This is a weekly report of the RCCE Social Listening and Infodemic Management team on COVID-19 vaccine and other health emergencies 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.

 

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KEY TRENDS | COVID-19

Questions on whether COVID-19 is back. There has been a steady increase in new COVID-19 infections, which has surprised many people. (Here)  People who thought COVID-19 would disappear are surprised. “Is Covid really back” and “It’s back again.” (Here) As the number of infections started increasing in September, technically we could be in a 6th wave, but there is still no need to panic”, according to the experts. (Here) Other sentiments included; “Why is this coming back on festive season mxm”, “My dad died last month from COVID-19, fully vaccinated, this thing is back again eish” (Here), and  “Covid cases are increasing every week as we head towards another wave. Get vaccinated and take boosters.” (Here)

Talk about under reported COVID-19 cases. More people now believe that the numbers of new COVID-19 cases are ‘actually higher’ than the 1 970 confirmed this week as there has been much discussion about the under reported number of new cases. (Here)My entire family including a 3-year-old tested positive two weeks ago”, “We have had 4 cases of children testing positive at our primary school in the past 2 weeks alone.” (Here)The numbers are probably quadruple the reported stats,” “most doctors aren’t sending people for testing”, and “the wastewater management says we’ve had a huge spike in COVID-19 in Cape Town, and it is higher in Gauteng.” (Here) “The results of rapid tests done in doctor’s rooms, or by those who have procured them from overseas are not reported, therefore not included in our official stats.” (Here)

Views about COVID-19’s changing nature. Considering the increasing infections, people are talking about the need for vaccine boosters to ensure extra protection during travel and holidays. (Here)  “The nature of the COVID-19 pandemic has changed‚ no longer coming in waves but in small spikes and outbreaks”, but “we are not seeing a significant rise in hospitalization, reflecting a combination of vaccination and past infection” and “COVID-19 vaccines are still critical”. (Here)

The sentiments include “hospital admissions for covid are up, but with so many mild cases, few people now test or bother to,” “the data from the testing sites are sparse and almost useless,” “we should let people buy testing kits at pharmacies to make it easier to protect vulnerable contacts/relatives” and “so few are testing anymore due to the effort and cost of testing“ and “so the figures are way higher than reported, given how few are actually testing.” (Here) According to the experts the overall PCR testing rate this week decreased from the previous week from (30 per 100 000 persons) to 29 per 100 000 persons, the lowest in Limpopo (4 per 100 000 persons) which also had the lowest 11,4% people testing positive.  (Here)

Concerns about COVID-19 vaccine ingredients. Received questions to address the religion’s permissibility of the different vaccines. They wanted to know about the ingredients found in different vaccines. “I would like to enquire regarding certain ingredients that may be found in different vaccines – which vaccines contain pork gelatin, which vaccines contain gelatin from other animal sources and do any of the vaccines contain animal-derived ingredient, apart from gelatin?” (Here) Others were concerned about safety. “How should I know whether the COVID-19 vaccine is safe to use?” (Here) “I never get sick but since taking the vaccine, I’ve been getting sick every month”. (Here) People are encouraged to contact the South African Health Products Regulatory Authority (SAHPRA) (012) 501 0300 or email enquiries@sahpra.org.za or use MedSafety App https://medsafety.sahpra.org.za/ or email AEFI@health.gov.za to report adverse events.

Confusion about booster doses for the immunocompromised over 50 years. On social media, there are conflicting information regarding the availability of the second boosters for immunocompromised people aged 50 and older. One claim is that “a glitch on the EVDS system which has been corrected did not allow for the immunocompromised over 50 years to take a 2nd booster” but someone disagreed, saying; “they have been available since February this year” and the other argued “they may be able to do the vaxx but it won’t be registered on the system for vaxx certificate until the EVDS issue is resolved”. (Here)

Several people expressed concern that the EVDS cannot register the second booster doses because “the system also did not allow for a 2nd dose – not taking into account those who must receive an additional dose for the immunocompromised!”, “I wasn’t successful. I’m going to ask my Oncologist for a letter requesting a further booster” and “Others were confident that the “update is underway as I type – and also includes other updates – like boosters for under 50s, vaccines for immunocompromised 5-11-year-olds on doctors referral”, (Here)

