ZOOM – If France was this Monday with a vaccination coverage of 38% of its population, significant territorial inequalities appear. Where are the lowest vaccination rates recorded and what are the avenues put forward to explain this?
ALG – 2021-06-01T16:26:30.999+02:00
It is a new source of data rich in lessons. For the first time on Friday, the Health Insurance (CNAM) unveiled a map of vaccination in France based on the place of residence and not on the only place of injection which until then served as a basis for Public Health France to put daily updated data.
Verdict: territorial inequalities are glaring, with a number of departments with much lower vaccination rates than elsewhere. Which ? What are the avenues put forward to explain such disparities?
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Where are vaccination rates lowest?
With regard to people aged over 75, the departments with the lowest vaccination rates are the Overseas Departments, followed by Corsica, Alpes-de-Haute-Provence and Seine- St Denis. Conversely, the departments of the Atlantic coast and particularly in Brittany, have the largest number of people over 75 years of age vaccinated.
All ages combined, the overseas departments are again those with the lowest vaccination rates. Then come the departments of Île-de-France, starting with Seine-Saint-Denis where only 22% of the population received a first injection (against 34.3 nationally) and 9.5% are completely vaccinated (against 15.8% nationally). In the wake of this department, Val-d’Oise has 29% of inhabitants having received a first dose of serum and 12% of inhabitants fully vaccinated. This proportion reaches 30% in Essonne (with 12.6% of the population for whom vaccination has been completed) and Val-de-Marne (13.2%). Hauts-de-Seine and Yvelines follow, where 14.2% of the inhabitants are fully vaccinated, and Seine-et-Marne (11.6%). As for the capital, 15.9% of Parisians have received their two doses of vaccine.
Outside the Paris region, a few departments also bear witness to these territorial inequalities. This is the case in Haute-Savoie where only 13.5% of the population is vaccinated, Loire-Atlantique (13.7%), Loiret (13.8%), Sarthe (13.9%) %) but also Ille-et-Vilaine (14.1%), Haute-Garonne (14.3%), Eure (14.4%), Rhône (14.6%) , North (14.7%), Oise (14.8%), Aisne and Marne (14.8%).
How to explain the rates in Seine-Saint-Denis?
Deploring a “very uneven policy” in terms of vaccination, LFI deputy Adrien Quatennens dwelled on the delay observed in Seine-Saint-Denis on Tuesday on franceinfo. “We are told that it is linked to the question of the distribution of the age, as we vaccinated in priority the oldest and that many died in Seine-Saint-Denis”, he explains, believing that the vaccine policy is through this example a “revealing inequalities”.
In detail, of the 475,634 people vaccinated in Seine-Saint-Denis on May 26, 70.1% of residents aged 75 and over were concerned, and 61.2% of those 65 to 74 years old. “The proportion of residents of the department who are vaccinated at this stage is very low compared to the rest of the country, especially for 65-74 year olds and younger people who are already eligible”, analyzes the Regional Health Agency. “Seine-Saint-Denis is akin to a medical desert: the density of general practitioners and specialists is 30% lower than the national average. This leads to less guidance towards the vaccination of the populations concerned”, underlines for his part the president of the department Stéphane Troussel to Actu.fr.
Other avenues to explain these disparities?
Last February, in a forum of the World three general practitioners, Jacques Battistoni, Alexandre Feltz and Denis Lemasson had already lingered on the sociology of the territories as a possible explanation in terms of inequalities in the face of vaccination. “A majority of the beneficiaries come from the wealthiest classes and do not represent the most vulnerable population”, they estimated, among others, also mentioning the example of Seine-Saint-Denis, one of the poorest departments of the metropolis.
Another factor conducive to inequalities: the digital divide. “Can the elderly, polypathological or bedridden, the most susceptible to severe forms, go to saturated centers from the first hours of registration on the Internet? No, priority is given to those who are sufficiently informed to make an appointment you online “, they still wrote.
However, vulnerability linked to age or disability does not alone make it possible to characterize the victims of the digital divide, the level of education or income being also decisive. Thus, four out of ten people without a diploma would never use the Internet (compared to 14% for the rest of the population.) Internet use would also be rarer among the most modest households, on average three times less likely to use it. use only the better-off households.
What about the role of doctors and political actors?
Last November, therefore before the vaccination campaign was launched in France, the geographer Lucie Guimier had for her part mentioned the role of doctors and political actors as a possible explanation for the progression of skepticism towards vaccines in certain territories. “We must now also take into account the recent development of the appropriation of vaccine-skeptical discourse by the complosphere, which largely explains the spread of vaccine hesitation and its most resistant forms within populations. young and poorly educated, who until recently were only slightly affected by this phenomenon “, she explained in particular. “It may be a relative, but we also see more and more often that dissident doctors or caregivers as well as political actors in search of voters play a role in the progression of this skepticism”, she also analyzed in a forum in Le Monde dedicated to the territorial disparities between the north and the south of France.
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