title: Attitudes toward vaccination and the H1N1 vaccine: poor people's unfounded fears or legitimate concerns of the elite?
abstract: In 2009-2010, the H1N1 episode occurred in a general context of decreasing public confidence in vaccination. We assumed opposition to vaccination in general to be an 'unfounded fear', reflecting ignorance and perceived vulnerability among low-socioeconomic status (SES) people, and opposition to the H1N1 vaccine a 'legitimate concern' reflecting the elite's commitment to 'risk culture' in a 'risk society'. We indirectly tested these assumptions by investigating the socioeconomic profiles associated with opposition to vaccination in general and opposition to the H1N1 vaccine specifically. Our second aim was to determine whether or not opposition to the H1N1 vaccine fuelled opposition to vaccination in general. We used data from a telephone survey conducted in 2009-2010 among a random sample of French people aged 15-79 (N = 9480). Attitudes toward vaccination in general and toward the H1N1 vaccine specifically varied significantly between October 2009 and June 2010 with strong correlation being observed between these attitudes throughout the whole period. In multivariable analysis attitudes toward vaccination in general remained a significant predictor of attitudes to the H1N1 vaccine and vice versa, for distinct profiles as follows: males, older people, low-SES people for opposition to vaccination in general, versus females, people aged 35-49 and those with an intermediate SES for opposition to the H1N1 vaccine. Results also differed regarding indicators of social vulnerability, proximity to preventive medicine and vaccination history. The first profile supported the "unfounded fears expressed by low-SES people" hypothesis, while the second echoed previous work related to middle-classes' "healthism". Opposition to vaccination should not be reduced to irrational reactions reflecting ignorance or misinformation and further research is needed to acquire a greater understanding of the motives of opponents.
authors.affiliation: INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France. Electronic address: patrick.peretti-watel@inserm.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Peretti-Watel
authors.affiliation: Department of Social and Behavioral Sciences, EHESP Rennes, Sorbonne Paris Cité, France; Aix-Marseille Univ, UMR EPV Emergence des Pathologies Virales - 190, France.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Raude
authors.affiliation: INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France.
authors.forename: Luis
authors.initials: L
authors.lastname: Sagaon-Teyssier
authors.affiliation: Department of Social and Behavioral Sciences, EHESP Rennes, Sorbonne Paris Cité, France; INSERM U897-IFR99, Equipe Avenir Prévention et Prise en Charge des Traumatismes, ISPED, Bordeaux, France.
authors.forename: Aymery
authors.initials: A
authors.lastname: Constant
authors.affiliation: INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Verger
authors.affiliation: Institut National de Prévention et d'Education pour la Santé (INPES), 93203 St Denis Cedex, France; Cermes3 - Equipe Cesames (Centre de recherche Médecine, Sciences, Santé, Santé mentale, Société, Université Paris Descartes, Sorbonne Paris Cité, CNRS UMR 8211/Inserm U988/EHESS), Paris Cedex 06, France.
authors.forename: François
authors.initials: F
authors.lastname: Beck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005239:Fear; D005260:Female; D005602:France; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012923:Social Class; D014611:Vaccination / Q000523:psychology*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Attitudes toward vaccination; France; Healthism; Influenza H1N1