Claims that EVDS not properly aligned with the booster rollout process. There are claims that EVDS was not aligned properly with the booster rollout process. Social media users expressed their frustrations that an “announcement about boosters” was made before the system had been updated and aligned with the booster rollout phases. “It’s so frustrating for all of us, that an announcement was made re boosters, and then the system still hasn’t been aligned to process these boosters(Here) “Still waiting oh dear last one was 6 months ago! I hope the system is updated soon!” (Here) “I phoned this morning and was told I could go for my 5th, but it won’t be recorded on the system. I really don’t know if I would be given it though! I think I’ll try next week when our Kynsna CDC is open.” (Here) “I Understand they don’t want to do constant updates but honestly at this stage just let all adults get their boosters now!” and “I’m running out of hope I’ll ever get this 5th much needed dose”. (Here)

More requests for boosters in preparation for holiday travel. News reports have suggested South Africa may face a grim festive season due to an increase in COVID-19 cases. (Here) People who are planning to travel abroad especially to the UK, elderly and have underlying health issues are desperate to get the 4th booster shots. (Here) Other countries are rolling out the 4th booster vaccines. In the UK, the autumn booster campaign is offering a 4th dose to those at higher risk from a COVID-19. (Here) The sentiments are “Get any additional protection that is offered.” (Here) “My sons aged 13, 16 and 19 have all had 2 doses of vaccination, the last one 9 months ago. Are they allowed boosters?” and one social media user said “your 19-year-old can get his booster yes! No boosters for under 18s yet! But you can go and get yours too!”(Here)

Frustrations about the lack of vaccination sites open on weekends. Many people who are willing to get shots or boosters are discouraged by structural barriers, such as the difficulty in finding a site open on the weekends or sites closing too early. “I have been battling to find a vaccination center in Fourways JHB. I eventually found somewhere miles away and was turned away as they said I didn’t have an SMS and wasn’t eligible for a booster anyway. I’ve had two J&J and a Pfizer in March 2022. I’m over 50.” (Here)Same. Can’t find a place to get the second Pfizer after 2 Jansen shots”  (Here) or “sites offering weekend vaccinations in Gauteng. (Here)  I know Bara used to” and “I am at Bara at 11.30 on Sunday and it’s closed unfortunately, despite notice on the door saying 8:00-18:00 on Sunday. It still looks like a vaccine centre, just closed”. (Here)

Persistent questions about what full vaccination means. There have been ongoing discussions about being “fully vaccinated.” “I was told EVDS considers me fully vaccinated, not what I understood from the depart of health brochure and very disappointed (Here) “Yes, most frustrating, especially as we see covid cases rise again” (Here) For some being “fully vaccinated does not include a COVID-19 booster and being fully vaccinated is not the same as having the best protection hence the need for boosters.” (Here)

 

KEY TRENDS | MEASLES

As of November 11th, 2022, there are 36 confirmed cases of the measles in the Limpopo districts of Sekhukhune and Mopani. Additionally, there are new sporadic measles cases in other districts that are unrelated to cases associated with the outbreak and are not counted in the outbreak total. There have been warnings about the spread of the measles outside of Limpopo province. (Here)

The outbreak remains a great concern for the country as it can result to fatalities. (Here) The Limpopo measles catch-up campaign continues to ensure that children are up to date with their measles vaccinations. The World Health Organisation calculates that immunisations prevent between four to five million deaths around the world. However, confidence in vaccines has declined in the country since the start of the COVID pandemic. The sentiment is that the “WHO is promoting their needles again(Here)

Others are critical of the government, saying it had done little during the COVID-19 pandemic to address the vaccine shortages for childhood immunization. “Limpopo ran short of the children’s measles vaccine in January last year.” (Here)It’s true we couldn’t find the 10 weeks vaccination from 4 clinic in Limpopo”, Very true even myself my son was not vaccination bcoz of that”. (Here) Others are keen to know about the action plan to eradicate measles. “So, wat is the plan now?”  (Here)

KEY TRENDS | POLIO

In South Africa, no outbreak of Polio has been declared, but sporadic cases were reported and discussed on social media. The conversation included “It was eradicated many years ago but its back,” “In northern KZN, polio is so prevalent that most homes have a polio sufferer.” (Here)

There are claims that children have not received their polio vaccines since the beginning of the year due to vaccine shortages in Bushbuck Ridge, Ehlanzeni district in Mpumalanga. “Bushbuck Ridge 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.” (Here)

“Some BCG and Polio vaccines have been out of stock on and off for many years now also in Limpopo. Why is it only news now,” “Even in 2018-2019, it was the same thing. Children were out of stock throughout the country and there was no COVID-19 then” and “Can this government just try and do one thing, right?” (Here)

