This is a weekly report of Covid & vaccine sentiment, rumours & misinformation in SA. Further info here. This is the half-birthday of this report – it has now come out every week for half a year.

Click here to download a pdf copy of this report

 KEY TRENDS

  • Fear of the fourth wave: Many people are concerned about the arrival of the fourth wave of Covid which is expected in South Africa in December or January. Others are already pointing fingers, and are suspicious about how a future surge in Covid can be predicted if it isn’t planned and controlled by people (see Here, Here, Here and Here). Other experts are unsure if there will be another surge in cases, as many people have now been vaccinated” (Here and Here).
  • People sceptical of the rising Covid-19 case numbers after the elections, suspicious that this was manipulated for political gain by the ruling party. “What a jump from a mere 100 to 344’. Others said that, “It was expected because of the gatherings at the election with zero physical distancing.” (Here,Here and Here).
  • Complaints about Covid-19 side effects: Three people claimed to have experienced shingles after vaccination and citing conspiracy theories to explain the effects. “it is because this thing suppresses the immune system and the situation is worse for someone with underlying conditions” (Here and Here). It Is certain that there is under-reporting of side effects. There is anecdotal evidence that there have been many serious (though not life-threatening) side effects in SA, with many people knowing someone who has experienced this, leading to reasonable concern. As official media does not talk much about this problem, there is mistrust in official communications promoting vaccination.
  • Official and unofficial side-effect reporting: There is an official channel for reporting vaccination side-effects. However, many do not know about this or use it. This has allowed unofficial efforts to gain support, especially the SAVAERS system (here) which gathers unverified data than can be used to undermine the national vaccine rollout.
  • Pfizer profiting from vaccine sales. The news that Pfizer has made billions in profits from their Covid vaccine has not been well received, with more negative comments (Here) describing the company as “modern day drug dealers”, accusing the company of being “a money scheme” and that “covid was created” for that purpose. (Here andHere).
  • Concerns about coercion: Ongoing concern about giving incentives (Vooma vouchers of R100 groceries to over 60s who vaccinate) are described that as “coercion” bribing poor people with food: Another said, “It is a choice to accept the incentives, and older people are vulnerable to the virus because of co-morbidities and need support.” (Here).
  • Vaccine hesitancy due to the high recovery rate: While there is widespread delight that new infections and deaths are reducing as the Third Wave ends (here), some are resisting vaccination because of the high Covid-19 recovery rate of over 96%, and the reduction in new cases. However, people are still at risk of being infected by the virus with serious consequence (Here).
  • … due to reportedly children’s low Covid-19 risk: Parents falsely believing their children should not vaccinate because of the perceived low risk of children being infected, with concern about the risk of myocarditis in young children due to vaccination. Others believing that both the parent and child should be empowered with information to make informed decisions (Here, Here and Here).
  • … due to perceived “good immune systems”: There are false claims that a person with a good immune system can fight off the virus without vaccination. “The logical approach would be to encourage people to eat healthily and boost immune system” because even a healthy person needs a vaccine for additional protection against the virus (Here).
  • Risks of private taxis in the townships: While many welcome the offer from Uber to drive people to vaccine sites for free, there is concern about the use of Uber free rides in the townships as there is often a disagreement with the public taxi drivers, and hence a safety risk for both the driver and passenger. “You should investigate the risks unless you were targeting the cities only” (Here).
  • Exclusion of the poor from the mainstream services: Some point out that people in the rural areas are always left out when they need more support to reach the vaccination sites. Here
  • Expensive testing: Frustration that Covid testing remains expensive while Covid vaccination is free.
  • Fear of other diagnosis: There are reports that some people are not vaccinating for fear that if they go to a health facility, they might be diagnosed with HIV or other serious disease.

 

LOCAL / DISTRICT / PROVINCIAL ISSUES

This new section summarises social listening from areas around the country. For more information on 13 reports from health districts, see here (section 7 onwards).

