This is a weekly report of Covid-19 and vaccine sentiment, rumours & misinformation in SA. Thanks to all who contribute to this report each week.

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KEY TRENDS

Low vaccine uptake among kids. According to news reports, parents remain resistant to their children being vaccinated (Here). Many parents were “concerned about vaccines affecting their children’s long-term development” (Here). Several countries are experiencing similar challenges (Here). There have been protests in SA to stop school vaccination drives in Cape Town, with posters saying: “School=Education NOT Vaccination” (Here). In the US, it was reported that parents slowed the efforts to get their kids from 6 months to 5 years vaccinated (Here). Views included “this group is going to be a much longer-term challenge in terms of getting them vaccinated” and “the problem requires a special degree of sensitivity and understanding” (Here). Other sentiments were:

  • I don’t have children in school, but this makes me so angry it’s time to move on without vaccines” (Here)
  • “And when there are any adverse effects no one will be around to pick up the pieces other than the parents” (Here)
  • “Disregarding parents and acting upon a 12-year-olds inclination is outright contempt and utterly disrespectful to parents.’’ (Here)

Concerns about new Covid-19 cases. There was great worry on social media when the National Department of Health reported 1,279 new cases of Covid-19. They were concerned about the recent predictions of the looming sixth wave (Here), saying “it’s starting again”, “Covid is not over” and “I heard one of the doctors saying South Africa should expect the sixth wave around mid-September” (Here). However, others were sceptical and said, “In all seriousness, we cannot take you guys serious anymore!”, “They are starting to program us for the 6th wave” and “as long as the weather is cold, they will start this nonsense”. Others wanted the Covid-19 update report to include more details. “How many are reinfections?” (Here).

Covid-19 vaccines to be destroyed. As news of a collaboration between SA Aspen and the Indian drug-maker SII so that the SA Covid-19 Vaccine Plant would ensure “vaccines are fully produced on the African content” (Here), there were concerns about millions of Pfizer vaccine doses about to expire and be destroyed in October (Here).  It was reported that there were 10 million doses of Pfizer vaccines to be destroyed in October because of the low uptake of Covid-19 vaccines, according to Minister of Health Dr Joe Phaahla. Currently about 10,000 doses are administered weekly in SA (Here). “We need to increase [vaccine uptake] quite urgently because we’re not out of the woods yet,” said Virologist Professor Barry Schoub (Here).

Traditional medicine and vaccines.  Many people in SA who were unsure about vaccines have been interested in traditional medicine, however the majority of people do not believe in their value as medicines for serious illnesses (Here). However, comments to this article include. “Whatever happened to the promised studies into Umhlonyane / artemisia Afra?”, “Remember back in July 2020 when it was announced they would investigate its efficacy against Covid?”, “Nothing was ever heard again in the meantime China promoted the use of their version against Covid and scientists in Europe promotes its use via peer-reviewed studies but here nothing! Wonder why?!” (Here). The WHO is currently working with eight African countries to monitor clinical trials of traditional medicine-based therapeutics proposed for Covid-19 (Here).

Covid-19 disrupting TB care. The Covid-19 pandemic has hurt testing and treatment of TB (Here). South Africa remains the sixth TB burden country in the world with a considerable proportion of drug resistant TB due to ongoing transmission of already circulating resistant TB strains, according to Prof Norbert Ndjeka (Here). There was a decline in finding TB cases during the pandemic and continuing with treatment resulting in high death rates. “Improved communication, advocacy and social mobilization was needed to find new cases and address retention of patients on treatment for improved TB treatment outcomes,” according to the Department of Health. Comments on social media recommended traditional medicine for TB. “Get traditional healing herbs to treat all kinds of ailments(Here). However, there has been a significant advance in treating MDR-TB, the “BPaL regimen. “The advance in treatments comes at a time when global efforts to fight tuberculosis are still reeling from the devastating impacts of Covid-19” and “It is now second only to Covid-19 as the greatest infectious disease killer in the world” (Here).

HIV/AIDS and Covid-19. According to a recent study, misinformation is a common thread between the Covid-19 and HIV/AIDS pandemics, with deadly consequences (Here). “There are striking parallels between the HIV/AIDS and Covid-19 pandemics that show the dire consequences disinformation can have on both patients and society as a whole. What sets the Covid-19 pandemic apart, however, is the sheer magnitude of damaging disinformation put in circulation around the world. Data shows that regions and countries where disinformation thrived experienced more lethal pandemic waves despite vaccine availability.” (Here)

Vaccine hesitancy and misinformation. Several international studies have highlighted how misinformation has contributed to Covid-19 vaccine hesitancy and how this evidence relates to South African experience:

  • US studies show that poor public-health communication and messaging throughout the Covid-19 pandemic has damaged the public’s trust in health agencies and institutions which contributed to vaccine hesitancy, noncompliance with mask recommendations and other protective measures, and general misinformation about the virus and how it is transmitted. “Unclear, opaque public-health messaging has been a major problem throughout the Covid-19 sowing confusion and making the crisis worse than it needed to be. To regain the public’s trust, health officials must start learning from their mistakes and stop confusing credibility with infallibility” (Here and here).Public experts have been pushing for a fast and effective vaccine rollout but science communicators keep getting it wrong about vaccine hesitancy” (Here).
  • There has been damaging misinformation about the effects of vaccines on pregnant women and their babies, especially women with comorbidities (Here). ‘It’s not true that nearly half of pregnant women in Pfizer’s Covid-19 trial miscarried nor that 80% of women who were vaccinated miscarried in the first trimester,” as some misinformation suggests (Here).
  • In California there is a plan to pass a law to punish doctors who spread misinformation on Covid-19 or vaccines (Here).
  • A WHO review revealed that infodemics and misinformation negatively affected people’s behaviours (Here). It showed that incorrect interpretations of health information increases during outbreaks and disasters. It concludes that the effects of infodemics and health misinformation online can be countered by “developing legal policies, creating and promoting awareness campaigns, improving health-related content in mass media and increasing people’s digital and health literacy”. “Twitter, Facebook, YouTube, and Instagram are critical in disseminating the rapid and far-reaching spread of information”. There was “an increase in erroneous interpretation of scientific knowledge, opinion polarization, escalating fear and panic or decreased access to health care” compounded by “the overproduction of data from multiple sources, the quality of the information and the speed at which new information is disseminated create social and health-related impacts.

