This is a weekly report of Covid-19 & vaccine sentiment, rumours & misinformation in SA. Further information  that provides the background to this report, especially input from many health districts, is available here.

Click here to download this report as a pdf

KEY TRENDS

Anxiety as infections increase in 5th wave … versus Covid fatigue. There are two contradictory widespread sentiments: increasing concern as the fifth wave of Covid seems to have started, and boredom at Covid with many feeling the pandemic is over. There are rising infections and positivity rates, particularly in Gauteng and KZN (Here). For example, the following were posted on the Department of Health Facebook site: “Scary for sure”, “We heading for a hard lock down soon look at the rest of the world its getting out of hand again!” (Here). Another post said, “We are tired of this, please don’t bother us”.

Vaccine hesitancy – and some support. Over 100 workshops on Covid and vaccinations have been held in SA, and the following views came up in every single session throughout the country: “Covid isn’t as dangerous as it used to be, and it’s not something that one needs to worry about“, “The vaccine might kill me or make me very sick” and concerns that vaccines are likely to cause “miscarriages and impotence” and that “Covid-19 is much less important because we don’t hear about it in the media anymore”. Most of the people just needed clear information and their questions answered, and many were persuaded to vaccinate during the workshop. As mentioned in the Misinformation section below, vaccines are highly effective against Covid, even with Omicron sub-variants driving the surge in Covid cases in South Africa (Here). Vaccine hesitancy has led to some vaccination sites being empty as Covid cases increase (Here). However, there have also been many social media posts of positive vaccination experiences, e.g. “I’m doing good so far. Only body ache and headache. I am vaccinated and I went for a booster. I believe that helped a lot”.

Social media. There were no stand-out social media trends. Interest in the following search queries was rising on Google over the past week: “Omicron symptoms” (+180% compared to the previous week), “Clicks vaccination times” (+150%), “Covid vaccine at Clicks price” (+100%), “Vaccine certificate download” (+100%). The most shared links on Twitter were about the risk of the Aspen Covid vaccine plant closing (Here) and a disinformation website falsely claiming millions of deaths from vaccination (Here). News articles about Covid in SA generated over 14,000 engagements (+8% compared to the previous week). Top articles on digital news media include: Rise in Covid infections (Here), New Covid wave in Gauteng and KZN (Here and here), No orders for vaccine for Aspen plant (Here). The chart below shows the share of engagement by vaccine subtopic, Twitter and digital news in South Africa:

Rural demand for vaccination. There still is great interest in vaccination in some rural areas. This week some communities in the Eastern Cape were very welcoming of mobile vaccination sites, especially in areas where vaccination had not been accessible previously. While vaccination rates in these areas were low, the people were not anti-vaccination – they simply needed correct information and access to vaccination sites.

Uncertainty at new Covid rules. New Covid regulations came into effect after the State of Disaster ended, including mandatory wearing of masks in indoor public spaces, such as public transport (Here). These are not widely known and there also is opposition to these rules, including from Afriforum and Dear SA (Here). In much / most of the country areas masks are not consistently and properly worn, including in many public indoor areas. There was confusion caused by mixed messages from the Department of Health on whether masks need to be worn in schools.

No orders for Aspen. There is concern that no orders for the J&J vaccine packaged and sold at the Aspen Pharmacare plant in Gqeberha, putting the production line at risk of closing (Here).

Opposition halting vaccination of children. The African Christian Democratic Party has been granted by court a postponement, with costs, to halt the roll-out of the Covid vaccine to children aged 12 and 17. SAHPRA says this is another setback in its vaccine roll-out programme (Here). There is online debate for and against around this issue.

National Covid Contact Centre. The call centre received more calls this week than last, largely about accessing vaccine certificates. They are finding many cases of vaccinators at sites not correctly updating records, with increasing back capture issues (entering the data after the event). There have been some calls about whether people receiving doses in different countries are considered fully vaccinated, and difficulties for people with two passports.

