This is a weekly report of COVID & vaccine sentiment, rumours & misinformation in SA. Further info here.

KEY TRENDS 

  • Improved demand: This week the demand for vaccination has increased, with around 250,000 daily jabs. This is fuelled by a surge of 18 – 34 youth now able to get it. It’s uncertain how long this will last.
  • Acknowledgement of improved rollout: Social media conversations are more positive about the vaccine rollout with improved services (free/subsidized transport, more vaccine sites, pop-up sites) (See here, here and here). Suggestion that low demand is about barriers of access more than hesitancy (here).
  • Social media trends. Over 1.1 million mentions of vaccines in social media in SA. In SA, 4 of top 5 tweets were pro-vaccination (other 1 was about Rev Meshoe). Engagements on news articles about Covid vaccines increased 30% (40,000). 250,000 engagements on SA Facebook about vaccine (up 60% on previous week). Much social media anti-vax, many with hashtags #saynotovaccine and #NoVaccinePassports. It is noticeable that most anti-vax videos are from other countries (especially US), while most pro-vax are local (e.g. South Africans celebrating being vaccinated).
  • Mixed views in young people: There is encouraging public discussion and clear eagerness for vaccination among many 18 – 34 youth. However, youth still appear to be the most vaccine-resistant age group. Many think they are young and healthy enough, already exposed and were not infected, or had Covid without severe illness – hence why bother with vaccination now? Sentiments include, “I travel in taxis every day and never got ill; I’m good without a vaccine” and “What is the use of the vaccine if you can still get sick?”
  • Concern about fertility: Many reports of fears that vaccines hurt the foetus during pregnancy and cause male infertility. US video circulating in SA (here) that children will be sterilized and 80% of vaccinated pregnant women have lost their babies (among many false claims). NICD messaging on vaccination & pregnancy has been welcomed (over 2,000 Likes). A viral video has been widely shared claiming that vaccines cause Covid, like a previously vaccine spread AIDS as an Apartheid strategy to kill Africans (here). It is reported that traditional medicines are better than Covid vaccine (here).
  • Mandatory? The debate continues whether vaccination should be compulsory or not (here, here & here), or the unvaccinated should lose certain abilities, e.g. losing job (here), buying alcohol (here & here). Many anti-vax messages suggest that it already is mandatory and is a sign of state abuse of power (here).
  • Pro-vax coverage by the media. There has been increasing vaccine supporting coverage in main stream media, including many newspapers and the SABC, and also on social media.
  • The NDOH vaccine demand acceleration plan. There is a new vaccine demand acceleration plan, which is widely welcomed by people who know of it. There is a call for all government departments, private sector companies, and civil society organisations to support the implementation of this plan.
  • Pfizer full approval: There has been favourable coverage of the US Federal Drug Administration (FDA) giving full approval to the Pfizer vaccine, which is one of the two vaccines currently used in SA.
  • Frustration about other service delivery: Some frustration that there appears to be more official focus on and resources for vaccines than on other service delivery which is more important to most people (e.g. jobs, water, food). There is widespread sentiment that government should equally commit to service delivery on what matters to people. “I’ve got no food, but government is pushing vaccines. Why?”
  • Mixed reactions to government’s free transport to vaccination sites: Many were appreciative of the effort but others said government should prioritise the elderly, people with disabilities and districts for free transportation. Some described government as cruel for prioritising transport for vaccination over “school kids who walk long distances on empty stomachs to school and crossing raging rivers with no bridges.”
  • Vaccinated encouraging others: A survey conducted on Covid WhatsApp system run by Praekelt.org suggests that 90% of 4,000 people who had been vaccinated are willing to encourage others to do so.
  • Reasonable worries: Many sources indicate that the concerns people have about vaccines are ‘rational’ ones (efficacy, side effects, developed so quickly, reports of deaths) and not the wilder conspiracy theories (depopulating poison, tracking devices, magnetism, 666, Bill Gates), which indicates that widespread public health information is more important than debunking specific misinformation.
  • Problematic statements: Rev Kenneth Meshoe vaccine-resistant statements (see here) and support for anti-vaxx Dr Susan Vosloo (here) have undermined trust in vaccines, as has Prof Tim Noakes (here).
  • Community mobilisations: There is a considerable effort at local level to promote vaccination from organisations such as the Community Constituency Front and Red Cross among many others.
  • Uncertainty: Debate about preference for J&J, Pfizer or other vaccines that may come to SA (Astra Zeneca, Sinovac). Confusion on reports that J&J second dose might be required and other booster shots.
  • Concern in Muslim world: There is some anti-vaccination sentiment in the Muslim community (here), with message from UK (here) circulated that vaccines are haram (forbidden by Sharia law), though most Muslim authorities produce responsible evidence-based views (here and here).

 

MISINFORMATION 

  • MISINFO: Anti vaccine mRNA will kill you in 6 months.  TRUTH: There is no evidence to suggest mRNA vaccines will cause accelerated death.  See here and here.
  • MISINFO: Vaccines are dangerous, and those vaccinated pose greater threat. Public figures (e.g. Prof Noakes and Rev Meshoe) endorsing or reposting anti-vaccine lends credibility. TRUTH: Vaccines are effective see here and vaccinated people are at less risk than the unvaccinated.  See here and here.
  • MISINFO: Vaccines are dangerous for young people and will make them sterile.  TRUTH: Vaccines do not cause infertility or men to be sterile, see here. Vaccines are safe for pregnant women, see here. Information developed for youth is here.
  • MISINFO: Traditional medicine is just as effective as the vaccine. TRUTH: WHO has given support for Phase 3 clinical trial of some traditional medicines, see here. There is also support for other medicines to be subjected to clinical trials, see here. There is a trust deficit about vaccines which means some people are more likely to rely on traditional medicine (see here), but this does not undermine the effectiveness of vaccines in reality.
  • MISINFO: The new variant, COVID-22, is even more deadly (here). TRUTH: There is no evidence of this new variant though there is constant watch for emerging new variants, see here, here and here.

