This is a weekly report of the Social Listening and Infodemic Management team on COVID-19 vaccine concerns, sentiments, rumours and misinformation in South Africa. It provides an analysis of online and offline content. Thanks to all who contribute to this report each week.

Click Here to Download as a PDF

 

KEY TRENDS

 

Huge dent on vaccine confidence. Misinformation regarding the safety and efficacy of the Pfizer vaccine has increased following the recent hearing of the Special COVID-19 Committee in the European Parliament. (Here) The headlines, including hashtags, “Pfizer vaccine untested for transmissibility and “Pfizer lied, People died” challenged people’s confidence in the vaccine. Social media users were using this video as evidence to further push their antivax sentiments.

Digital media users continue to disseminate distorted facts and unverified claims about vaccine-related adverse events and deaths that have been widely misinterpreted. (Here) and (Here) Digital media have been accused of being malicious in presenting facts, including in selecting experts for interviews. (Here) “You will see that the media have been mischievous in using this misleading headline – Pfizer vaccine untested for transmissibility,” said a member of a health stakeholder WhatsApp group. (Here)

The facts-check on “Pfizer untested” highlights that “to get emergency approval, companies needed to show that the vaccines were safe and prevented people from getting ill. They did not have to show that the vaccine would also prevent people from spreading the virus to others.” (Here) “The primary focus was to prevent people having symptomatic infection and more importantly serious diseases or death. That was tested and proved effective in real life, for the earlier variants and before natural immunity spread.” (Here)

The sentiments to be addressed include the following: (Here), (Here) and (Here)

  • When people asked if it was tested, they were called antivaxxers
  • They don’t like it when people are standing up against their agenda
  • It should never have been mandated because it doesn’t stop transmission.
  • It’s not that it wasn’t tested properly, it was not tested for transmission.
  • There was no transparency, how come we only get to know about this now.
  • They had to go with the speed of science and what the market offered to gain herd immunity
  • If Pfizer was not tested yet administered, then they should be held accountable for adverse effects
  • Vaccines do not stop transmission, they prevent the onset of a virus, reduce the severity of diseases.
  • I have no intention of getting further boosters. Natural immunity can maintain a low risk of disease.
  • The routine vaccines prevented infection and stopped transmission. When you were vaccinated you had immunity from that disease. Breakthrough infections were almost unheard of now it’s
  • I’m not sure why ”conspiracy theorists” need it spelling out for them, but vaccines to prevent pandemics are in the work before the pandemic is even born, that is why they are released so ”quickly”
  • Conspiracy theorist is an outdated term, now it’s simply realist. Listen to yourself, how do you prepare vac to something you don’t know? Unless you planning on creating one from the lab
  • For the first time ever, the phases of the trials ran concurrently. This has never happened before. Phase 2 started before phase 1 was finished. Phase 3 started before phase 2 was finished.

High interest in Pfizer vaccine. Search queries on Google over the past week for “Pfizer Covid vaccine transmission” (+5000% compared to previous week) and “which Covid vaccine is the safest” (+5000%), “Pfizer vaccine news” (+100%) were high compared to previous week. Tweets about COVID-19 vaccines in the country generated 3.5k engagements (+90% compared to last week).

The tweets included the following sentiments: (Here) and (Here)

  • The way I even forgot I got vaccinated against Covid twice and antivaxxers keep asking us if we regret it. Only think I regret is that the people we lost to Covid before the vaccine became available didn’t have a chance to make that same decision doe themselves
  • The admission by Pfizer that its vaccine doesn’t stop transmission of Covid-19 is not a scandal. We’ve known this for over a year. They all agreed vaccines don’t stop transmission. You just follow authority slavishly. Deal.

