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 the report as a pdf

 

KEY TRENDS

First vaccine-related death and opposition to SAHPRA. There is great concern that the first confirmed death in SA due to the Covid vaccination has been reported at a news conference last Thursday by the SA Health Products Regulatory Authority (SAHPRA) (Here and here). The patient developed Guillain-Barré Syndrome soon after receiving the J&J Covid vaccine and later died. Reports of this tragic death have been circulated widely on social media, especially in vaccine-resistant social media groups, both public-facing and private. Many commenting said they knew about vaccine risks all along, but that the WHO and CDC had “consistently downplayed potential harm“. Some accused SAHPRA of colluding with the pharmaceutical industry for financial gain, describing it as a “bought organisation“, and “there is nothing anyone can do to convince people to vaccinate(Here & here). Sentiments on EWN Facebook (Here): Someone wants SAHPRA to admit also that, “The FINANCIAL benefits outweigh the health risks yes, for J&J”, “Sahpra is another one on the list for crimes against humanity 😡, “Are we back on this topic again? People reporting about side effects were called all sorts of things here” and “We’re done with vaccination. Those who have not vaccinated thus far, clearly do not need the vaccines, and all those who wanted the vaccine got vaccinated.” Some also supported SAHPRA, “A lot of people have adverse events to a lot of medication” and the benefits outweigh the risks. In response to SABC story, someone said, “Eish… multiply it with a 1000 to be more accurate”

Vaccines still overwhelmingly safe. At the same news conference Boitumelo Semete-Makokotlela of SAHPRA said, “The benefit of vaccination still far outweighs the risk.” After 9 million J&J vaccinations in SA, this is the first verified vaccine-related death. Health Minister Joe Phaahla said that in mid-July there had been just over 6,200 reported vaccine-related adverse events out of over 37 million Covid vaccinations, which is 0.017%. SAHPRA has investigated 160 deaths after Covid vaccination but had not detected a causal link to vaccination until now.

Digital news and social media engagement on Covid-19. Interest in the following search queries on Google rose: “How does Pfizer vaccine work?” (+1,050%), “Cominarty meaning” (+600%), “When did Covid-19 start?” (+400%), “Vaccine certification” (+150%).  Hashtags related to Covid in SA are shown below (from hostile to vaccines red on left, to supportive of vaccines green on right, with text size showing the usage frequency).

Tweets about Covid-19 vaccines in the country generated 2,500 engagements (+150%) over the previous week. News articles about Covid-19 vaccines generated over 10,000 engagements (+10% compared to previous week). Facebook engagement was, however, down by 50%.

Department of Health cuts back Covid-19 reporting to once weekly. The Department of Health will no longer release daily Covid-19 reports, but instead will release weekly reports (here). This news has been met with mixed feelings, but general sentiment seems to be one of understanding.

Decline in testing numbers continues. The number of PCR tests for Covid-19 reported this week was 7.8% lower than the number of tests performed the week before. The testing rate was highest in Gauteng and lowest in Limpopo. The percentage testing positive remained at 4.6%, with the highest percentage testing positive in the Western Cape. In total 2,220 new confirmed Covid-19 cases were reported since last week, marking a 12.9% decrease in the number of new cases detected in the week.

No new cases of monkeypox reported. Since 22 June 2022 there have been just three unlinked laboratory-confirmed cases of monkeypox reported in South Africa with no deaths. There have been no secondary cases linked to these three confirmed cases. Even though the risk of monkeypox is low, the NICD has stated that healthcare workers should be on high alert for individuals presenting with an unexplained acute rash or skin lesions

Monkeypox scepticism. Common views included that the condition was a “non-issue”, that “it poses no threat to the public”, that “it is being over-hyped”, that “only fools believe this rubbish”, that “it is another scam”; and that “it is just another phase of Covid-19” (Here). Examples of comments on monkeypox and Covid-19 from social media platforms include: “Let talk about how the health department exploits its workers like myself” (Here); “We got bigger problems in South Africa – unemployment for one, starvation kills 100%” (Here); “Mr President – our clinic was shut down by the community of Chiawelo. It’s been seven days now with the main road closed. They are protesting for electricity” (Here). Some anti-LGBT+ sentiment has started, “It does not affect me, it’s prevelant in the gay community”, and others see this as an opportunity for the government who are “Already salivating on the Disaster Fund this will generate 🙄” (Here).

Only one university requires Covid vaccination. In January this year more than six universities in South Africa were requiring staff, students and visitors to be vaccinated against Covid-19 or show negative tests for the virus to access their campuses. Now only Rhodes University in Makhanda retains the policy (Here). A US study examined 700 colleges and universities that established Covid-19 vaccine mandates, and found that in vaccine mandates reduced new Covid-19 cases by 339 per 100,000 residents, and new deaths by 5.4 per 100,000 residents (Here).

