This is a weekly report of COVID & vaccine sentiment, rumours & misinformation in SA. Further information giving the background to this report is given here.

You may download a pdf copy of this report here

 

KEY TRENDS 

  • Many have celebrated that over 10 million people in SA have had at least one vaccination. There is clear evidence of reduced risk from Covid for vaccinated people (here). There are some reports of people changing to support vaccination after Covid illness (here).
  • Politicization: There have been demonstrations about vaccination: both Against (here) and For (organized by the National Vaccine Monitoring Group). There are reports that people are not vaccinating as they do not support the ANC (which is associated with the vaccine rollout), particularly in the North West province; and also reports of vaccine-supporting local activists being accused of “Working for Ramaphosa” and threatened.
  • Not important to me: Many people feel that government focus is on vaccination rather than issues that are more important to them, e.g. unemployment and hunger. There is some opposition to vaccination as they perceive the government is not doing anything to resolve the issues that really matter to them.
  • Side effects: There are major concerns and questions around side effects of the vaccine (e.g. here and here). Lots of discussion regarding this on social media. Several people are saying they have not taken the second dose of Pfizer vaccine due to side effects from the first dose.
  • Social media: Interest in the following search queries was rising on Google over the past week: “nanotechnology” (+450%), “South African Covid 19 vaccination program” (+300%), “Booking Clicks za” (+250%), “Can a breastfeeding woman take the COVID-19 vaccine?” (+80%), “Can you be forced to take the Covid vaccine” (+60%). Tweets about COVID-19 vaccines in the country generated 45,000 engagements, a 30% decrease compared to the previous reporting period. Facebook posts about COVID-19 vaccines generated 160k over the past week (+6% compared to previous). UNICEF SA, NDoH and Steve Hofmeyr were the top 3 posts. News articles about COVID-19 vaccines generated over 70,000 engagements – most popular articles about Mpumalanga doctor refusing to see unvaccinated patients due to compassion fatigue (here), and SAHPRA announcement about no deaths linked to vaccine in SA (here).
  • Rights around vaccination: Debates and discussions ongoing regarding whether vaccination should be mandatory and about offering incentives & disincentives. Sentiment for vaccination (here) and against coercion to vaccinate (here and here). People are being encouraged to vaccinate to watch sport (here) and other benefits (here); Discovery policy is that vaccination is mandatory for staff (here). There’s concern that people will not be able to vote (here) or receive government services if unvaccinated.
  • Youth hesitancy is concerning. After an initial surge when 18 – 35 year olds were allowed to vaccinate, there has been a drop-off in youth coming for vaccination. See here. Vaccinations have now been taken to tertiary institutions in many areas and yet uptake is low, emphasising that logistical issues are not the main challenge in this age group.
  • Logistical issues: There are many requests that vaccination sites are brought closer to peoples and more pop-up sites are established to allow convenient vaccination. This is particularly requested in Eastern Cape, Limpopo and KZN.
  • Employment issues: Many people have reported difficulties in taking time off work for vaccination, even though there is official policy supporting this. A related issues is that there are requests for vaccination centres to be open on weekends for easier access by working people.
  • Request for vaccine booster: People seeking clarity about whether booster shots will be required in the future, i.e. does immunity wane with time? Some people are also asking about booster shots to provide protection against new variants. 
  • Conversations about a fourth wave: There is fear that the country will experience a fourth wave of Ovid infections and deaths before the end of the year, due to many people not adhering to rules around masks, hand washing etc. Concerns that the country will go into hard lockdown in December again.
  • Many vaccinated people are willing to encourage others: A survey of 22,0000 from the Covid WhatsApp system run by Praekelt.org suggests 88% of vaccinated people would advise others to vaccinate. For the remaining 12% the main reason cited is side effects.
  • Trust in doctors and nurses: Health professionals are the most trust people giving health information (see here).
  • There has been a positive response to the new functionality on EVDS to change appointments, and that EVDS is not barrier to vaccination (you can go for vaccination even if you have not registered).

 

MISINFORMATION 

  • MISINFO: Vaccine side effects are dangerous and people are dying.  TRUTH: Covid Vaccines have side-effects but they are safe; there’s no evidence of deaths due to covid vaccine in SA. Tragically, a few people have died after vaccination, but after investigation the death was not linked to vaccination. See here and here.
  • MISINFO: Kebby Maphatsoe passed away due to being vaccinated. TRUTH: Kebby Maphatsoe has passed away, RIP. His family said he passed away due to a heart attack.  See here.
  • MISINFO: I am a doctor / health professional, so what I say must be true even if it goes against evidence. TRUTH: Some prominent figures, including a few doctors and other linked to health and well-being, use their credibility to make anti-vaccine statements. Vaccines are safe.  See here
  • MISINFO: The number of deaths due to Covid in South Africa are wildly exaggerated, it’s not more dangerous than the common cold. TRUTH: It is certain that the number of deaths as a result of Covid (referred to as ‘excess deaths’) is higher than the official statistic of people who have died due to COVID. See here, here and here. By 4 September, over 250,000 in SA have died as a result of Covid (here).

 

PROPOSED ACTIONS FOR RISK COMMUNICATION AND COMMUNITY ENGAGEMENT 

  • Reinforce messaging on side effects: Unpleasant (though not life-threatening) side effects have happened in SA. Clear messaging should explain this to manage expectations, and to indicate the pathway for people to seek care to offer reassurance.
  • Social listening at local level: Vaccination rates vary greatly across different districts of the country. Community-level social listening will be strengthened to understand local issues affecting vaccination, through collaboration with local activists, community health workers, GCIS staff, CC agent and others.
  • Launch a Covid champion programme to encourage pro-vaccine people to promote vaccination to friends and family (see here).
  • Treat hesitant people with respect: Many people have genuine worries and concerns about vaccination. All health communicators, community mobilisers and media content produced should demonstrate respect for people who are currently vaccine hesitant as we seek to allay concerns and encourage them to vaccinate (see here).
  • Explain break-through infections: Vaccinated people can contract Covid. While this fact is well-known medically, examples of people becoming infected after vaccination causes confusion and undermines motivation to vaccinate, especially among the youth. There needs to be new messaging explaining this more clearly.

 

ISSUES RAISED FOR FOLLOW-UP

  • Suggestion to train all medics as ‘messengers’ or influencers supporting vaccination. Several surveys suggest that medics are the most trusted source of health information. We could run short training courses for doctors, nurses, community health workers and other health professionals so they have the skills to encourage others to vaccinate.

 

 

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.

Drafting team: Lizzie Harrison, Sowo Tucker, Charity Bhengu, William Mapham & 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