship! It requires tak­ing into account the whole social con­text: people are not just clin­ic­al cases. In can­cer patients, for example, the rate of non-adher­ence to pre­scrip­tions is close to 20% in dif­fer­ent clin­ic­al con­di­tions ^{4 5}. This res­ults in con­sid­er­able loss of oppor­tun­ity and is inex­plic­able from a strictly clin­ic­al point of view. In the work we are cur­rently doing, this non-adher­ence seems to be explained by social phe­nom­ena: the rela­tion­ship to life, the level of isol­a­tion, las­sit­ude or the deteri­or­a­tion of the pro­fes­sion­al situ­ation. This social dimen­sion must be taken into account to optim­ise care. The same approach must be adop­ted to under­stand the reluct­ance of cit­izens to be vac­cin­ated and the health passport.

Interview by Juliette Parmentier and Clément Boulle