Concern about shortage of healthcare workers. The Minister of Home Affairs has updated the critical skills list to include 41 professional codes in the healthcare sector. The critical skills list includes qualifications that the government prioritizes when allowing working expatriates to have a regulated legal stay in SA (Here). However, the SA Nursing Council is blocking the training of new nurses by preventing private hospitals from taking on more students (Here).

Report from Namakwa (Northern Cape):

  • There is growing belief that mostly elderly people with comorbidities such as diabetes, hypertension, asthma, etc. and not the younger generation, are at risk of becoming seriously ill with Covid-19.
  • New myth is spreading that “cold weather conditions can kill the Covid-19 virus”. There is also a persistent belief that home remedies such as garlic, sage, essential oils can cure and protect a person against Covid-19. Also, some people still believe that big pharmaceutical companies are pushing vaccines to boost their profits, saying “The announcement of the second Pfizer booster for persons older than 50 years is proof”.
  • Challenges for vaccine uptake. District communicators have reported Covid-19 fatigue, dwindling commitment of businesses to enforce health protocols and bad conditions of gravel roads, as barriers to vaccine uptake.
  • Proposed solutions. The district communicators have recommended (i) Incentives, such as voucher for groceries, airtime, data, toiletries, etc, (ii) Engagements between authorities and businesses, and (iii) to continue reporting and highlighting conditions of roads, as well as strengthening collaborations between communities and government, private sector, and local authorities. They also said that better cooperation with large chain stores helped to mobilize for vaccination. They also highlighted the need for virtual information sessions about monkey pox and other communicable diseases.

 

Youth Mobilization reporting on activities with you around the country.

  • Sentiments: The youth feel that the government is trying to force them into vaccination and thereby control their lives and movements.
  • Reasons for not vaccinating. It was reported that (i) the youth are buying into the fake news and misinformation that is being spread on social media, (ii) young people are not engaging with health care services as frequently as older people, and (iii) they do not recognize themselves as being at high risk of developing severe disease.
  • Proposed actions to encourage vaccination. Incentives, such as voucher for airtime, data, toiletries, etc., could generate more interest in vaccination, (ii) vaccination should be promoted among the youth as part of routine wellness and taking care of themselves and their bodies, and (iii) vaccination of entertainers and sports people in public settings who speak of the benefits of vaccination, would encourage vaccine acceptance.

 

MISINFORMATION

MISINFO: The Covid Vaccine death reported by SAHPRA is not the first in SA and hundreds more have died from being vaccinated.  TRUTH: This is not true. This is the first verified case of death being directly caused by Covid vaccination in SA. The SA Health Products Regulatory Authority (SAHPRA) thoroughly assesses suspected cases, and this is the first verified case of vaccine-caused death in SA. It is certainly possible for someone to die after having a vaccination, but the events may be unrelated (e.g. like being hit by a car after having toast for breakfast – one follows the other but one did not cause the other).  SAHPRA has been transparent about this, making the news public quickly.  See here and here. 

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: Now that Covid regulations been dropped there is no need to get vaccinated.  TRUTH: With the Covid regulations ending, vaccination is even more important. Covid-19 is still widespread and killing people every day. Vaccination is the main way to protect yourself and your family. It’s still recommended to wear masks in indoor public spaces and to ventilate rooms. 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: 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 and the vaccines do not have any live virus in them. Monekypox is not new but recently has mutated to be more contagious and has spread to SA.  See here and here. 

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

New Viral Facts content

Viral Facts Africa campaign countering vaccine hesitancy, together with the UK Government (here and here).

 

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

Crisis communication on 1st vaccine death. The first death due to Covid vaccine reported in SA (see above) is a genuine cause for concern. This is reinforcing anti-vaccination sentiment and reducing willingness to vaccinate. The Crisis & Risk Communication Principles are: Be first; Be right; Be credible; Express empathy; Promote action; Show respect (Here). The Department of Health and RCCE partners must urgently develop and communicate evidence-based content to reassure the public.

Benefit / risks of vaccination. Related to the last point, clear communication on the benefits and risks associated with Covid vaccination is required. There are minimal risks associated with vaccines, which are small (1 death after 37 million vaccinations in SA). Risk perception is very emotive (recent alarming news tends to be more influential than longer-term statistics of low risk), and Covid vaccines appears safer than common low-risk medications such as Ibuprofen, for example. Good quality communications should be produced and disseminated.

Vaccine communications for healthcare workers. Recent surveys show that health professionals, including community health workers, are highly trusted in giving health information. The National Department of Health should develop clear guides to vaccine benefits and risks, responses to key concerns and related information and run short training sessions for all healthcare workers (vaccine trainings are already being run by several SA organisations), This training should include advice for communicating with vaccine-resistant people.

 

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: Reports from 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: network of communications specialists producing 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: NDOH, NICD, HealthEnabled, UNICEF, Real411, University of Free State, Right To Care and Health Systems Trust.

 

This week’s drafting team: Lizzie Harrison, William Bird 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