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

Click here to download this report as a pdf

KEY TRENDS

Mixed reactions to the lifting of remaining Covid-19 restrictions. The news that the government has lifted SA’s remaining Covid restrictions, including an end to regulated mask wearing, as gazetted, was received with mixed feelings. Most people were relieved and glad that the regulations have ended.  Some were concerned about the timing of the announcements and are choosing to continue wearing masks because “it is too premature and indecisive a decision to end mask-wearing indoors in winter” (Here). Others were happier but still concerned, “I’m somehow relieved but still concerned about the risks” (Here). There were also those who believed that “dropping masks might increase vaccine uptake as individual risk perception increases” (Here). Many activists regarded the government’s announcement on face masks, border checks, and the gatherings ban drop (Here) as a “victory for the civil society” or “the culmination of hundreds of thousands of public objections, persistently opposing irrational government policy” (Here). Others said they thought “the battle against Covid-19 had long been won” and that “Covid is gone” (Here).

Opponents of vaccination celebrating. There are several groups actively organizing against the Covid vaccine rollout, such at KR-Code-19. On these WhatsApp groups there is widespread celebration, claiming that they the “won” the Covid war, that unvaccinated people are heroes for standing against state tyranny and that their actions have forced the government now to retreat.

SA confirms its first case of monkeypox. A case of monkeypox involving a 30-year-old man was confirmed in Gauteng this week. Useful information on monkeypox is available here. Calls for calm have been issued with people being reminded that the condition is usually not serious and very manageable (Here). It is important to note that any person, regardless of their gender identity or sexual orientation, can catch monkeypox if in close contact with an infected person. As several of the people initially diagnosed were gay and bisexual men, there has been stigma and homophobia attached to the disease. These are completely misinformed as monkeypox is spread by any kind of close physical contact between any two people. Some believe there is significant risk that the stigma and homophobia experienced by gay and bisexual men during the AIDS crisis in 1980-90s, “could stop people from seeking the treatment they need” for monkeypox (Here). Other people are still skeptical of another virus outbreak, saying “the timing of this is highly suspicious”, calling it “another word for AIDS”, a “Covid-19 side effect”, and “WHO virus or Moneypox” (Here). Negativity toward vaccines for Covid is also impacting the monkeypox narrative as some African citizens are concerned that public health experts are once again using Africa as a testing ground for vaccine efficacy and safety for use in the USA and European countries (Here).

Social media: rising interest in Covid-19 vaccines. Google searches about “EVDS login for healthcare workers” (increased by 1,050% compared to last week), “vaccine certificate health gov za” (+700%), and “how to download vaccine certificate online” (+110%). Tweets about Covid-19 vaccines generated 4,400 engagements (65% less compared to last week), Facebook posts about Covid-19 vaccines generated about 18,000 engagements over the past week (-10%), and digital news articles generated over 8,700 engagements (+35%).

Engagement on Twitter, digital news and selected Facebook channels, in South Africa:

Strong views for and against the vaccination of infants and toddlers. The US Centre for Disease Control (CDC) recommends Covid-19 vaccines for children as young as 6 months (Here). “Together, with science leading the charge, we have taken another important step forward in our nation’s fight against Covid-19. We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” said Dr Rochelle Walensky (Here). Responses to the news have been mixed.

Growing distrust of vaccines among those with higher risk of severe infections.  People with HIV have a higher risk of breakthrough Covid-19 infection after vaccination, according to a study (Here) and trust in vaccines in this population seems to be waning, with sentiments on social media suggesting that the number of breakthrough infections is causing hesitancy to take boosters or vaccinate at all.

Recurring debates about vaccines. A tweet describing the survival of “anti-vaxxers without the Covid-19 vaccines as a miracle” (Here) has been trending for two weeks, encouraging a heated debate. Those opposed to vaccination described that they were able to avert infection through “prayers”, “good nutrition”, “traditional medicine”, and “natural immunity” (Here). Those supporting vaccines, on the other, maintained that “leaving their lives to chance without being vaccinated was both irresponsible and naïve” (Here).

Confusion as to why SA needs a loan for vaccines when “Covid-19 is almost gone”. News broke of the approval of the loan by the World Bank to fight Covid-19 in South Africa (Here), just after the country received an intellectual property rights waiver on Covid-related treatments (Here). Shortly after this WHO stated that Covid-19 infections and related deaths had fallen by 90% worldwide from the peak earlier this year. This has created a somewhat confusing “global agenda” according to many on social media and the news headline; “WTO agrees to lift Covid vaccine patents, but is it too late?” (Here), prompted more speculations. The sentiments on SABC Facebook expressed confusion and distrust. “So, tell me again why SA needs to take a R8 billion loan from the world bank to buy R47 million Covid-19 vaccines?” and “Why is South Africa borrowing money for a virus that has a 90 percent decline… we are already swimming in debt as a country” (Here). Efforts to continue vaccination, have been interpreted by many on social media as “Trying harder to justify the recent loan from world bank…” (Here).