 

COMMUNITY FEEDBACK

Umlazi, Ethekwini, KwaZulu-Natal: There is growing concern about the slow uptake of Covid-19 vaccines in Umlazi township in the Ethekwini district. This district has the highest number of Covid cases and deaths in KwaZulu-Natal, 352,148 cases and 5,690 deaths as of 31 August 2022. Umlazi township within this district is among the high-risk areas with a high infection rate. A mini-vax campaign was introduced last month to support the KwaZulu-Natal Department of Health. The response to the vaccination drive started slow due to student protests which delayed access to services, but has been encouraging with over 200 vaccinations done, which included first and booster vaccinations, as well as other services related to HIV and TB.

About 592 people refused to take up the services including vaccines, TB screening and IST for HIV-positive clients, according to the Health Systems Trust (HST). Prior to the actual mobilisation starting, three focus group sessions were held and the key takeaway was that clear and accurate Covid-19 communication was still necessary in encouraging hesitant individuals to get vaccinated. “The 200 is a big win considering the tiny catchment with only 20 mobilisers [who distributed over 2,000 Get Vaccinated information leaflets] and over a three week period.” (Here)

MISINFORMATION

MISINFO: Covid vaccinations make you more susceptible to serious illness and death OR Most Covid deaths now are triple vaccinated people.   TRUTH: This is not true, there is no evidence to support these claims. Millions of people have lost their lives during the pandemic due to Covid-19 and not the vaccine. See here and here and here.

MISINFO: More than half of the pregnant women miscarried during the Pfizer vaccine trial.  TRUTH: This is not true. The figure comes from a misunderstanding of data on a trial (see here) and in this study miscarriage rates were in line with people outside of the trial (see here).

MISINFO: Covid vaccines are not safe for children.  TRUTH: There is no evidence to support the claim.  Vaccines have been found to be safe for children.  See here, here and here

MISINFO: The death related to the Covid vaccine reported by SAHPRA is not the first and hundreds more have died from being vaccinated.  TRUTH: There is no evidence to back up this claim.  SAHPRA was transparent because it was the first clearly attributable death.  See here and here. 

MISINFO: Monkey Pox and Chicken Pox are the same thing and used to spread fear.  TRUTH: This is not correct: Monkeypox is an orthopoxvirus, while chickenpox is a herpes virus are not the same virus.  See here and here.

MISINFO: Monkey pox is the new Covid and is a scam to control or kill us. TRUTH: Monkey Pox is not new but it has changed to allow it to spread further. It is a different disease from Covid-19 due to a different virus. The spread of monkey pox is not being intentionally controlled by anyone. See here and here.

MISINFO: Vaccines cause infertility and erectile dysfunction.  TRUTH: There is no evidence to support these claims.  However, Covid, can impair sexual performance. See here, 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. AIRA infodemic trends reports are at AIRA page and TechNet-21.

Key misinformation identified in Africa

Covid-19 Misinformation: Medical professionals call for the end of vax mandates
Monkeypox Misinformation: Monkeypox outbreak is misdiagnosed tomato flu

New Viral Facts Africa resources 

EXPLAINER: Monkey pox self-management (Twitter, Facebook)
EXPLAINER: PHEIC (Twitter, Facebook)
DEBUNK: Ivermectin on essential medicines list (Twitter, Facebook)
SHORT: Childhood vaccine success (Twitter, Facebook)

 

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

  • Covid-19, TB and HIV/AIDS sensitisation training for the public sector. RCCE members to develop training materials the impact of Covid-19 as well TB and HIV/AIDS and work with other government departments to offer training throughout the public sector.
  • Engage communities about misinformation and vaccine hesitancy through community healthcare workers. By upskilling CHWs, they can serve as a community engagement mechanism to address vaccine hesitancy in communities throughout SA.
  • Incorporate routine vaccination communication training within patient facing healthcare workers. All healthcare workers dealing with patients, such as nurses, phlebotomists, pharmacists, medical officers, doctors & allied health professionals, should be trained in effective risk communications to sensitise vaccine uptake and demand during all encounters with patients.
  • Study the impact Covid-19 misinformation on other health issues. The impact of misinformation about Covid-19 on other health issues such as TB, routine childhood immunisation, and HIV/AIDS should be studied. Recommendation should be acted on for an integrated health systems response.
  • Collaborate with general practitioners, church leaders and traditional healers around vaccination programmes. These local leaders have a key role in informing and motivating their communities about vaccination.
  • Collaborate with the department of basic education to strengthen the vaccine rollout within schools

 

 

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 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.

Drafting team this week: Charity Bhengu, Herkulaas Combrink, William Bird & Peter Benjamin. Data collection for this report: NDOH, HST and Real 411

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