This is the weekly RCCE Social Listening and Infodemic Management trends report on COVID-19 vaccine and other health emergencies tracking and responding to public concerns, sentiments, rumours, and misinformation in South Africa. It provides key trends and analysis of online and offline content. Thanks to all  contributors to this weekly report.

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KEY TRENDS | COVID-19

Declining online conversations. We are seeing a continuous declining interest in vaccines. The levels of mentions and engagements on COVID-19 are no longer as high as they used to be. Of a total of 12,298 vaccines administered in the country in the last 7 days – 4,988 for the first dose, 1,166 Pfizer second dose, and 5,359 general booster dose, and 785 continuous booster doses as of 03 September 2023. (Here)

The public reactions are not as substantial as the overwhelming numbers seen before. Of the total 1.2K engagement by media over a month, 13,9% were positive, 44% neutral and 41% negative remarks about COVID-19 vaccines. Most of the people driving these conversations on Twitter are male, nearly double the people leading the conversation online, 61% male, and only 38% female.

The top active authors on COVID-19 conversations on Facebook are The Truth Panther, Daily Maverick, followed by these top influencers including SABC News, eNCA, Sheep Dog Society, Find it nuus, Health Justice Initiative, Image, TimeLive and NDoH. The key themes include “COVID-19 cost to government” and “VaxxPoisonJabs”. The reactions were mixed with sadness, fear and anger.

COVID-19 conversations at risk for rumours:

  • Some people know that COVID is highly mutated form of a very bad flu created in the lab”,
  • “We also know that if you go to a hospital for treatment, you’ll most likely end up in a body bag because some pharmaceutical companies need to make record profit this year.”

Counter reactions:

  • Feels like COVID all over again, people spreading so much misinformation about 5G while bringing no actual proof. Like everyone bringing up “farm murders by black people” without actual proof… bunch of idiots really”.

Concerning reactions. There are persistent negative reactions among parents about the rollout of the vaccination of 5- to 11-year-old children who are immunocompromised. Currently, the negative reactions are based on “fear of side effects“, “low confidence in vaccines,” and “general complacency” linked to past lived experiences and ongoing misinformation on COVID-19 vaccines. (Here)

Sentiments:

  • “Kids have the lowest risk from contracting serious Covid complications. Stop using children to advance your agenda to usher in a new set of Lockdowns and Mandates 2.0 on behalf of Pfizer. (Here)
  • You not going to get away with bullying us with fear-based propaganda again”, “prove COVID existed; you still have not proved in a court of law covid existed”. (Here)
  • Covid is fake news. (Here)
  • You want to poison our kids. (Here)
  • “My kids will not vaccinate. Never!” (Here)
  • “Someone’s way making money: The person who created computer virus is the same who created the antivirus.” (Here)
  • “How much is Pfizer paying our government to peddle this life-threatening vaccine that helps absolutely nothing.” (Here)
  • “Since I vaccinated last year, my cough have never stopped” and “I can’t put my child through that” (Here)

While there are fewer pro-vaccine reactions to balance out the anti-vaxxers, it is still encouraging that one or two users would attempt to debunk the misinformation. “It is very unfortunate considering the many immunocompromised children who are exposed to COVID. We have anti-vaccine nutcases who do not care about these children with chronic conditions. How else do we protect them? Tell us.” (Here)

The users of the pro-vaccination group SouthAfricaVacciNation have welcomed the news that Pfizer is back in stock and are eager to obtain it and take it once a year. (Here), (Here) and (Here)

  • However, none of the few clinics I know where I live had stock yet.” (Here) and (Here)
  • “Has SAHPRA approved the use of the Pfizer vaccines that are in stock or are only J&J available at present?” (Here) and (Here)
  • “How regularly will we be able to get COVID jabs? Once a year? At this stage I have had 5 because of commorbidities. I had the last one in February. I’d love to be able to get it once a year like the flu shot.” (Here) and (Here)
  • “The winter flu season is officially over in SA and COVID-19 is still here. In the past week, I know of 3 people who have tested positive for COVID-19 (One in SA, One in UK and one in USA). Vaccines remain our best defence against severe-illness, complications, hospitalisation and death. (Here) and (Here)
  • I have friends in the states, and some countries are requiring masks against for certain situations like public and/or government buildings, etc” (Here) and (Here)

 KEY TRENDS | NATIONAL HEALTH HOTLINE, WEBCHAT, WHATSAPP

COVID-related enquiries. Citizens continue to seek access to public and private vaccination sites. There is still no clear official list of sites which are currently administering Covid-19 vaccinations. It has been BAU as far as the administrative queries are concerned, especially around vaccination codes, certificates, updates to personal information etc.

Common FAQs searches for Covid-19 include: How do I access my Covid-19 Vaccine certificate? Which SMSs can I expect to receive? What should I do if I lost the EVDS vaccination code that was sent via SMS? Why are there new versions of the COVID-19 Vaccination Certificate? I did not receive my COVID-19 vaccination code via SMS. Why did this happen? How do I change my email address, mobile/cell number or location/allocated facility? Why can’t I scan my certificate?

Some people are struggling to estimate their next dose or to tell if they are eligible for vaccine boosters since the EVDS is no longer sending SMSs to clients. They also want to know if the isolation period for COVID-19 of seven days is still applicable.

