The French Covid-19 vaccination policy did not solve vaccination inequities: a nationwide study on 64.5 million people

Florence Débarre · Emmanuel Lecoeur · Lucie Guimier · Marie Jauffret‐Roustide · Anne‐Sophie Jannot

22 citations0/0 files storedEuropean Journal of Public Health

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Vaccine Coverage and Hesitancy SARS-CoV-2 and COVID-19 Research COVID-19 epidemiological studies

Abstract

BACKGROUND: To encourage Covid-19 vaccination, France introduced during the Summer 2021 a 'Sanitary Pass', which morphed into a 'Vaccine Pass' in early 2022. While the sanitary pass led to an increase in Covid-19 vaccination rates, spatial heterogeneities in vaccination rates remained. To identify potential determinants of these heterogeneities and evaluate the French sanitary and vaccine passes' efficacies in reducing them, we used a data-driven approach on exhaustive nationwide data, gathering 141 socio-economic, political and geographic indicators. METHODS: We considered the association between vaccination rates and each indicator at different time points: before the sanitary pass announcement (week 2021-W27), before the sanitary pass came into force (week 2021-W31) and 1 month after (week 2021-W35) and the equivalent dates for the vaccine pass (weeks 2021-W49, 2022-W03 and 2022-W07). RESULTS: The indicators most associated with vaccination rates were the share of local income coming from unemployment benefits, overcrowded households rate, immigrants rate and vote for an 'anti-establishment' candidate at the 2017 Presidential election. These associations increase over time. Consequently, living in a district below the median of such indicator decreases the probability to be vaccinated by about 30% at the end of the studied period, and this probability gradually decreases by deciles of these indicators. CONCLUSIONS: Our analysis reveals that factors related to poverty, immigration and trust in the government are strong determinants of vaccination rate, and that vaccination inequities tended to increase after the introduction of the French sanitary and vaccination passes.

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References

2021Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment 2021COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics 2020The French public's attitudes to a future COVID-19 vaccine: The politicization of a public health issue 2021Public acceptance of COVID-19 vaccines: cross-national evidence on levels and individual-level predictors using observational data 2021Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021 2021A beautiful idea: how COVAX has fallen short 2018The state of vaccine confidence 2022The French health pass holds lessons for mandatory COVID-19 vaccination

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2023The Brazilian vaccine divide: How some municipalities were left behind in the Covid-19 vaccine coverage 2023Social inequalities and the early provision and dispersal of COVID-19 vaccinations in the United States: A population trends study

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