Special Section: Islands of refuge, islands of contagion. (Special Section: Islands of refuge, islands of contagion.)

This section contains three papers dealing with: toxic colonialism in Ilet la Mere, French Guiana;the isolation of Mediterranean islands from COVID-19 and the recovery of their tourism economy;and the effect of colonialism and neocolonialism on the response of Barbuda and Puerto Rico to COVID-19.

Attitudes towards the COVID-19 vaccine and vaccination willingness among healthcare workers in French Guiana

Background - In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (P1) variant of concern (VOC), mRNA vaccines were made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimes to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods - A cross-sectional survey was conducted from January 22 to March 26, 2021, among a sample of HCWs in French Guiana based on an anonymous online questionnaire. Results - A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing to be or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. In multivariate analysis, factors associated with vaccination willingness were older age, level of concern about COVID-19, confidence in vaccine information, and having been vaccinated against influenza in the previous year. Conversely, reluctance to certain vaccinations in general (adjusted OR=0.23, CI95%: [0.13-0.41]) and being from the West Indies or French Guiana (aOR=0.39 [0.21-0.73]) were associated with greater vaccine distrust. Conclusion - Negative opinions and attitudes toward vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with P1 VOC. Territorial specificities, general vaccine hesitancy and concerns about future side effects in particular represent important barriers and/or issues. Low confidence in government and science are important for COVID-19 vaccine refusal among non-medical staff. Public health messages with information on vaccine safety should be tailored to address these concerns.