Pandemic worsens lack of trust in public health, say experts.

On the occasion of the annual Public Health Days, experts raised awareness of this reality in order to deal with it. Among the defendants is the misinformation that has spread around the planet faster than the virus. This phenomenon has even been called infodemic by the World Health Organization.

Among the harmful effects observed during the health crisis, there is this growing distrust of vaccines. Vaccine hesitancy, which existed before the pandemic, took on a whole new dimension over the course of the vaccination campaign against the SARS-CoV-2 virus and the booster doses that followed.

At a conference held on Thursday morning, the scientific advisor specializing in immunization at the Institut national de santé publique du Québec Ève Dubé described vaccine hesitancy as a serious public health problem.

A distinction must be made here between vaccine hesitation and refusal of vaccination, or even anti-vaccine activism. These convinced resistants correspond to only a minority of the population, indicates the research of Ms. Dubé, but the hesitant people who are being dragged or who are slow to get their dose are more and more numerous.

In the eyes of Dr. Paul Le Guerrier, who moderated the session, this relative mistrust is not temporary. I believe vaccine hesitancy is here to staylaunched the one who is medical manager of the immunization and vaccination teams against COVID-19 at the Public Health Department of CIUSSS of the Center-South-of-the-Island-of-Montreal.

Loss of trust and communication problems

In addition to the surge of malicious misinformation and misleading information circulating on the Internet and social networks, several other factors have contributed to the erosion of general trust in health institutions.

First, many communities already have a deep distrust of anything that represents authority, be it the state, law enforcement or health institutions. This is particularly the case for groups that have been victims of discrimination or trauma related to colonization.

As for the factors directly related to the management of the pandemic, the confusion in certain public messages would have perplexed part of the population, for example with regard to wearing a mask. This was recognized by the communication advisor to the Ministry of Health and Social Services Viviane St-Gelais, in a presentation Wednesday afternoon.

« The public should have been better prepared for the fact that the recommendations could change quickly from one day to the next according to the evolution of knowledge. »

A quote from Viviane St-Gelais, Communications Advisor at the Ministry of Health and Social Services

At the start of the pandemic, public health had completely rejected the idea of ​​asking people to wear a mask. Then, this measure later became mandatory. According to Ms. St-Gelais, Quebec should have foreseen the possibility of a change and qualified its message.

An illusion of the end of the pandemic

Another aspect that has damaged the bond of trust is the feeling of betrayal that people would have felt after the arrival of the vaccine. While the end of the health crisis was promised as soon as the vaccine arrived, the wave of the Omicron variant hit the health system hard and forced the imposition of new restrictive measures. It was also realized that the vaccine did not prevent contracting the disease, but limited the risk of serious complications.

According to researcher Ève Dubé, people have felt cheated by the speech of end of pandemic that accompanied the start of the vaccination campaign. So many vaccine-friendly people began to conceive of hesitation.

Then, over the doses and reminders, a weariness won another part of those in favor of vaccines. We have thus swelled the ranks of hesitant.

It is now feared that this hesitation, which would affect approximately 14% of Quebecers, will undermine the long-term work with regard to the other routine vaccines administered to children and adolescents. Fears are all the more serious since people aged 34 and under are the most hesitant, according to data from Ms. Dubé.

Possible solutions

Most stakeholders agree that the solution begins with the long term. According to the science journalist at the newspaper The Soleil Jean-François Cliche, the best remedy for misinformation remains good information. However, this implies presenting complete and above all not simplistic information.

The complexity, the nuance, that can be explainedhe argues, casting some of the blame on the media, which sometimes sensationalizes by only showing disaster scenarios drawn from studies that are not at all alarmist.

Other researchers, such as Professor Arnaud Gagneur, from the Faculty of Medicine at the University of Sherbrooke, recommend a personalized approach. Although such an individualized approach seems counter-intuitive in the context of population medicine, Professor Gagneur drew inspiration from the motivational approach, which makes it possible to listen to the concerns of a refractory person in order to then help them resolve her own problem.

Her research project is now being extended to all of Quebec under the EMMIE program (motivational interviewing in maternity for child immunization). This program is intended for new parents in hospital maternity units. We take the time to talk with them about everything related to childhood vaccination.

So far, the results show a significant gain in the vaccination coverage of children and above all a lasting effect on parents’ perception of the benefits of vaccination.

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