Facebook posts about COVID-19 vaccines generated about 4k over the past week (+300% compared to the previous week). Conversations about COVID-19 vaccines that generated most engagements in the past week were related to expiration and safety. (Here), (Here), (Here), (Here) and (Here)

The sentiments on Facebook included:

  • What do we know so far about older adults and COVID-19? How long does the effect of the vaccine last and how successful have countries been in vaccinating older adults?
  • “Most Covid-19 vaccine misinformation is driven by individuals, most of whom work in alternative medicine

 

Resistance to blood transfusion. There have heard stories about doctors seeing resistance to blood transfusions over unfounded concerns about the COVID vaccine. This trend of misinformation has been described as dangerous because it could cost lives. (Here) “A patient recently refused to consent to a blood transfusion if it came from a donor who had received the COVID-19 vaccine.” (Here) “So, this was a first time for me. A patient declined blood transfusion if the donor had been a covid vaccination.” The tweet gained traction with 33,7k likes and 6k retweets. (Here) The health care providers also reached out with similar stories. (Here)

 

A report has been shared on Telegram about blood donations in South Africa which reads; “Collection of blood from vaccinated donors”. The SA National Blood Service (SANBS) has stated “that it does not defer vaccinated persons from donating nor do they record whether a donor was vaccinated in line with other international blood services” and that the “hospitals and doctors are therefore not able to inform patients whether a unit of blood was donated by vaccinated donor”. The SANBS is “confident that the currently approved vaccines do not pose a safety risk to blood”.  (Here)

 

The sentiment on Twitter included: (Here)

  • Avoid blood donors who had covid vaccine
  • Blood is pooled by several donors per batch
  • Blood transfusions prevent many women from dying from childbirth
  • That means there would be more available for the rational folks
  • Myocardotis risk significantly higher after COVID-19 infection
  • Pretty discerning I’d say, especially now with excess deaths and heart attacks
  • I don’t think anyone was tracking Covid status from blood donations or vs
  • How are people still buying this nonsense about unsafe vaccines
  • They have the freedom to reject modern medicine and die like the medieval peasant
  • Smart patient. mRNA spike proteins were detected in the brain and heart in a deceased man
  • Sadly, misinformation kills.

 

Long-Covid threats. Long suffering after a COVID-19 infection has increased the fear of the disease. (Here)  Misinformation about vaccine and lack of trust in science are major let-downs. (Here) Speculation has linked a rise in non-communicable diseases such as heart disease, cancer, chronic respiratory diseases and diabetes to COVID-19. There are concerns that “very few health services have been developed for long Covid which has impacted routine services. (Here). The WHO director general has called for “sustained action” to help people still experiencing “prolonged suffering”. (Here)

 

The sentiments on long-COVID include the following: (Here) and (Here)

  • The risk of long Covid conditions increase with each infection. So, it is not benign.
  • Yeah, I get dizzy randomly while I’m up now” or “I can’t exercise like I did before.
  • Her lung collapsed twice, but no one suspected endometriosis: ‘I was fighting for my life’
  • My worry is that we’re going to be left with waves of people with chronic diseases
  • The most important thing is that we collect good, robust data on what long Covid is, how it’s affecting people. We need good evidence on what works.

Steady increase of measles cases.  The total number of measles cases in the country rose to nine as of October 24, 2022. (Here) Poor coverage during the pandemic has heightened the measles outbreak risk. (Here). Affected provinces have begun their “catch up” campaigns to find children who have not been vaccinated. (Here) The clinicians are on the alert as large measles outbreaks are occurring in sub-saharan Africa. (Here) More than 700 children have died from measles in Zimbabwe.

The sentiments on social media:

  • Every single child gets German measles and chicken pox sometimes in their young lives. We all had it as kids and we were vaccinated back in the day. What’s the problem? (Here)
  • Measles is deadly compared to the other two especially for children under 5 years. Chickenpox is rarely ever lethal. My mother was deaf because of measles. (Here)
  • “Two weeks ago, myself and my daughter had measles like it’s doing the rounds.” (Here)
  • I blame these outbreaks on the choice to or not to vaccinate your child (Here)
  • You want forced vaccination (Here)
  • Multiple reports of measles outbreak in East London, Eastern Cape. Is this not a communicable disease that requires reporting? Concerning to hear of cases bit cannot see it reported on your website. (Here)
  • Are you sure Omicron is not back? Because this flu I’m suffering from hhaykhona and almost everyone is known is sick or has been sick.(Here)
  • You are all complicit and liable for the deaths you occasioned on Mzansi through your betrayal of public trust, medical negligence, abdication of oversight and total abandon of academic skepticism.

 

Concerns about Polio vaccine stock levels. There is widespread concern regarding claims that children have not received their polio vaccines since the beginning of the year due to vaccine shortages. “Bushbuck Ridge district has not had RCG and Polio vaccines since January this year. Some were sent to the local hospitals but there was only enough for 100 patients.”