A concerned parent of a 6-year-old learner reports that a child was immunised at school without parental consent and wants clarity on whether the Health Department is currently running a specific campaign. We have had a request for more information around how Hepatitis E can be prevented.

KEY TRENDS | GENERAL HEALTH ENQUIRIES

The nature of complaints received on COVID-19 focuses on services received and unresolved EVDS issues. There have been claims of negligence and bad service at public health vaccination sites, and EVDS issues mainly relate to the unresolved capture of medical records.

Young women also claim that they are being turned away when they request help to terminate their pregnancies, and their reasons include being asked to bring along parents before they could be seen. “We are still looking into the matter.”

People’s reactions to a World Mosquito Day awareness  campaign revealed misinformation about mosquitos – that these mosquitos “are not natural species but man-made in the lab .and health hazards of working with raw sewerage.

Conversations on UFS social network focusing on a report by Bhekisisa centre for health journalism reveal that female sex workers are at greater risks of HIV, STIs, and unwanted pregnancies in the country – more than double the HIV infection rate of adult women in general.

The general sentiment on sex workers has highlighted that their experiences in the public health facilities which they describe as appalling because “healthcare workers have negative attitudes towards the sex work profession, and this makes it hard for them  to visit a clinic or report violent clients.”

Some of the positive remarks include a high court ruling that qualified pharmacists can now provide HIV and TB medications to treat uncomplicated HIV patients without doctor’s notes. Many people felt that this could expand access to HIV treatment and care for sex workers. Other sex workers have more interest in knowing more about the morning after pill.

KEY TRENDS | COMMUNITY FEEDBACK

In Gauteng, cholera outbreak teams of trained volunteers continued their work of educating people about cholera. More concerns about cholera and other diseases are being reported regularly, as well as a demand for timely and accurate cholera-related information, which can be addressed through interactive community radio talks and community outreach.

The mobilizing teams working in the health facilities in Gauteng and KwaZulu-Natal reporting through the social mobilizer App reveal that a total 1,895 people have been reached, of which 690 (36%) were pro COVID vaccination, 772 (41%) not interested and 433 (23%) still unsure about vaccination. Vaccine hesitancy is more prevalent among females than males.

They cited the following reasons:

  • “I am scared of needles” (13%)
  • I don’t trust the vaccines because they were developed too quickly” (12%)
  • “I don’t know enough about the vaccines to decided” (11%) and “I don’t trust government that want me to be vaccinated” (11%)
  • “I don’t think that COVID is a threat to me” (9%), “My family or friends are against vaccines” (9%), “My religious leader is against the vaccine” (9%) and “I worry that the vaccine might give me serious side effects” (9%)
  • “I am on medication for chronic diseases and worry that the vaccine might affect my medication” (5%) , and “vaccine sites are not open at convenient times” (5%)”.
  • “Vaccine sites are too far” (4%)
  • “I don’t have money to travel to a vaccine site” (3%)
  • “I don’t have an ID document” (1%) and Other reasons (1%)

MISINFORMATION

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: Vaccines are harmful to people who are immunocompromised. TRUTH COVID-19 vaccine is made available to provide ongoing protection, especially for older persons and those who are immunocompromised and are at the highest risk of severe COVID complications. (Here)

MISINFO: The measles vaccine can kill you. The vaccine is very safe and is effective at preventing measles. TRUTH There have not been any recorded deaths directly caused by the measles vaccine. Some of the common side effects of the vaccine would include fevers, mild rashes, and temporary pain in the joints. Very rarely, a person may have a serious allergic reaction to the vaccine. Nonetheless, being vaccinated is much safer than getting measles. (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.

Key resources: Measles

  • (WHO) Measles fact sheet
  • (VFA) Measles social media toolkit

Key resources – Cholera

  • (WHO) Cholera fact sheet
  • (VFA) cholera social media toolkit
  • (WHO) Global Task Force on Cholera Control, clarifying rumors and community concerns.

 Key resources: Diphtheria

  • (WHO) Diphtheria fact sheet
  • (VFA) diphtheria social media toolkit

PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT

More cholera messages are required to address the immediate concerns of those who have no access to tap water, and frequent water supply cuts. The RCCE will use the Global Handwashing Day (16 October), to reinforce messages on proper hygiene and safe water practices and promote accurate information to protect the public.

Establishing trust with parents and caregivers is paramount in facilitating the vaccination of children against measles and other preventable diseases. The RCCE Social Mobilization team should target clinics to educate mothers about the importance and safety of vaccination.

Hearing parent’s preoccupations and concerns first and addressing them ahead of immediate immunization of children could be one way to improve vaccine confidence and uptake. Use community radio slots to address their concerns and fears.

Online news agencies have shown limited coverage of the 5–11-year-olds vaccination rollout so far. Target key traditional and social media influencers to engage parents.

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
  • National Health Hotline: Reports from the national callcentre
National Health Hotline: 0800 029 999
WhatsApp: 0600-123456|Healthhotline@health.gov.za

Twitter | Instagram |YouTube

https://medsafety.sahpra.org.za/

AEFI@health.gov.za

https://findmyjab.co.za/

https://www.real411.org/Report Misinfo

WHO/AIRA ViralFacts

  • 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
  • SA 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). The data for this report was collected by the National Department of Health (NDOH), Health Systems Trust (HST), NICD, UFS Interdisciplinary Centre for Digital Futures (ICDF), KeReady, Right To Care, UNICEF and SA Red Cross.

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