Les représentations de l'épidémiede Covid-19 à l'épreuve des différences sociales et du temps

Les termes choisis pour évoquer ľépidémie de Covid-19 révěient plusieurs types de rapport á cet événement inserit dans la durée : les représentations changent seion le genre, l'âge, le diplome, la categorie socioprofessionnelle, et seion la position dans la sphere domestique et la confrontation directe â la maladie. Â partir de ľexpioitation statistique de réponses â une question ouverte posée lors de deux passations ďune enquete portant sur le coronavirus entre avril et juin 2020, sur un méme panel, nous mettons en lumiére deux rapports trés différents â ľépidémie : une relation personnels qui se rencontre davantage chez les femmes et consiste å appréhender les effets de la maladie â ľéchelle de ľespace domestique ou de sa santé individuelle, et une relation politique, plus masculine, qui se situe å une échelle plus globale. Alors que la relation personnels reste relativement stable, la relation politique est plus fluctuante, et fait l'objet de reformulations successives.Alternate :The terms people choose when speaking of the Covid-19 epidemic reveal several types of attitudes toward this long-lasting event. Representations vary by gender, age, educational level, socio-occupational category, position occupied in the home sphere, and whether or not the speaker has had direct experience of the disease. In a statistical study of responses to an open question asked of a single panel in two waves of a coronavirus survey conducted from April to June 2020, we found two sharply different attitudes to the epidemic: a personal attitude, more commonly found among women, where respondents apprehend the effects of the disease at the scale of the home or their own health;and a political attitude, more common among men, that references a more global scale. Whereas the personal attitude remains relatively stable over time, the political view of the problem fluctuates and responses are more likely to be reformulated.Alternate :Die gewählten Begriffe zur Bezeichnung der Covid-19 Epidemie enthüllen verschiedene Beziehungsarten zu diesem langdauernden Ereignis: Die Vorstellungen ändern sich entsprechend Gender, Alter, Diplom, sozloökonomischer Kategorie und nach der Stellung innerhalb der häuslichen Sphäre und der direkten Konfrontation mit der Krankheit. Anhand der statistischen Auswertung der Antworten auf eine offene Frage, die im zweimaligen Ablauf einer Untersuchung zum Coronavirus gestellt wurde, zwischen April und Juni 2020, bei einem identischen Panel, beleuchten wir zwei sehr unterschiedliche Beziehungen zur Epidemie: eine persönliche Beziehung, die vorwiegend bei Frauen vorliegt und darin besteht, die Auswirkungen der Krankheit auf der Ebene der häuslichen Sphäre und bezüglich der individuellen Gesundheit zu erfassen, und andererseits die politische eher männliche Beziehung, die auf einer mehr globalen Stufe liegt. Während die persönliche Beziehung relativ stabil bleibt, ist die politische Beziehung eher schwankend und gibt Anlass zu aufeinanderfolgenden Umformulierungen.

When Lack of Trust in the Government and in Scientists Reinforces Social Inequalities in Vaccination Against COVID-19

Objective To assess whether lack of trust in the government and scientists reinforces social and racial inequalities in vaccination practices. Design A follow-up of the EpiCov random population-based cohort survey. Setting In July 2021, in France. Participants Eighty-thousand nine hundred and seventy-one participants aged 18 years and more. Main Outcome Measures Adjusted odds ratios of COVID-19 vaccination status (received at least one dose/ intends to get vaccinated/ does not know whether to get vaccinated/refuses vaccination) were assessed using multinomial regressions to test associations with social and trust factors and to study how these two factors interacted with each other. Results In all, 72.2% were vaccinated at the time of the survey. The population of unvaccinated people was younger, less educated, had lower incomes, and more often belonged to racially minoritized groups, as compared to vaccinated people. Lack of trust in the government and scientists to curb the spread of the epidemic were the factors most associated with refusing to be vaccinated: OR = 8.86 (7.13 to 11.00) for the government and OR = 9.07 (7.71 to 10.07) for scientists, compared to vaccinated people. Lack of trust was more prevalent among the poorest which consequently reinforced social inequalities in vaccination. The poorest 10% who did not trust the government reached an OR of 16.2 (11.9 to 22.0) for refusing to be vaccinated compared to the richest 10% who did. Conclusion There is a need to develop depoliticised outreach programmes targeted at the most socially disadvantaged groups, and to design vaccination strategies conceived with people from different social and racial backgrounds to enable them to make fully informed choices.

The social specificities of hostility toward vaccination against Covid-19 in France.