Transition into Covid-19 endemic phase and the end of Covid-19 restrictions interpreted as the end of the need for vaccines. As Covid-19 infection is likely to remain a challenge in the country for a long time, the MAC advisory, dated 23 June 2022, has recommended an integration of Covid-19 pandemic preparedness and response functions into routine health systems and services, which ties in with the lifting of the Covid-19 restrictions. However, many people have interpreted this as an “end of Covid-19 vaccinations” creating a grey area that may further increase vaccine hesitancy.

School disruptions and mental health risks due to Covid-19 effects revisited. A generation of students across the globe will likely suffer life-long losses to their earning potential because of the closure of schools and universities due to the Covid-19 pandemic, according to a recent study (Here). Recovery from this would require serious investment in the mental health of children and adolescents affected, according to the University of Cape Town in the article, “Children’s mental health: A catalyst for development”, launched on the eve of Youth Day in South Africa (Here).

Lessons on gender equality to assist the Covid-19 recovery period welcomed. New global data (Here) recommending the full participation of women in decision making positions during the transition period after Covid-19 was welcomed. The data provides specific recommendations for governments to ensure their economic recovery and emergency preparedness strategies are gender responsive, integrated and resilient (Here). The tool identifies how global decision-makers reacted to the pandemic’s economic and social impacts, which continue to fall disproportionately on women (Here).

In Namakwa (Northen Cape) people feel that only elderl people with comorbidities (e.g. diabetes, hypertension) are at risk of serious illness with Covid-19, not youth. A new myth is that cold weather conditions can kill the Covid-19 virus. There is a persistent belief that “Home remedies such as garlic, sage, essential oils can cure and protect a person against Covid-19”. Also, some people believe that big pharmaceutical companies are pushing vaccines to boost profits, saying “The announcement of the second Pfizer booster for people over 50 years is proof”. There is Covid-19 fatigue, with dwindling commitment of businesses to enforce health protocols. Many youth feel that the government is trying to force them to vaccinate to control their lives and movements. Many youth believe fake news and misinformation on social media and they don’t see themselves at risk of developing severe disease.

 

MISINFORMATION

MISINFO: People who have been vaccinated are more likely to get seriously ill from Covid-19. TRUTH:  There is no evidence to support this claim.  People who have been vaccinated are far less likely to experience severe symptoms. See here and here

MISINFO: Covid-19 vaccines are not safe for children. TRUTH: There is no evidence to support this claim.  Different countries’ medical regulatory authorities have approved Covid vaccines for different age groups – in SA the SA Health Products Regulatory Authority (SAHPRA) has approved the vaccine for anyone 12 years and older. Vaccines have been found to be safe for children. See here and here.

MISINFO:  Garlic, sage and essential oils are better at prevention and curing Covid-19 than vaccines. TRUTH: While it can be good to use natural substances that are proven to improve your immune system for your general health, there is no evidence to support claims that they prevent getting Covid-19 or curing it. However, some people do use essential oils and garlic to regain smell after having Covid-19. See here and here.

MISINFO: Monkeypox is just the new Covid-19 scam to control and or kill us OR monkeypox is the scam name for the side effects of the Pfizer Covid-19 vaccine. TRUTH: Monkeypox is a viral disease and not an auto-immune disease, so it cannot be a side effect of a vaccine and Covid-19 vaccines do not have any live virus in them. See here, here, here and here.

MISINFO: Monkey pox only impacts gay people. TRUTH: This is wrong. Most cases of monkeypox are not among the LGBT+ community. However, it is true that several cases have been identified with people who identify as gay or bisexual. We must be careful of creating stigma, especially when there isn’t evidence to support the claim. Similar false rumours were damaging at the start of the AIDS epidemic. See here and here.

MISINFO: “You have participated in a Covid test and you will get paid (if you do something)”, sent in a text to your phone. TRUTH: These messages are scams. Participation in any legitimate clinical trial in South Africa requires informed consent, and any payments have to be approved by an ethics committee and will usually only cover transport. See here for all the policies followed locally and here for an explanation of informed consent.

MISINFO: Vaccines have a tracker chip to track movement and shut you down if you misbehave. TRUTH: This is wrong; it’s a scare conspiracy theory with no truth. See here and here.

MISINFO: Ivermectin is an effective treatment for Covid-19. TRUTH: The SA Health Products Regulatory Authority (SAHPRA) carried out a study into the use of Ivermectin and concluded that “there is currently no credible evidence to support a therapeutic role for Ivermectin in Covid-19”. They therefore ended the trial early. See here and here.

