“Skepticism” toward vaccination—which takes various forms of attitudes that fall between pro- and anti-vaccination stances—is indeed difficult to measure: various studies have provided estimates for specific populations, such as parents of young children or older adults, but there is no standardized indicator for measuring it in the general population.

One way to address this hesitancy has been to survey the population not on mistrust, but rather on their support for the principle of vaccination. This support has been tracked for over 20 years by the Santé publique France Barometer through the question: “Are you in favor of vaccination in general?”

This system of repeated surveys relies on large samples (generally between 15,000 and 25,000 respondents) that are rigorously selected (using a probabilistic method). The Santé publique France Barometer tracks changes over time in health-related habits and opinions among the population residing in metropolitan France and, for the past decade, in the overseas departments and regions (DROM). The results of these surveys enable us to evaluate our prevention efforts and adapt our messages and information campaigns. The data collected is therefore invaluable to all those involved in the field of public health and, in this case, in the promotion of vaccination.

Vaccination uptake overall had declined from 89.9% in 2005 to 61.2% in 2010, following the 2009 influenza pandemic.

Uptake then increased (78.8% in 2014), fluctuated in the following years, and rose again in 2020 (80.0%) and 2021 (82.5%). The latest data, not published in this article, shows a continued increase, with a vaccination rate of 84.6% in 2022. An increase in vaccination uptake was thus observed during the COVID-19 crisis.

Regardless of the year, uptake was higher among people with high incomes, those with high levels of education, and those who do not live alone. In 2021, for the first time, vaccination uptake was higher among people aged 45 and older (and particularly among those aged 65 and older, with an 85.9% uptake rate) compared to those aged 18–24 and among retirees (compared to employed individuals)—and thus largely among those who benefited most from COVID-19 vaccination.

The overall increase in uptake in recent years should not obscure the trend toward widening disparities in uptake based on socioeconomic status. Uptake in 2021 was low among people with the lowest levels of income and education, and well below the levels observed for these groups prior to 2009.

The article shows not only that vaccination uptake has not returned to the levels observed before 2010, but also that in 2021, the gap between those with the lowest incomes and the most affluent is wider than it was before 2010. To sustain the increase in vaccination uptake by reducing social health inequalities, the priority is to develop vaccination promotion initiatives that take the social gradient into account.

During European Immunization Week 2023, numerous initiatives were implemented targeting lower-income populations, such as catch-up vaccination appointments, promotion of hepatitis B vaccination, vaccination status checks, awareness-raising about vaccination against human papillomavirus (HPV) infections, and general promotion of vaccination.

In addition, Santé publique France has developed numerous vaccination resources featuring information that is easy to understand and accessible to the general public. The “vaccination-info-service” website, for example, has been developed in both professional and public versions, with concise, clear, and visual information for the general population. In an effort to reach as many people as possible, the agency also produces materials tailored to specific populations: videos on certain vaccine-preventable diseases (measles, hepatitis, shingles, whooping cough, etc.) have been published in French Sign Language, and some brochures are adapted into an “easy-to-read and easy-to-understand” format.

The HPV vaccination campaign, which began in September 2023 in middle schools, is part of the same initiative. Its goal is to improve the low HPV vaccination coverage rate, but also to increase HPV vaccination uptake by reducing social inequalities in access to healthcare and prevention systems.

Furthermore, a study conducted by the PACA Regional Unit (Regional Directorate) of Santé publique France in collaboration with ORS PACA (see Box – Motivational Interviewing to Reduce Vaccine Hesitancy Among Mothers) among pregnant women also demonstrated the impact of an educational initiative based on conducting motivational interviews in maternity wards on vaccine confidence.

We are therefore continuing our efforts to identify and evaluate promising interventions that can increase vaccination uptake among the population, while aiming to reduce the gaps that have widened between individuals due to differences in socioeconomic status.