Equal Access to the COVID-19 vaccine for all remains a major public health issue. The current study compared the prevalence of vaccination reluctance in general and COVID-19 vaccine hesitancy and social and health factors associated with intentions to receive the vaccine. A random socio-epidemiological population-based survey was conducted in France in November 2020, in which 85,855 adults participants were included in this study. We used logistic regressions to study being "not at all in favor" to vaccination in general, and being "certainly not" willing to get vaccinated against Covid-19. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against COVID-19 (OR = 1.88 (95% CI: 1.79-1.97)). We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, were more likely to refuse the COVID-19 vaccine (from OR = 1.22 (95% CI:1.10-1.35) for respondents without diploma to OR = 0.52 (95% CI:0.47-0.57) for High school +5 or more years level). People from the French overseas departments, immigrants and descendants of immigrants, were all more reluctant to the Covid-19 vaccine (first-generation Africa/Asia immigrants OR = 1.16 (95% CI:1.04-1.30)) versus OR = 2.19 (95% CI:1.96-2.43) for the majority population). Finally, our analysis showed that those who reported not trusting the government were more likely to be Covid-19 vaccine-reluctant (OR = 3.29 (95% CI: 3.13-3.45)). Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.

Social inequalities and dynamics of the early COVID-19 epidemic: a prospective cohort study in France.

OBJECTIVE: Although social inequalities in COVID-19 mortality by race, gender and socioeconomic status are well documented, less is known about social disparities in infection rates and their shift over time. We aim to study the evolution of social disparities in infection at the early stage of the epidemic in France with regard to the policies implemented. DESIGN: Random population-based prospective cohort. SETTING: From May to June 2020 in France. PARTICIPANTS: Adults included in the Epidémiologie et Conditions de Vie cohort (n=77 588). MAIN OUTCOME MEASURES: Self-reported anosmia and/or ageusia in three categories: no symptom, during the first epidemic peak (in March 2020) or thereafter (during lockdown). RESULTS: In all, 2052 participants (1.53%) reported anosmia/ageusia. The social distribution of exposure factors (density of place of residence, overcrowded housing and working outside the home) was described. Multinomial regressions were used to identify changes in social variables (gender, class and race) associated with symptoms of anosmia/ageusia. Women were more likely to report symptoms during the peak and after. Racialised minorities accumulated more exposure risk factors than the mainstream population and were at higher risk of anosmia/ageusia during the peak and after. By contrast, senior executive professionals were the least exposed to the virus with the lower rate of working outside the home during lockdown. They were more affected than lower social classes at the peak of the epidemic, but this effect disappeared after the peak. CONCLUSION: The shift in the social profile of the epidemic was related to a shift in exposure factors under the implementation of a stringent stay-at-home order. Our study shows the importance to consider in a dynamic way the gender, socioeconomic and race direct and indirect effects of the COVID-19 pandemic, notably to implement policies that do not widen health inequalities.

When lockdown policies amplify social inequalities in COVID-19 infections: evidence from a cross-sectional population-based survey in France.

BACKGROUND: Significant differences in COVID-19 incidence by gender, class and race/ethnicity are recorded in many countries in the world. Lockdown measures, shown to be effective in reducing the number of new cases, may not have been effective in the same way for all, failing to protect the most vulnerable populations. This survey aims to assess social inequalities in the trends in COVID-19 infections following lockdown. METHODS: A cross-sectional survey conducted among the general population in France in April 2020, during COVID-19 lockdown. Ten thousand one hundred one participants aged 18-64, from a national cohort who lived in the three metropolitan French regions most affected by the first wave of COVID-19. The main outcome was occurrence of possible COVID-19 symptoms, defined as the occurrence of sudden onset of cough, fever, dyspnea, ageusia and/or anosmia, that lasted more than 3 days in the 15 days before the survey. We used multinomial regression models to identify social and health factors related to possible COVID-19 before and during the lockdown. RESULTS: In all, 1304 (13.0%; 95% CI: 12.0-14.0%) reported cases of possible COVID-19. The effect of lockdown on the occurrence of possible COVID-19 was different across social hierarchies. The most privileged class individuals saw a significant decline in possible COVID-19 infections between the period prior to lockdown and during the lockdown (from 8.8 to 4.3%, P = 0.0001) while the decline was less pronounced among working class individuals (6.9% before lockdown and 5.5% during lockdown, P = 0.03). This differential effect of lockdown remained significant after adjusting for other factors including history of chronic disease. The odds of being infected during lockdown as opposed to the prior period increased by 57% among working class individuals (OR = 1.57; 95% CI: 1.00-2.48). The same was true for those engaged in in-person professional activities during lockdown (OR = 1.53; 95% CI: 1.03-2.29). CONCLUSIONS: Lockdown was associated with social inequalities in the decline in COVID-19 infections, calling for the adoption of preventive policies to account for living and working conditions. Such adoptions are critical to reduce social inequalities related to COVID-19, as working-class individuals also have the highest COVID-19 related mortality, due to higher prevalence of comorbidities.