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