Misconceptions. Issues taken from the social listening district reports (see below):

– Some people say they do not want the vaccine, they just want the booster – they are encouraged by the terminology of ‘booster’ as if it is something different; the product name changes perception. Booster gives it ‘Vooma’ (could be related to advertising for sexual health products) and changes the attitude and stigma.

– A negative Covid test means that the person is immune from the virus.

– Some people trust the flu vaccine more, and then don’t see a need to take the Covid vaccine after they have the flu vaccine (especially as the symptoms of the illnesses can be the same).

– We already should have herd immunity as by now over 70% of the population have either been vaccinated or have been infected and so have natural immunity.

– Some youth feel they don’t need to vaccinate as they take dagga which they believe is a medicinal herb.

DISTRICT REPORTS

  • Ekurhuleni (Gauteng). Vaccine acceptance is increasing, with growing fear that Covid could increase as winter approaches and people see vaccination as a preventative measure. There is fear that the 5th wave could be coming. A 65 year-old women told me, “We are scared”. I have been asked several questions: How many booster shots people will need? Should immunocompromised children take extra doses? Changes in the district plan have been confusing. There are now 100 Solidarity Funded mobilisers in Ekurhuleni, which is good. Many youth are tired of Covid. Some say they don’t need to vaccinate as people can still get Covid after vaccination. People want more campaigns like KeReady to engage youth.
  • Johannesburg (Gauteng). Vaccine acceptance is increasing with youth, and vaccination in schools makes it easy for many of them to access it. However, many people still believe that vaccination will make no difference. Many school learners feel conflicted about being vaccinated, but several take it for fear of hospitalization.
  • Ethekwini (KZN). Community radio helps get the message out and engaging with people one-on-one and in groups around Pop-up sites is effective. Working people find it difficult to get to vaccination sites during the week – weekend opening would be very helpful or local pop-up sites. Transport is still a problem, especially as Ethekwini is very big. People are still coming to vaccinate, though others are reluctant due to peer pressure from friends not to. We should have loud-hailers to assist with community mobilization. Soccer tournaments and weekend events would help to motivate youth. Pop-up sites work – we need them in malls around Umlazi. Loud-hailers and radio interviews help information sharing and responding to myths and misinformation. Fear of adverse side effects in social media is a factor.
  • Harry Gwala (KZN). Many young people have vaccinated because it is mandatory for many companies and learning institutions. Worry about the fifth wave has increased vaccination rates, and large numbers of people are coming in farm areas. There isn’t much social media disinformation circulating now. Pro-vaccination programmes on several community radio stations have been helpful.
  • Namakwa (Northern Cape). There is reckless behaviour, especially among youth, in spite of warnings about the looming fifth wave. Very few people are coming to vaccinate now. One myth is that a negative Covid test means that the person is immune from the virus; another is that herd immunity has already been reached from the number vaccinated and also who have been infected and have natural immunity. People who haven’t been infected yet feel invulnerable now and so feel they don’t need the vaccine. There is non-compliance with regulations in business, night clubs, taverns and restaurants where the rules are not enforced. There is a slight increase in the number of young people vaccinated. We have had successful training with our new partner Re-Action and have reached many people through door-to-door visits. Many people are struggling with grief about the death of loved ones from Covid and professional counselling should be offered. There should be better collaboration with other government department such as Education, Social development, and Sports, arts & culture. Community leaders and elderly people are not helping motivate the youth – there is a laissez-faire attitude (anything goes). In-school vaccination would help
  • Dr Ruth Segomotsi Mompati (North West). Youth are more exposed to misinformation as they use the internet and social media, where they are exposed to myths, e.g. people become zombies after vaccination; the vaccine will kill you; side effects are severe; it places a micro-chip in you; the vaccine is just for older people as they are the only ones who get sick with Covid. Demand creation is hampered by a lack of transport, rain and weak cooperation with various local partners. Some youth don’t have smart phones. More vaccination sites have been set up in more convenient locations which reduces logistical barriers, though transport to sites remains a problem for many. KeReady has helped to motivate youth to vaccinate – but there is still a huge problem with most youth not wanting to. More women get vaccinated than men. Many youths don’t believe in vaccines and think that there are very few people sick with Covid any more. More youth would vaccinate if they see their peers and role models getting vaccinated. Entertainment, airtime and other incentives would help motivate youth to vaccinate.
  • Cape Winelands (Western Cape). Vaccines have a negative connotation in many communities. Some people say they do not want to vaccine, they just want the booster – they are encouraged by the terminology of ‘booster’ as if it is something different. Some people who felt sore after the first vaccination say they will only take a second if they can be promised that the second one won’t hurt. The Drakenstein sports clubs require participants to vaccinate and monitor this strictly, which helps. Door-to-door visits work well where there isn’t stigma and we can immediately respond to the fears that people have.
  • Central Karoo (Western Cape). Many are concerned about the coming 5th wave, with some saying it coming as predicted shows that Covid is planned and controlled by humans. Some youth feel they don’t need to vaccinate because they take dagga which they think is a medicinal herb. Vaccine acceptance is now higher in 12 – 17 year olds. More older people are coming for booster shots, but it is still a struggle with youth 18 – 34 years. Data or airtime would be a strong incentive for youth to vaccinate.
  • Garden Route (Western Cape). Uptake of the flu vaccine is overtaking Covid vaccination. Some people trust the flu vaccine more, and then don’t see a need to take the Covid vaccine after they have the flu vaccine. Some parents want their younger children and toddlers to be vaccinated and don’t know what to believe. The KeReady campaign had an impact in getting youth to vaccinate –someone in my area won the competition which motivated some youths get the jab.
  • Swartland (Western Cape). Vaccine acceptance is rising with elderly people, and is slowly increasing for young people. Many people, however, have no interest in vaccination anymore; and others ask why must we always take more boosters all the time? People like that we advertise the opening times of the vaccine sites – some even call me in the streets asking when the next vaccine site will open. Community Health Workers are assisting the vaccination effort well. Elderly people generally accept vaccines, while most young people totally refuse. However, when I do site visits I can persuade a few youths. They are scared as they do not have correct information about vaccines, and fear injections. Several say taking dagga keeps them safe and healthy. People need vaccination certificates to go to many places which motivates some people to vaccinate.

