More than four out of 10 French people would be reluctant to get a vaccine for Covid-19 should one become available, a new study has found. FRANCE 24 spoke to a public health expert who says the government should commit to transparency and listening to medical professionals to help ease the roll-out of any future inoculation plans. In a survey of global public acceptance of a Covid-19 vaccine published in the scientific journal Nature Medicine this week, researchers found that 41.11 percent of French citizens indicated they would be reluctant or even refuse to be vaccinated if one were to become available. Only Poland and Russia expressed less willingness to get inoculated.This rejection comes as no surprise to Lucie Guimier, a public health expert at Institut Français de Géopolitique and author of a report on the geopolitical consequences of vaccine scepticism. FRANCE 24: Do the results of the study surprise you?Lucie Guimier: There’s nothing surprising about these results. It would be wrong to categorise these respondents as "anti-vaxxers” because we’re talking about a vaccine that is still in the process of being developed and for which we will have little or no time for hindsight or perspective. In general, it takes about 10 years to develop a vaccine before it is ready for the market. So these are legitimate concerns – a wave of mistrust regarding a Covid-19 vaccination is to be expected.Even in the context of a pandemic, laboratories should not rush a vaccine to market that has not been sufficiently studied or that would have adverse effects on parts of the population. This would only add to the crisis we are already experiencing and would generate even more mistrust of the authorities. The reaction of the French to the vaccine will also depend on how the government manages this campaign and communicates its message. Many questions remain unanswered: How will these vaccines be made available to the population? Who will be included in the debate? Will there be sufficient stocks?F24: How can the authorities gain the population's confidence?LG: To limit this mistrust, in my opinion, all health professionals – doctors, nurses, midwives, etc – should be included in the debate, because these medical professionals inspire much more confidence among patients than government representatives. If we don't succeed in including them in this vaccination campaign and listen to them, it will be difficult to raise awareness. F24: Could greater transparency on health policies also play a role? LG: Health researchers have been hammering on about this for years. More transparency is absolutely essential. We must not hide behind simplistic arguments or take a paternalistic tone by just saying, "Get vaccinated". And although the French public health system is already trying to raise awareness on this issue, it is not an easy task.The problem is, when faced with people who refuse to be vaccinated, the more we argue the more likely they are to view this as justification that the state has some hidden agenda – that it’s about collusion between the pharmaceutical companies and the political elites, that sort of thing. We know that this minority of anti-vaccine people will be very difficult to convince. And the efforts at persuasion must, above all, reach those who are sceptical or hesitant. F24: Is the mistrust of vaccines more prevalent in France than elsewhere?LG: Not necessarily. The history of vaccinations has always been marked by protest movements, but each country has its own particularities, which depend on the historical context and the ideology underlying the health systems.For example, China's view of public health is not the same as in some other countries. China (which has a vaccine acceptance rate of more than 80 percent, according to the study) is a state with a communist system and a strong public health culture. Vaccination policies are implemented there without major reluctance or pushback. On the other hand, one of the particularities of France could be that, when it comes to health, the French expect a lot of the state while also being very critical when it intervenes. France has also had some unique experiences with vaccines. Many still remember the winter of 2009-2010, when the H1N1 vaccination campaign was rolled out very rapidly. Around 60 cases of narcolepsy were subsequently recorded in the country, which was not a small number. Obviously, these undesirable effects have left an impression on people. But while the anti-vaccine discourse is very voluble, and has even gained strength or fused with the anti-mask movements in some parts of the world, their impact remains limited in France. One only has to look at the current shortage of the flu vaccine in pharmacies to see this.F24: Does mandatory vaccination seem like a legitimate option? LG: Introducing a mandatory vaccination policy for Covid-19 seems very difficult to me – the state would meet with enormous opposition. We saw this in 2018, when the government extended the list of mandatory vaccinations for children. This was met with a lot of mistrust from some people. When we see that some people are already reluctant to wear masks, imposing a mandatory vaccination policy – which is more intrusive –would seem to be extremely complicated.Even if the state would prefer everyone to be vaccinated, the question remains whether we could do it, logistically. But a first step would be to make it mandatory, or strongly recommend, for the most fragile sections of society, such as the elderly or the otherwise vulnerable. This article has been translated from the original interview in French.