  • Amathole, Eastern Cape: There is decrease in vaccination among youth. Young people generally seem to have lost trust in government – this despondency in youth is also reflected in their lower voter turn-out. The J&J vaccine is much proferred, especialy among men believe that the Pfizer vaccine can lead to erectile disfunction. Vooma vaccination vouchers for the lederly will probably be very effective in mobilising the elderly.
  • Buffalo city, Eastern Cape: Less vaccinations this week, possibly due to ‘vaccine communication fatigue’ and the smaller number of cases leading to people seeing Covid as less important. There is a sentiment that, “We prayed for this pandemic to end, and now God has answered our prayers”. There is now vaccine hesitancy among all age groups. School learners are preparing for exams so it is difficult to motivate them about vaccination.
  • OR Tambo, Eastern Cape: Many pregnant women & breastfeeding mothers believe it is not safe for them to vaccinate. There are suspicions that the reduction in Covid infections and death was controlled for the political advantage of the ANC, and that the pandemic will get worse now the elections are over. The death of some people after they were vaccinated (cause undetermined) has led to increased hesitancy as people speculate it was due to the vaccine.
  • Mangaung, Free State: Vaccination uptake has declined, particularly among the 18 – 35 year old age group – another Vooma weekend would help. Some remote areas have no access and people have to travel long distances which is expensive to vaccinate, e.g. Tweespruit. This is a major barrier to increased vaccination. Unemployed youth are unmotivated to get vaccinated, and feel the government shouid be addressing socio-economic needs more than vaccines. Incentives like free WiFi at vaccine sites would attract people, especially the yout.
  • Ekurhuleni, Gauteng: Vaccine acceptance is slowly increasing, largely due to encouraging stories from those who have already vaccinated. People are also vaccinated as there is a perception that people will need to show a vaccine certificate to apply for jobs. Thereis more vaccinee acceptance in the suburbs than in rural areas, where misinformation tends to be more believed. People ask, “How do we know that 4th wave is coming soon – is it controlled and there’s a timetable for these waves?” There is a belief that people with chronic illness will die once they get vaccinated. Pop-up vaccination sites in populous areas are effective, and some need this on more than the one day currently provided. Sometime pop-up sites start too late & end to early so there are people waiting who remain unvaccinated. It would be better opening earlier & later, especially for working people. This district was the most successful in Gauteng for vaccinating.
  • eThekwini, KZN: Some youth are very scared of vaccination. Mobile vaccination facilities need to go to rural areas, not just the centres and malls. Many men are working during the week and so vaccination sites need to be open at the weekend. Some people don’t vaccinate as they have heard of severe side effects. Many belief that government is benefiting from the Covid vaccination rollout somehow – there was Lockdown level 1 around the elections, now it will go higher again. The fear that vaccination will implant an electronic chip in them is still widespread. More health talks, community engagement and leaflet in isiZulu (not just in English) will be helpful. Having mobile vaccination sites at the university campus of UZN (Edgewood) was effective.
  • Harry Gwala, KZN: Vaccination among youth and teenagers is increasing, though some youth have come for vaccination while drunk.
  • King Cetshwayo, KZN: Vaccine acceptance has increased with the help of community, traditional and religious leaders. Vaccination has been conducted inside schools in this district, which has been effective at reaching 12 – 17 year olds. Fewer myths are being spread about vaccines due to better education on vaccination. It is hard vaccinating the elderly over 60s, with many of them concerned about vaccination while taking chronic medication. Community mobilisation and education the day before pop-up vaccination sites arrive has been effective, as is loud hailing on the day itself.
  • Ehlanzeni, Mpumalanga: Reduced numbers vaccinating compared to the previous week, possibly due to the elections. Many men don’t want to be “lab rats” and they believe something will be implanted in them. The only time they will accept help from the health system is in the case of a serious disease or accident like a car accident. They are also fearful that by going for vaccination it will be uncovered that they have HIV. There is a higher vaccination rate among women, and many said that they experienced serious side effects after the first dose of Pfizer. Pregnant women say they will not vaccinate during this period and no one will change their minds. Some people say that they have rely on herbs and don’t believe in the power of western medicine. Some people believe that its only “black” people that are being vaccinated with the “real” vaccination (which is unsafe), whereas politicians, the wealthy and other ethnic groups are being vaccinated with “water” (safe). People ask us if the government will increase R350 grant if they vaccinate: Some people think that vaccination benefits the government more than it benefits themselves. They feel they are doing it for the government, hence they are requesting to be compensated with money. The sentiment is that vaccination is not a benefit for them. There is concern among undocumented foreigners about when they can get vaccinated, but whether they would be deported if they do so. People are scared of the hospital, saying that if they vaccinate now, they will become “continuous victims of the health system” by develop health conditions from something implanted by the vaccine. A video is circulating on social media of a woman who was pregnant and got vaccinated, who then prematurely gave birth to a ‘deformed’ child. This video is affecting pregnant and breastfeeding women. Direct community engagement and education is effective.
  • Namaqua, Northern Cape: Teenagers 12 – 17 are more keen to vaccinate than adults over 18. More people are willing to vaccinate to see their loved ones during the Christmas holidays, avoid another hard lockdown and possible fourth wave of the pandemic. People prefer the J&J vaccine, and the usual myths persist (Devil 666, erectile dysfunction, dead in 2 years, herbs are better). Pastors and Rastafarian leaders have tight control on their follwers are very opposed to vaccination.
  • Dr Ruth Segomotsi Mompati, North West: Good numbers of 12 – 17 year olds are coming for vaccination. Many people question, “Why do we have to force kids to vaccinate if we say that are not in danger?” Several adults are scared to vaccinate because they think they will die, and there is widespread sentiment that parents should have to give consent before their children are vaccinated. Transport to vaccine sites is still a problem for many people. Many people did vaccinate on election day. Many community groups would like to help the vaccination drive, but they require transport, food & airtime to assist.
  • Garden Route, Western Cape: Several pastors are still hesitant and advise members of the church not to vaccine. Bishops ans senior pastors advocating for vaccination and being vaccinated on TV would help. Senior religious leaders need to talk to local pastors to persuade them. To reach 12 – 17 year olds, we should vaccinate at schools, but the Dept of Basic Education does not allow this. The J&J vaccine is preferred – it would improve vaccine uptake is both J&J and Pfizer were always available at facilities and people could choose.
  • Khayelitsha and Eastern Sub-Structure, Western Cape: Pop-up vaccination sites are effective at attracting more people to vaccinate.

