Jean-Yves Durand

Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews.

BackgroundDespite effective national immunisation programmes in Europe, some groups remain incompletely or un-vaccinated (‘under-vaccinated’), with underserved minorities and certain religious/ideological groups repeatedly being involved in outbreaks of vaccine preventable diseases (VPD).Gaining insight into factors regarding acceptance of vaccination of ‘under-vaccinated groups’ (UVGs) might give opportunities to communicate with them in a trusty and reliable manner that respects their belief system and that, maybe, increase vaccination uptake. We aimed to identify and describe UVGs in Europe and to describe beliefs, attitudes and reasons for non-vaccination in the identified UVGs.MethodsWe defined a UVG as a group of persons who share the same beliefs and/or live in socially close-knit communities in Europe and who have/had historically low vaccination coverage and/or experienced outbreaks of VPDs since 1950. We searched MEDLINE, EMBASE and PsycINFO databases using specific search term combinations. For the first systematic review, studies that described a group in Europe with an outbreak or low vaccination coverage for a VPD were selected and for the second systematic review, studies that described possible factors that are associated with non-vaccination in these groups were selected.ResultsWe selected 48 articles out of 606 and 13 articles out of 406 from the first and second search, respectively. Five UVGs were identified in the literature: Orthodox Protestant communities, Anthroposophists, Roma, Irish Travellers, and Orthodox Jewish communities. The main reported factors regarding vaccination were perceived non-severity of traditional “childhood” diseases, fear of vaccine side-effects, and need for more information about for example risk of vaccination.ConclusionsWithin each UVG identified, there are a variety of health beliefs and objections to vaccination. In addition, similar factors are shared by several of these groups. Communication strategies regarding these similar factors such as educating people about the risks associated with being vaccinated versus not being vaccinated, addressing their concerns, and countering vaccination myths present among members of a specific UVG through a trusted source, can establish a reliable relationship with these groups and increase their vaccination uptake. Furthermore, other interventions such as improving access to health care could certainly increase vaccination uptake in Roma and Irish travellers.

Faut-il jeter la Méditerranée avec l'eau du bain?: conclusion

The authors of this contribution first examine and relativise the main criticisms that have be levelled against the anthropology of the Mediterranean world. They then go on to question the pertinence of this geographical framework for study and comparison. Mediterranean societies certainly present a number of ‘family resemblances’, resulting from their complex history. But the coherence of any project of Bromberger et Durand, “Faut-il jeter la Mediterranee avec l’eau du bain ?” (2001) 7 Mediterranean comparison can become systematic only when based on complementary differences rather than such identified resemblances. The Mediterranean world can be envisaged as a space of dialogue and confrontations where identities are defined in a play of mirrors. Ce volume, et les debats dont il se fait l’echo, jette-t-il une pierre supplementaire dans le jardin de l’anthropologie mediterraneenne ou contribue-t-il a reconstruire un edifice inacheve, quitte a en modifier les plans ? Rappelons-nous la nature des pieces a charge reunies par plusieurs chercheurs 1 1 M. Herzfeld, 1987 ; J. de Pina-Cabral, 1989, en particulier. , agaces par l’antienne mediterraneenne et lui deniant toute consistance. Le monde mediterraneen serait, pour eux, une categorie fantasmatique, une sorte de mirage anthropologique, un agglomerat de stereotypes touristiques et savants, cautionnes ou elabores par des chercheurs venus du nord ; un modele dominant et altier, celui de l’anthropologie sociale britannique, aurait fait de ces territoires sa chasse gardee. Encore s’agirait-il d’une Mediterranee bien particuliere, cantonnee a ses franges europeennes. Et la timidite des avancees meridionales et orientales ne serait que la rancon de l’incongruite d’un projet postulant une unite factice. Au demeurant, le sentiment d’appartenance mediterraneenne n’affleurerait que dans la conscience de quelques privilegies amateurs de litterature ancienne, de festivals ou de soleil. Les contributions reunies dans ce volume, les reflexions et les echappees qu’elles suscitent, renforcent-elles ces critiques ou invitent-elles a ne pas jeter la Mediterranee avec l’eau du bain ? Bromberger et Durand, “Faut-il jeter la Mediterranee avec l’eau du bain ?” (2001) 8