 

Declining focus on COVID and vaccines. 186 people participated in this week’s KeReady Twitter Space to discuss mental health. With less interest in COVID-19 and vaccines, there is a focus on other health issues. There were more questions with respect to reproductive health, HIV, and nutrition. The number of patients reporting difficulty getting help from clinics was concerning. One of them was an eight-month-old pregnant woman who wanted to remain anonymous. KeReady doctors were on standby to respond to questions.

COMMUNITY FEEDBACK

Umlazi, eThekwini District, KwaZulu-Natal. A total of 1 632 of the 6 410 people reached via community dialogues and door-to-door refused vaccines during a mini vaccination campaign of the Health Systems Trust (HST) in support of the KwaZulu-Natal Department of Health. The campaign targeting youth aged 12-17 men and 35-49 years ran for two months from end-July to end-September in Umlazi.

Alfred Nzo District, Bizana, Eastern Cape. To support the demand creation drive, 127 community health workers from different clinics in the area went to Saint Patrick Hospital in Joe District. The nurses and clinical staff were not aware of why the people were requesting an additional booster shot. “Luckily I also had one on my phone, so I showed them and told them that I actually went for that extra booster.” Evidently, the information about extra booster doses had not reached the health workers.

“People sometimes get turned away after walking long distances, and most of them never return. It happens even to those who bring their children for immunization because it is provided on a particular day of a week.” In other cases, the health workers would refuse to open a pack of five to vaccinate one or two persons. “The nurses are saying it’s a waste.” They did not know they that one person could be vaccinated without waiting for four people to show up, and the other four vails could be discarded.

MISINFORMATION

MISINFO: Moderna COVID vaccine causes diabetes type 1 in children.  TRUTH: There was 1 recorded case of a child becoming type 1 diabetic after vaccine, but diabetes was prominent in the family.  Vaccines remain safe and effective in children.  See here, here and here.

MISINFO: Long covid is really long term side effects of COVID vaccines.  TRUTH: No evidence to support this claim.  Long covid is caused by COVID not covid vaccines.  See here, here and here.

MISINFO: Children are dying in increased numbers in Europe as a result of COVID vaccine.  TRUTH: The number of excess death of children form the last half of 2021 and the first half of 2022 have in fact declined. See here.  COVID vaccines have helped prevent deaths of children. See here.

MISINFO: A New variant of COVID Omicron BA2.75 is more infectious and deadly than the current Omicron 5 variant.  TRUTH: Only one case in July in South Africa, and not enough known about BA 2.75.  Most cases in South Africa are Omicorn 5.  See here and here.

MISINFO: Covid vaccines cause heart attacks and inflammation of the heart.  TRUTH:  While there are some cases of inflammation of the heart (myocarditis, the risk is very low, see here) there is no evidence to support claims that covid vaccines directly cause heart attacks.  See here.  

MISINFO: Vaccines side effects are being under reported and can kill you. SA Adverse reactions site shows how many have died!  TRUTH:  No evidence to support this claim, most side effect are mild and self-resolving.  See here, here and here. SA has excellent adverse reporting mechanisms backed by evidence see here for credible local site on adverse reactions.

MISINFO: The second COVID Vaccine death reported by SAHPRA is one of hundreds of those who have died from being vaccinated.  TRUTH: No evidence to back up this claim.  SAHPRA was transparent because it was the second clearly attributable death.  See here and here.  

MISINFO: COVID vaccinations make you more susceptible to serious illness and death and most COVID deaths now are triple vaccinated people.   TRUTH: No evidence to support these claims.  More people did lose their lives during COVID – due to COVID not the vaccine see here and here and here.

MISINFO: More than half of the pregnant women miscarried during the Pfizer vaccine trial.  TRUTH: Not true, the figures released was based on inaccurate data and miscarriage trends were in line with people outside of the trial.  See here and here.

MISINFO: People who have been vaccinated are more likely to get seriously il from COVID. TRUTH:  No evidence to support this claim.  People who have been vaccinated far less likely to experience severe symptoms.  See here and here.  

MISINFO:  Messages saying you have participated in a COVID drug trial asking you to take action to get paid are legitimate.  TRUTH: 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 informed consent. 