 

MISINFORMATION

  • MISINFO: Covid is no longer a threat. TRUTH: The numbers of infections and deaths in SA are now low, but it’s important we keep social distancing, wearing masks in public, adhere to frequent hand-washing and get 70% of the adult population vaccinated (around 28 million). If we don’t, the numbers will climb and a 4th wave of the Covid pandemic in SA could be terrible (here).
  • MISINFO: Covid is controlled by the government: that’s why it went down before the elections and is now predicted to increase with the 4th wave. TRUTH: Covid is real and is not directly controlled by any individual, corporation or government – though vaccination campaigns and other non-pharmaceutical interventions can reduce it. The reason for the pandemic to come as waves in a population is complicated but is well understood in epidemiology (here and here).
  • MISINFO: Covid isn’t that serious, it’s no worse than the flu. TRUTH: Covid has taken over 5 million lives globally (here). In South Africa, the official statistics show that over 90,000 have passed due to Covid (here), but the real figures is definitely much higher. The SA Medical Research Council estimates that there have been over 268,000 ‘excess deaths’ in the Covid period (here), which is a better measure of how many have lost their lives due to Covid. Flu kills between 6,000 – 11,000 people in SA each year (here).
  • MISINFO: Johnson & Johnson Vaccine is more effective than Pfizer. TRUTH: While they are different types of vaccines and there are small differences in efficacy, they are both approved for use in SA, both are highly effective and both are safe. You should take whichever vaccine is available at your health facility now (here).
  • MISINFO: Vaccines go against the word of God. TRUTH: Vaccines are not in conflict with religious practice and beliefs. See globally here and here and locally in SA here.
  • MISNFO: Foreigners will be deported if they try and get vaccinated. TRUTH: While undocumented foreign citizens in SA may well be fearful, anyone in South Africa can be vaccinated, regardless of nationality. Foreign nationals are not at risk of arrest or deportation from visiting a health facility. See here
  • MISINFO: Vaccines cause infertility in men and women and negatively impacts their sexual performance. TRUTH: There is no evidence to support these claims – it is not true. See here, here and here.
  • MISINFO Being vaccinated while pregnant or breastfeeding will make your baby deformed or die. TRUTH: Pregnant women should get vaccinated as the risk of having Covid while pregnant poses far greater risks to the woman and to the foetus / baby than side effects of vaccines. Speak to your health care provider for specific concerns. See here, here and here.

 

PROPOSED ACTION FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

  • Emphasize hopeful messages highlighting that vaccines are crucial to ending the pandemic. Share solidarity messages and testimonials from leaders and normal people promoting vaccination and other protective measures and safe behaviours.
  • Vax Champs: The Vooma Vaccination Champions (“Vax Champs”) programme will be launched on 12 November. This encourages everyone in SA to join the team to end Covid by encouraging their friends and neighbours to vaccinate. Help control the pandemic, protect your friends and family, be a vax champ! (here). Mobilise people who have vaccinated and others who understand evidence-based medicine to make visible their support for vaccination by establish a social norm to vaccinate.
  • Continue producing information for community mobiliser to help them debunk rampant misinformation in the communities; information that demonstrates that the risks associated with contracting COVID-19 far outweigh the risks of vaccination, and why vaccines are considered safe and effective.
  • Side-effect reporting: Produce and circulate widely information on how to report side-effects, both for health professionals and the general public. Publish and share verified statistics on the risk of contracting the virus and having severe symptoms after vaccination. Without clear evidence that side-effects are being reported, acknowledged and responded to, perceived and real side-effects will undermine confidence in official communications and the vaccination campaign.
  • Vaccination and co-morbidities: Many people, especially the elderly, are not vaccinating due to fear of side-effects due to their existing diseases and chronic medication. There is much uncertainty about this, with some health officials not being able to clarify the issues. Produce clear communications materials on this, distribute widely (including to health professionals including Community Health Workers). Provide information on this at monthly SASSA grant payment sites.

ISSUES RAISED FOR FOLLOW-UP:

  • Further consideration of vaccination at high schools: It is requested that the Department off Basic Education review the decision not to allow vaccination on school premises, especially in the short period after exams and before the school holidays.
  • WiFi at vaccination sites: As youth 18 – 34 remain the most vaccine resistant age group, one idea to consider would be to establish WiFi connectivity hotspots at vaccination sites that can only be used by the vaccinated. This could be highly motivating for youth and others to come, and should be a relatively cheap way of reaching large numbers (especially with sponsorship from tech companies). It is at least worth run as a pilot at a few health facilities to assess the response.

 

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
  • 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.

 

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