 

 

MISINFORMATION

  • MISINFO: Vaccines cause infertility and erectile dysfunction. TRUTH: There is no evidence to support these claims.  Covid, however, can impair sexual performance. See here, here and here.
  • MISINFO: Covid booster vaccines are dangerous. TRUTH: There is no evidence to support this claim. Boosters shots normal practice with many vaccines. The drug in the booster shot is the same as in previous vaccinations (either Pfizer or J&J in South Africa).  See here and here.
  • MISINFO: The prediction of a 5th wave shows that the pandemic is carefully planned to control. TRUTH: There is no evidence to support this. Prediction by epidemiologists and other scientist come from carefully considered models, based on previous experience and predictions made to support planning and preparation. See here and here.
  • MISINFO: I have survived four waves of Covid so I don’t need a vaccine to survive a fifth. TRUTH: Being vaccinated increases your chances of not getting Covid at any time in the pandemic. Also, vaccination helps you prevent spread of Covid to others and limits dangerous new variants emerging. See here and here.
  • MISINFO: Vaccines side effects are being under reported and can kill you. TRUTH:  There is no evidence for this. Most side effect are mild and self-resolving and no one has died from the Covid vaccine in SA after over 30 million vaccinations.  See here, here and here.
  • MISINFO: Covid isn’t that bad so we don’t need to be vaccinated. TRUTH: While some people who get Covid can show no symptoms, vaccines are highly effective in preventing serious illness and hospitalisation. It is still a nasty disease for many people who get it. See here and here.
  • MISINFO: Natural immunity is better than vaccine immunity and shows we don’t need to be vaccinated. TRUTH: Natural immunity can help protect you but it depends on when you had Covid, which variant and your own immunity strength and health. Vaccines are essential to giving sufficient anti-bodies to protect you more fully, which is why boosters are essential too.  See here and here.
  • MISINFO: Foreigners will be deported if they try and get vaccinated. TRUTH: While it is understandable that vulnerable people including foreigners may be fearful, all adults in SA regardless of nationality will be vaccinated, without any fear of arrest or deportation. See here and here.
  • MISINFO: Vaccines are dangerous and now linked to “vaccine-acquired immunodeficiency syndrome” or “VAIDS”. TRUTH: This is not true and there is no evidence at all to support the claim of immunodeficiency being related to Covid-19 vaccines. See here and here.
  • MISINFO: Pfizer’s own data shows over 1,291 side effects of Covid vaccine. TRUTH: It is true that a report from Pfizer released in 2021 does list 1,291 potential side effects of any new drug. However, this is NOT a list of side effects of their Covid vaccine; instead it is a list of the possible side effects that their study was watching out for. The vaccine is safe, being authorised by the SA Health Products Regulatory Authority and similar bodies around the world. See here and here.