MISINFO: Vaccines side effects are being under reported and can kill you. The SA Adverse reactions site shows how many have died! TRUTH: This is false. See here, here and here. SA has excellent adverse event reporting mechanisms backed by evidence (see here for a credible local site on adverse reactions). The SA Health Products Regulatory Authority has conducted extensive research and determined that no one in SA has died due to Covid-19 vaccines (Here).

MISINFO: I have survived four waves of Covid-19 already so I don’t need a vaccine now to survive a fifth one. TRUTH: Getting vaccinated helps you reduce your chance of getting Covid-19 which is still highly contagious, it reduces the spread of Covid-19 to others, and also helps to reduce the risk of new variants emerging. See here and here.

MISINFO: Covid-19 isn’t that bad, so we don’t need to be vaccinated. TRUTH: While some people who get Covid-19 can show no symptoms, vaccines are highly effective in preventing serious illness and hospitalisation. See here and here.

MISINFO: Vaccines cause infertility and erectile dysfunction.  TRUTH: There’s no evidence to support these claims. Covid-19 however can impair sexual performance. See here, here and here.

MISINFO: Covid-19 booster vaccines are dangerous. TRUTH: There is no evidence to support this claim. The Covid-19 booster vaccines are the same drugs used in the previous injections. Giving booster shots is normal practice. See here and here.

MISINFO: Foreigners will be deported if they try and get vaccinated. TRUTH: It is understandable that vulnerable people especially may be fearful of dealing with official bodies. However, anyone in South Africa can be vaccinated, regardless of nationality or official status; and no one has been arrested or deported when vaccinating. See here and here

MISINFO: Vaccines are dangerous and now linked to “vaccine-acquired immunodeficiency syndrome” or “VAIDS”. TRUTH: No evidence at all to support the claim of immunodeficiency being related to Covid-19 vaccines. See here and here.

MISINFO: Covid-19 vaccination requires long painful needles. TRUTH: Covid-19 vaccines may cause slight pain, like a poke or pinch for only for a few seconds. Very long needles are not used. See here and here for tips and advice on managing fear and pain.

MISINFO: Pfizer’s own data shows over 1,291 side effects of the covid vaccine. TRUTH: A report from 2021 did have a long list of potential side effects, but these were NOT side effects of their Covid-19 vaccine. It was a list of potential side effects that the safety study was watching out for. The vaccine is safe and side effects are mostly mild. 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 Africa resources (please use them):

 

Key concerning Covid-19 Trends and Viral Facts

  • Monkeypox does not exist
  • Monkeypox Cases (Quarantines and Ring Vaccination)
  • Covid-19 vaccination deaths

VIRAL FACTS RESOURCES

Explainer: Covid and Flu (Twitter, Facebook)

Debunk: Covid vaccines cause AIDS (Twitter, Facebook)

Debunk: Covid vaccines cause monkeypox (Twitter, Facebook)

Misinformation literacy: Anatomy of a false claim (Twitter, Facebook)

Explainer: How mRNA vaccines work (Twitter, Facebook)

Gavi, the Vaccine Alliance, vaccine resource pack here

Viral Facts Africa campaign countering vaccine hesitancy, with UK Government (here & here).

 

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

  • Vaccination matters even more now. With the lifting of Covid-19 regulations, there is a widespread feeling that Covid-19 is over, no need to worry and no need to vaccinate. This is not true – the easing of regulations actually makes vaccinations even more important. Covid-19 is still widespread in SA causing deaths every day. Vaccination is now the only public health mechanism for limiting the spread and resultant severe illness from Covid-19. We must not become complacent which could lead to worse waves of Covid-19 infections and more severe variants emerging. Vaccination still matters and saves lives.
  • Keep calm about monkeypox. There is more fear about monkeypox than is warranted by one confirmed case in the country. There should be messaging that monkeypox is being watched for carefully, and is not a major health risk. It is important to communicate that monkeypox is generally a mild illness that is transmitted through skin-to-skin contact between any two people. Some people have incorrectly ascribed the illness to only certain groups of people or particular sexualities. In fact, everyone can catch monkeypox through touching an infected person, but the illness is generally not dangerous.

 

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 contact centre: The national 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.

 

Contributors to this report through writing and inputs include the following members, who also participated in this week’s discussions co-chaired by government and civil society; NDOH, Free State DOH, KwaZulu-Natal DOH, NICD, HealthEnabled, UNICEF, Real411, University of Free State, Right To Care, Project Last Mile, Community Constituency Forum, Health Systems Trust, DG Murray Trust, and Covid-19Comms.

 

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