KEY TRENDS | MONKEYPOX

Questions about the availability of monkeypox vaccine. The NICD received questions about monkeypox vaccine availability and whether meningitis vaccine could be used to treat monkeypox. “I have been contacting private hospitals and public clinics regarding the monkeypox vaccine and its availability in RSA, and none of them have it. I have just returned from the USA and there are huge campaigns to vaccinate for monkeypox there. When is it likely to become available? Is it advisable to take the meningitis vaccine for monkeypox? I am a cautious but sexually active gay man.” The monkeypox cases in RSA remain unchanged at five cases to date. RSA received the all-clear for monkeypox after the last patients were successfully treated. (Here)

 

KEY TRENDS | MALARIA

The SADC commemorated the fight against malaria in KwaZulu-Natal on 6 November which coincides with the period of increased malaria transmission in the southern hemisphere. The Gauteng health department reported 1 103 malaria cases with 11 deaths over nine months this year. “Most recorded cases in the province are from Mozambique, followed by Malawi, Zimbabwe and Ethiopia.” (Here)

The Department of Health encourages travelers visiting malaria-endemic areas, including Limpopo, Mpumalanga, and KwaZulu-Natal during the festive period to take precautionary measures. The department is working with multiple stakeholders, including the tourism and transport sectors, to fight this disease. (Here)

The sentiments include “Vaccines could be a game-changer in the fight against malaria in Africa,” “wouldn’t touch any vaccine that is promoted now,” “are these vaccines available in clinics?” (Here)

KEY TRENDS | PNEUMONIA

People have been encouraged to vaccinate to prevent pneumonia. A marked presence of pneumonia caused by viruses such as influenza and SARS-CoV-2 in the country reported by media. The experts have encouraged the public to get the flu shots and vaccinate for COVID-19 to prevent pneumonia. The sentiments include; “I wish there was a vaccine freely available to us with compromised immune,” and “can we have a vaccine for pneumonia please,” (Here)

KEY TRENDS | HIV

Zimbabwe surpasses global target on HIV. The news about Zimbabwe having surpassed the global target on HIV testing, treatment and viral suppression, three years ahead of the set time, have been received positively and a few sarcastic comments were also noted on social media. (Here)

The sentiments are “the youth in South Africa don’t care about HIV,” “The majority of Zim stay is South Africa, easy target to achieve,” “at least there is something they’re doing right, well done” and “we keep following global targets surely we should know better about this man-made disease by now.” (Here)

MISINFORMATION

MISINFO: Moderna COVID vaccine causes diabetes type 1 in children.  TRUTH: There was one 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 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: 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: 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: 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.  

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 Viral Facts content responding to misinformation which can be used freely. You can find previous reports on the AIRA page.

The key trends this week included:

  • Say no to Lockdown, No Ebola in Uganda (Here)
  • Ebola targets pupils at school in Uganda (Here)
  • Nigerian Refugees brought Cholera into Cameroon (Here)

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. [LINK], and [LINK]

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 of 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

Childhood immunization. People continue to complain that government has not done enough to ensure all children are vaccinated against measles and about polio vaccine shortages. The RCCE TWG must communicate clearly to the public the national efforts being made to eradicate measles and polio, as well as how government and stakeholders plan to address vaccine shortages. Parents and caregivers are encouraged to use the Children’s Road-to-Health booklet to ensure that all children are up to date with their measles vaccinations. Click www.sidebyside.org.za for the booklet or Index for the latest updates.

Malaria transmission period. As malaria transmission increases in the southern hemisphere, cases have been reported in Gauteng, Limpopo, Mpumalanga, and KwaZulu-Natal. The RCCE TWG is working with relevant stakeholders including tourism and transport sector to prevent the spread. It has also cautioned travelers visiting malaria-endemic areas in South Africa and other SADC countries during the festive period to take precautionary measures.

COVID-19 boosters. As COVID-19 is not yet over, the RCCE TWG continues to promote the vaccination rollout and to reinforce messages about the benefits of vaccines and booster shots to keep your immunity up. If you are not sure about your next vaccine or booster shot, contact the National Health Hotline 0800 029 999 for assistance and FindMyJab to confirm the operational vaccination sites.

Adverse events. The RCCE TWG continues to educate the public about how to report adverse events after vaccination to advice on the next possible action to take to prevent complications. The public is encouraged to contact the National Health Hotline 0800 029 999, use MedSafety App https://medsafety.sahpra.org.za/ or email AEFI@health.gov.za to report adverse events.

Monkeypox vaccine. There are persistent questions about the vaccine for monkeypox which is currently not available in South Africa. The RCCE TWG has intensified communication to prevent the spread of the monkeypox virus, and to respond to questions in real time.

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 and Nombulelo Leburu (NDOH). The data for this report was collected by the National Department of Health (NDOH), Health Systems Trust (HST), National Institute of Communicable Diseases (NICD) 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