Why the vaccine hesitancy in SA? Experts take a closer look

The advent of the Omicron variant in South Africa is ushering in the much-anticipated fourth wave of Covid-19. The greatest challenge, however, is not just the virus itself, but the doubt, apathy and ease of access to vaccines.

These were the sentiments shared by experts from healthcare, civil society and even mining sectors at the Vooma Vax Champs webinar on Tuesday, November 30.

In recent weeks, vaccination numbers have dipped. Just 41% of the adult population is vaccinated, far behind the government’s target of 70% by the end of December. Just 22% of 18 to 34-years-olds have been vaccinated. Statistics show that only 16.5 million people have been fully vaccinated out of roughly 36 million South Africans over the age of 19. This week, reports have shown a spike in infections at Tshwane University of Technology due to the omnicron variant.

According to David Harrison, the National Lead for Demand Acceleration for the Vooma Vaccination initiative, reasons for vaccine hesitancy differ among the various age groups.

Around 17% of people over the age of 50 remain anxious and unsure of the vaccines’ effectiveness and look to leaders for guidance. About 27% of those between ages 35 and 49 rely on their religious faith as a substitute for the vaccine.

Most concerning, Harrison pointed out, is that 56% of 17 to 34-year-olds place jobs before jabs. Currently, youth unemployment in South Africa is at an all-time high of 64,4%.

He said they are disaffected and experience a level of mistrust and resentfulness towards the vaccine and authority.

Since the [local] election, we have seen a decline in first doses. So, we have to use Omicron to heighten awareness of vaccination. The Vooma Vax Champs can help in getting those numbers up.”

He added that the vaccine remains effective against the Omicron variant. “These variants may affect vaccine effectiveness but are very unlikely to make it useless. There is still a lot to draw on, like the cellular immunity. We are constantly building and scaffolding with the tricks this virus is coming up with.”

Cellular immunity takes over after the vaccine’s antibody immunity has waned. Little is know about it but scientists have said that it is crucial in warding off reinfection. Waning periods differ according to each manufacturer. For instance, the Pfizer vaccine’s effectiveness dwindles after eight months, whereas Johnson & Johnson is anywhere between six to eight months. However, it does not mean antibody immunity is depleted as some resistance still occurs. It is for this reason that boosters are needed.

‘It should actually be jabs before jobs’

Lebo Motshegoa, a youth mobilisation and content development specialist, said that young adults would need to be more serious about getting the vaccine as it is worsening youth unemployment.

“It should actually be jabs before jobs,” said Motshegoa.

We have seen parts of the world that have restricted travel to South Africa and it has impacted the economy negatively. They are using our low vaccination statistics as a reason. When it comes to employment, it affects us negatively.”

Motshegoa said the youth is at the centre of the vaccination agenda and mobilising them to vaccinate will, in turn, get their families and friends to do the same. He added that companies and universities have made the vaccine mandatory for 2022, which will affect youth job creation and university admissions.

As a communications specialist, he said messaging that is relevant in tone and language can help to get the youth to vaccination sites. “We are saying things like ‘you do not want to join the underground gang’ when they talk about ancestors. We are also telling them that what the world is doing to South Africa and its sister countries is that they are leaving us behind.”

Pauline Maketa, the spokesperson for the Vooma Vax Champs campaign, said that spreading messages on media platforms that youth frequently use is critical in reaching out to them. “If you can talk to youth in their language and on their media, they will be a part of [the vaccine programme] and encourage each other. If the messaging is on TV or on radio, they might miss out because they are always on their phones.”

Maketa hopes that through Vooma Vax Champs, bottlenecks in the vaccination programme can be identified and tackled sooner.

We will be able to bring up problems quicker and spread information that people are not sure of. We can bring it to relevant leaders at a faster pace because we will be working closer with traditional, religious and youth leaders.”

Taking the vaccine to people

Access to vaccination sites has been a problem for marginalised groups. Those with little money find it hard to pay for transport to the sites. However, taking the vaccine to communities is a solution, according to Mabalane Mfundisi, the Executive Director of the Community Constituency Trust for Covid-19.

He said vaccination drives would need to be proactive, place people first and be agile. “We first had to go to sites, now we are taking sites to people. These small efforts count. If we are to go into a lockdown, we must have plans in place for those who are downtrodden.”

Government has already set up sites at shopping malls, taxi ranks and SASSA offices where people can get incidental vaccinations while running errands.

Intervention ideas coming from an unlikely source

South Africa’s mining sector offers the country a glimpse into how it can manage the virus on a larger scale.

Charmane Russell, the Minerals Council South Africa’s Communications Consultant, said 68% of mining employees and contractors have at least received the first vaccine. It translates to just over 300 000 vaccines administered. This is due to an intensive communications approach. “We implemented fact-based communication because the reservations people have are pretty rational and if we can educate them, we can convince them.”

She added that the sector tackled myths head-on, created a sense of urgency, collaborated with unions and created communications that are multichannel and multilingual. It also took the vaccine to workers, making it convenient.

The challenges mining faced are not different to what we see nationally. Our biggest challenge in South Africa is apathy and that is what we need to build against.”

Mining is now switching from the mass communications approach to personalised messaging. “We have learnt from HIV and TB that people believe and trust others who are just like them – peer education – which is why I am for the Vooma Vax Champs idea.”

NPIs still effective in the fight against Covid-19

Harrison emphasised the importance of continuing to practice the non-pharmaceutical interventions (NPIs) that have helped prevent the spread of the virus. “There is a scientific basis that shows NPIs, like wearing masks, washing hands and physical distancing are effective.”

He encouraged South Africans to keep their heads up for the upcoming fourth wave.

It is important, in the context of so much flux, that we do not lose hope. We must look at what works and keep working incrementally towards the end of the virus. We came from a place of not knowing a lot to knowing something [about the virus].”

If you wish to become a Voom Vax Champ, dial its toll free number on 0800 029 999. You can also text JOIN to 0600 123 456 via WhatsApp. Visit vaxchamp.org.za for more information. All material is presented in one of South Africa’s 11 official languages.