MISINFO: Vaccines cause infertility and erectile dysfunction.  TRUTH: No evidence to support these claims.  COVID however 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, managing 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. You can find previous AIRA infodemic trends reports on the AIRA page.

Persistent Rumours

COVID-19 is over What can RCCE do? Highlight the vaccine’s ability to mitigate severe symptoms and complications from contracting the disease without inoculation, and how it can protect individuals from new strains of COVID that may become prevalent. [Here], and [Here]

Fear of vaccine side effects/ long-term effects continue to be misinterpreted or overstated What to do? Continue to address COVID-19 side effects with updated material that is relevant to the specific concerns. Provide clarity to the findings of the study. Continue to provide verified accurate information regarding the COVID-19 vaccine with updated information around the usefulness of booster doses.

Vaccines contain mRNA which is leading to an increase in monkeypox What can RCCE do? Consistently promote accurate information regarding monkeypox symptoms, transmission, and mitigation methods as communities have expressed confusion about the disease. (Here) and utilize social science research to determine community-specific barriers and enablers for responses to the monkeypox outbreak to enable tailoring of RCCE and other interventions. (Here) and (Here)

 

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

Adverse events. Adverse events are still a prevalent theme among the ani-vaccine groups as well as the general public. It is vital that such evidence is shared with the public to ensure that the context and the science is well understood by members of the public. RCCE to promote and distribute messages on adverse events and to educate the public on how to report these events using MedSafety App https://medsafety.sahpra.org.za/ or AEFI@health.gov.za or National Health Hotline 0800 029 999 or by visit any health public health facility.

Community feedback mechanisms: RCCE to reinforce national community feedback mechanisms created as part of the pandemic response to monitor and address emerging concerns regarding other health outbreaks, including monkeypox, to enable rapid response and to limit adverse effects such as increased stigma, risky behaviours, delayed access to health services, and noncompliance with public health recommendations. As part of this campaign, HIV, TB and AIDS awareness is vital as well as other public healthcare interventions.

Long COVID:  Develop messages on the facts of long COVID and how vaccines can reduce the risks.

Booster dose campaign. The RCCE and the demand creation team will implement a booster dose campaign before the festive season. The communication Strategy has been developed, presented to the MAC for Social Behavior Change, RCCE technical working group and provincial health communicators. The RCCE will also communicate a schedule for the booster doses.

Measles:  The number of measles cases is increasing in the Greater Sekhukhune district and as well cross border transmission.  RCCE to develop preparedness and response plans and activate risk communication and community engagement activities including social mobilization to raise awareness.

Expanded Immunisation Programme: RCCE to encourage parents and caregivers to take their children for immunizations and remind them to check The Road to Health booklet if their children are up to date with their vaccinations. Check www.sidebyside.org.za

Practical barriers to vaccination. There are practical barriers to accessing vaccines as the number of sites has reduced, particularly in the private sector where it’s no longer viable to keep vaccination sites open in the way that they were during the mass uptake. The strategy has now shifted to using routine health services to focus on low-coverage districts. The RCCE will continue to update and publicize the vaccination sites list.

Use the toll-free National Heath Hotline 0800 029 999 or FindMyJab to confirm the operational vaccination sites. or visit any health facility for vaccination. Use the MedSafety app https://medsafety.sahpra.org.za/ or email AEFI@health.gov.za to report adverse events.

METHODOLOGY AND COLLABORATION

The Social Listening & Infodemiology team that produces this report is part of the Risk Communications & Community Engagement (RCCE) Working Group of the Department of Health in South Africa. 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
  • Health Systems Trust, Community Constituency Front (CCF), HealthEnabled
  • 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, Deaf SA, SA National Council for the Blind, Treatment Action Campaign and Disability SA.

The drafting team this week includes Charity Bhengu (NDOH), Herkulaas Combrink (UFS) and William Bird (Real 4110 The data for this report was collected by the National Department of Health (NDOH), COVID Contact Centre, Health Systems Trust (HST), University of Free State (UFS), National Institute of Communicable Diseases (NICD), UNICEF, Right To Care, DGMT’s KeReady Campaign, HealthEnabled and Real 411. The inputs of the social listening bi-weekly meeting on 21 October 2022 were considered. The report has been reviewed by Nombulelo Leburu (NDOH).

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