Mandatory vaccination in France: perception by outpatients and self-evaluation of its impact on their vaccine confidence

Abstract

In France, for many vaccines, vaccine coverage is below the 95% cutoff. One reason is mistrust from a growing proportion of the general population toward vaccination. In 2017, a new law was promulgated, extending the number of mandatory vaccines from 3 to 11. Our objectives were twofold: to assess the population’s perception of the extension of mandatory vaccination (MV) 1 year after its introduction, and to evaluate how it affected their vaccine confidence. We performed a descriptive cross-sectional study using a questionnaire for adults who consulted a family physician in south-east France. Overall, 453 questionnaires were analyzed. The median age of respondents (female 78.4%) was 43 years; 85% had children. On a 0 to 100 scale, respondents evaluated their confidence in vaccination at a median of 75 (IQR 50–90). For 60% of respondents, MV was a good public health measure; for 47%, it was poorly explained by the Ministry of Health; for 46%, it was a violation of personal freedom; and for 49%, it resulted from pharmaceutical industry lobbying. When asked about the influence of the extension of MV, only 26.2% declared that it had changed (a little/a lot) their opinion, and this change was for the majority (74.7%) toward less confidence. Respondents who declared an increased level of confidence already had a better perception of vaccination (and inversely). In conclusion, our results show that MV only changed the perception of vaccination among a small proportion of respondents. For most respondents, MV reinforced their initial views about vaccination.