 

WHO Africa Infodemic Response Alliance (AIRA) & Viral Facts

 AIRA is the Africa-wide initiative of the World Health Organisation, managaing the infodemic of misinformation and communications overload related to Covid and vaccination. They produce the Viral Facts content responding to misinformation which can be used freely. Here are the latest Viral Facts resources (please use them):

  • Explainer: Routine childhood immunization (Here)
  • Explainer: Malaria vaccine development (Here)
  • Explainer: The XE variant (Here)
  • Mythbuster: Flu & Covid vaccines (Here)
  • Importance of vaccination as countries relax Covid-19 restrictions Dropbox, Twitter, Facebook

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

  • Overcoming Covid fatigue. As Covid infections are rising, it is important to re-emphasize that vaccination and non-pharmaceutical interventions (e.g. mask wearing and physical distancing) are needed to reduce the fifth wave. What people do now has a direct impact on illness and death soon. It is requested that the Presidency consider having a ‘Family meeting’ with our President Cyril Ramaphosa giving a televised address to the nation (which can be linked to the point below).
  • “We are the majority” (coming soon). Currently 49.5% of adults in SA have received at least one Covid vaccination and the number will reach 50% in the next few weeks. This must be celebrated widely (even though this is not 70%, is just of adults, and is for the 1st jab not full vaccination). Five provinces (Free State, Western Cape, Limpopo, Eastern Cape and Northern Cape) are already over 50%, and a communications campaign should start in these provinces around “Most adults are vaccinated; be part of the majority protecting our country; why be left out?” To change the social norm, we must make this fact very visible (not just a statistic on a website). Organisations involved in communications around Covid should consider how to make it clear that most adults are vaccinated, for example, by disseminating pro-vaccination lapel badges to demonstrate that many people believe in science and are committed to ending the pandemic. Start in the 5 provinces now, moving to a national campaign within weeks.
  • Clarify new regulations. The new Covid regulations are not widely known and even less widely followed. They should be communicated with an explanation of why they are important, with information in all SA languages widely disseminated.
  • Respond to misconceptions. See the list at the end of the Trends section above.

 

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-19 Hotline: Reports from the national Covid-19 call centre
  • Org: NDOH Covid-19 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-19 Comms: a network of communications specialists that produces information on the pandemic
  • DOH Free State & KZN: Provincial Departments of Health
  • Community Constituency Front (CCF), Covid-19 Hotline, Health Systems Trust
  • Centre for Communication Impact, Centre for Analytics & Behavioural Change, Section 27
  • Medical Research Council, National Institute for Communicable Diseases,
  • SA Vaccination and Immunisation Centre, HSRC, DG Murray Trust, Right To Care
  • 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, IPSOS, People’s Health Movement, and 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