Read the interview to Dr Anne Sophie Ronnaux-Baron

Background

In the context of a Europe increasingly hesitant about vaccination, with dropping vaccination coverage, Immuniser Lyon was a French campaign aiming to re-inform the population of the greater Lyon area in centre-east of France, of the proven benefits of vaccination and to incite people of all ages (children, adults, seniors) to be up-to-date with their vaccinations. This campaign strongly involved the local Civil Society in an active manner. Such an immunization campaign was even timelier in the context of the observed resurgence of pertussis and measles.

Project description

Immuniser Lyon, which translates to “Immunize Lyon”, was an innovative initiative in the city of Lyon and the greater Lyon area, France, which was launched during the European Immunization Week in May 2015, and lasted for one year. The campaign’s goals were to provide accessible, accurate and trustworthy information on vaccination to all citizens, in order to keep themselves, their entourage and the city of Lyon healthy. The Immuniser Lyon initiative consisted of three interconnected parts: a communication campaign, actions aimed at raising awareness and providing access, and a dedicated internet website. The first two parts were deployed over the course of one year, with the help and support of various partners from the city of Lyon, while the website is still fully functioning to this day, and is a source of unbiased, clear information on immunization for all members of society.

As part of the communication campaign, posters, flyers and messages were distributed in health settings (general practitioners, pharmacies, hospitals, health centres), social settings (social services, regional agencies), education settings, and civil society settings (universities, patient organisations). After the 1 year communication campaign was over, the posters remained freely available on the dedicated website. As part of this prevention campaign, the statements of ten people from Civil Society were assembled and presented as part of posters, sending a message to the general population to be up to date with their vaccinations. The messengers were 7 anonymous citizens and 3 well known personalities from Lyon: the actress Mimie Mathy, the football player Alexandre Lacazette, and the chef Mathieu Viannay (Lyon is considered as the capital of French food, and a significant part of citizens works in restaurants, in food shops and industries).

The initiative was aimed at both regular citizens and health professionals, of all age groups (infants, children, teenagers, adults, and seniors). Vaccination calendars were developed, with the use of which one could check whether their vaccination status was up to date, or if any boosters were needed. The calendars are freely and easily accessed on the http://www.immuniser-lyon.org website.

The dedicated website, which also has a mobile version, allows users to input personal characteristics, and then delivers a personalized assessment of, past and future, required and recommended vaccines. The assessment takes into account all main key factors: age, gender, place of residence, pregnancy status, travels, history of infectious diseases, diagnosed diseases, profession, entourage, treatments, living conditions and personal refusal of vaccinations. Users can also go through a list frequently asked questions about vaccinations, which are answered clearly and succinctly. Links to official sources and reference sites on vaccination are provided for further information (disclaimer that the contents are not stemming from the vaccine industry and that no links direct to a laboratory’s website). All the content of the website has been designed and approved by a scientific committee, in order to provide state-of-the-art data and knowledge.

Another personalised tool on the website allows the user to find out about vaccine recommendations for travel destinations all over the world, by country and by season. The website also provides a list of all vaccine-preventable infectious diseases, with information for each disease on: characteristics and descriptive of the disease, vaccine recommendations, vaccination schedule, epidemiologic data, and references for further reading.

Who were the projects’ participants?

The project involved over 30 partners, from various areas, with an active and important role for civil society:

• the city of Lyon, the regional health agency
• hospitals and medical research centres
• healthcare workers representatives
• health, prevention, and vaccination centres
• educational actors, schools and universities health
• patients’ organizations and health web platforms
• complimentary health insurance agencies
• pharmaceutical distributors, wholesalers
• vaccines companies

The project was designed collaboratively by a steering committee, and the campaign’s materials and messages were designed and validated by the project partners within a scientific committee and 4 operational committees. An important part of addressing the general population, was the participation and support of known local personalities from Civil Society (the actress Mimie Mathy, the football player Alexandre Lacazette, and the chef Mathieu Viannay). Involving key public figures (religious, sports, cinema or other local/national public figures or community leaders) in awareness campaigns has been shown to have a beneficial effect on getting the message across and increasing the trust of the general population (London School of Hygiene & Tropical Medicine, 2015). Celebrities with a personal, often emotional, connection to the health issue for which they are being ambassadors, can impact public opinion and attitudes towards that specific health issue (Cram et al., 2003).

Lessons learned and challenges

An evaluation of the project’s impact was planned for in the design stages of the project. The following aspects were assessed in order to evaluate the “Immuniser Lyon” initiative (Faurié-Gauthier, 2016):

• online survey of public, pharmacists’, students’, nurses’ opinions on vaccination adherence and on how the campaign was perceived
• number of partners engaged in the project
• number of posters and flyers distributed
• number of actions in Lyon
• media coverage
• website statistics (traffic, referencing on Google, number of support votes, etc.)

Preliminary results of these evaluations showed high media coverage, new collaborations emerging, and support for the initiative from decision makers, national experts, and health professionals’ unions. No anti-vaccinations attacks or controversies were observed (Faurié-Gauthier, 2016).

The project received 2 prizes: the gold prize for Public Health Communication at the Health Communication festival, and a poster describing the project received in 2015 the audience award at the “États Généraux de la Santé en Régions” (General States of health in the Regions) meeting.

For the elaboration of messages and for choosing the best course of action, social psychologists were involved in the decisional process. They were able to guide the messages towards promoting health (and not fearing disease) and motivating people to verify if they are up to date with their vaccinations. Also, by creating messages targeted at different groups (health care workers, seniors, teenagers, adults), people would more easily identify with one of them (Faurié-Gauthier, 2016).

Status of the project

The communication campaign part of the project is terminated, however the dedicated website with all its tools is continuously available online. The “Immuniser Lyon” project participated in the French citizen consultation on vaccination, and also helped to promote the “Electronic Vaccination Booklet” which has been tested in Lyon).

References

Cram P, Fendrick AM, Inadomi J, Cowen ME, Carpenter D, Vijan S. The impact of a celebrity promotional campaign on the use of colon cancer screening: the Katie Couric effect. Arch Intern Med. 2003; 163(13):1601-1605.

Faurié-Gauthier C. Immuniser Lyon - Territoires et santé: quels enjeux? RFVS - OMS,  2016 [cited 13 Feb 2017]. Available from: http://www.villes-sante.com/wp-content/uploads/AT3_presentation_Lyon_31mai2016.pdf.

London School of Hygiene & Tropical Medicine. The state of vaccine confidence. 2015.   

Available from: http://www.vaccineconfidence.org/research/the-state-of-vaccine-confidence/