 

PROPOSED ACTIONS FOR RISK COMMUNICATION AND COMMUNITY ENGAGEMENT 

  • Youth communication: Develop media focusing on young people, including debunking that young people are less likely to be infected by Covid-19; the importance of not waiting (many youth seem to wait for friends to vaccinate first to see reaction). Encourage youth to bring a friend to get vaccinated. Start a competition for the best picture / video of young people being vaccinated with weekly prizes.
  • Reproductive health messaging: Produce and disseminate content that vaccines do not cause miscarriages or infertility.
  • Majority on side: Communicate that most adults in SA are pro-vaccination. This is not widely known.
  • Local social listening: Strengthen local social listening & community feedback which can feed into national to enable national resources to respond to local challenges to vaccination. Include community organisations (CCF, PVC, PHM, TAC etc), community health workers, and GCIS.
  • Vaccinated as promoters: 90% of the vaccinated would encourage others to do so (above). Communications through SMS from EVDS, leaflets at vaccine sites and public media should ask the vaccinated to promote vaccination for others. This is a resource for mobilisation that is largely untapped.
  • SABC training: Run training workshop(s) with SABC TV and radio for presenters and producers on Covid and vaccine issues, so that they will be able to respond to questions coming in.
  • Messaging for Muslims: Content should be created addressing the concerns about vaccines among Muslims, through working with respected Muslim organisations.
  • Vaccine training: Organise training courses on Covid and vaccines to be delivered (in multiple languages) to community health workers, councillors, faith leaders, traditional leaders among others.
  • Get all on EVDS to come: The Covid hotline callcentre received calls reporting that some elderly and others registered in the EVDS system are still waiting for SMS to tell them to come. EVDS should message everyone who has not vaccinated at all to come now, and those who have had Pfizer first dose to come after suitable delay from the first vaccination.
  • Family meeting: In the next televised speech by President Ramaphosa, include a short video on vaccine safety, efficacy, how they were quickly made, and that millions have taken them safely.

 

ISSUES RAISED FOR FOLLOW-UP

  • Rural awareness: Overall there is insufficient awareness of the vaccine rollout in rural areas. This is urgent need for public information and education campaigns in rural areas of SA.
  • Education mobilisation: Vaccine promotion should happen at colleges, universities &TVET, as was done around HIV. This means more than leaflets & posters. Collaborate with HEAIDS & others experienced in student HIV comms. The Department of Basic Education should promote vaccine confidence in high schools and primary schools (it reaches parents).
  • Home-based vaccination: Where resources allow, home-based vaccinations are encouraged (as done in KZN) to reach the elderly, disabled and others with difficulties coming to vaccination sites.
  • Facility vaccination data capture: Many calls to the Covid hotline show that several health facilities have a backlog of vaccine data captured on paper but not entered on EVDS. This causes difficulty for people coming for Pfizer second jab. This data capture should be completed with urgency.

 

METHODOLOGY AND COLLABORATION

The Social Listening & Infodemiology team that produces this report is part of the Risk Communications & Community Engagement Working Group of the Department of Health. This report is compiled following the methodology of the WHO Africa Infodemic Response Alliance (AIRA, see here), the “Identify” stage.  We pool information from the following:

  • SA National Department of Health
  • Covid Hotline: Reports from the national Covid call centre
  • Praekelt.Org: NDOH Covid WhatsApp system
  • WHO Africa Infodemic Response Alliance (AIRA)
  • UNICEF: digital analysis of content on Google, Twitter, YouTube and Facebook, and digital news
  • Red Cross: Network of over 2,000 community volunteers reporting misinformation and concerns
  • Real 411 Media Monitoring Africa: a mis- and disinformation reporting and debunking initiative
  • COVID Comms: a network of communications specialists that produces information on the pandemic
  • DOH Free State & KZN: Provincial Departments of Health
  • Community Constituency Front (CCF), People’s Vaccine Campaign
  • Centre for Communication Impact, Centre for Analytics & Behavioural Change, Section 27 
  • Medical Research Council, National Institute for Communicable Diseases, Right To Care, 
  • SA Vaccination and Immunisation Centre, Health Systems Trust, HSRC, IPSOS
  • Universities of Johannesburg, Cape Town, Free State, Wits, Stellenbosch, Sefako Makgatho 

 

Other organisations involved: Government Communications & Information Service, SA Council of Churches, Clinton Health Access Initiative, Heartlines, Children’s Radio Foundation, DG Murray Trust, People’s Health Movement, Business for SA, SA Minerals Council, Wits Reproductive Health & HIV Institute, UN Verified, HealthEnabled, Deaf SA, SA National Council for the Blind, Treatment Action Campaign and Disability SA.

Thanks to this week’s drafting team: Sowo Tucker, William Mapham, Nnete Mothibi, Charity Bhengu, Brenda Goldblatt and Peter Benjamin.

Contact:
Nombulelo Leburu, National Department of Health.    nombulelo.leburu@health.gov.za    082 444 9503
Peter Benjamin, HealthEnabled.             peter@healthenabled.org         082 829 3353
Charity Bhengu, National Department of Health.    charity.bhengu@health.gov.za    083 679 7424