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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.
KEY TRENDS | COVID-19
Anti-COVID-19 vax. Resistance to vaccination is a persistent challenge. Both persuasion and coercion often fall short when it comes to changing the minds and behaviors of individuals who are determined to refuse vaccines or believe in misinformation spread by the anti-vax movement. “Despite efforts to combat this, the anti-vax movement remains prevalent. Anti-vax movement isn’t going away.” (Here)
There are persistent false claims that sunlight, vitamins, and a healthy diet can protect one against COVID-19 severe illness. “All this will build your immune system, but they will not protect against severe COVID-19 and death. If you are young and healthy, you don’t need the vaccine” and one person added “I refused the jab and “I didn’t. I refused to take a vaccine because it was developed over a short period of time.” (Here)
Declining interest in COVID-19. Despite the decreased interest in COVID-19 vaccine on social media, inquiries about the new COVID-19 strain continue to be frequently asked. They are more concerned about the isolation period. “Is the 7-day isolation period for Covid still applicable or not? What are the updated guidelines on this?”
“We are aware that there is a new covid strain surfacing in South Africa. What protocols do you suggest for conferences being held in Pretoria at present. i.e., masks? Distance enforcement? Sanitizers, etc? We need a bit of reinforcement and more engagement from the political leaders”.
Social media users are still casting doubt on the COVID-19 vaccine by sharing a misleading meme that suggests the flu, measles, mumps and rubella exist even though inoculations against those diseases have been around for decades, yet diseases haven’t been eradicated, and that proving the immunizations don’t work. (Here)
In the past week, community mobilisers have reached over 1998 people with vaccine education in the facilities and communities, of these 787 positives (39%), 671 (34%) not interested and 540 (27%) still hesitant to vaccinate. The reach compared to previous months has increased but many people are fatigued. Their reasons include the following:
- Religious leader is against vaccine (13%)
- Scared of needles (12%)
- Do not trust the government (10%)
- My family and friends are against vaccine (9%)
- COVID-19 is not a threat (8%)
- I don’t have money to travel to a vaccine site (6%)
- I am scared of needles (12%)
- I don’t know enough to decided (8%)
- I don’t have an ID document (5%)
- I am on medication for chronic disease and afraid that the vaccine might affect my medication (7%)
- Vaccine sites are not opened at a convenient time (7%)
- I don’t think COVID is a threat to me (8%)
There is also low interest on social media in response to the social media banners posted about the rollout of the vaccination for the 4–11-year-olds. Of the 10 social media posters this week, engagement on COVID-19 is the lowest. The reasons include describing the vaccine as “poison”, (Here) “death vaccine”, (Here) ”killing our children”. (Here) (Here)
Misinformation involving kids. A trend of targeting kids with videos containing false scientific information have caused a stir among parents. A team that analyses disinformation, information that is deliberately misleading and false, found “more than 50 channels in more than 20 languages spreading disinformation disguised as STEM [Science Technology Engineering Maths] content”. (Here)
These include pseudo-science – that’s presenting information as scientific fact that is not based on proper scientific methods, plus outright false information, and conspiracy theories. “These are theories or beliefs that some groups of people are trying to deliberately mislead the general public, typically for the benefit of a small powerful group”. (Here)
Rabies confirmed cases. Social media users’ scepticism about reported cases of rabies following cholera, measles, and COVID-19, and their reference to conspiracy theories, is a concern. Two children from KwaZulu-Natal are the latest confirmed human rabies cases in South Africa. As of August 23, eight confirmed human rabies cases have been recorded in South Africa since the start of the year. “Cases, including those described here, were identified in the provinces of KwaZulu-Natal (4), Eastern Cape (3) and Limpopo (1),”(Here)
Community concerns and questions. To gauge the information seeking behaviour of people, a composite indicator was created. The composite indicator for information-seeking behaviour is designed to provide a comprehensive view of public interest across three key categories: One of the health priorities was specific around nutrition, physical health, type 2 diabetes, nutrition, and how to eat healthy.
From this, a trend analysis conducted by UFS ICDF:
- There is an increase in the breast cancer information seeking behaviour.
- No difference is observed in the information seeking behaviour related to vaccines in general.
- There is a decrease in the information seeking behaviour related to healthy living, weight loss, and people searching for healthy food alternatives.
- Campaigns that were conducted specific to nutrition and healthy living did not effectively shift the information seeking behaviour of the public.
People have engaged with Breast Cancer Awareness discourse on online platforms such as Telegram and Twitter. Included in these trends were people sharing words of encouragement for people to take care of themselves and screen test for Breast Cancer. A respondent added:
- “Right now, I know you’re busy taking care of everyone else, but when was the last time you took care of yourself? This Breast Cancer Awareness Month, @lifetimetv and I are 3 | P a g e 15-October-2023 encouraging you to talk to a doctor about whether it’s time for your mammogram or other cancer screenings.”
- “Dear Ladies, October is Breast Cancer Awareness Month, a crucial time to remind you all of the importance of early detection. Regular breast cancer screening can be a lifesaver”
These post are examples of the way in which the public encourages each other to get screened. Unfortunately, there were instances of misinformation related to breast cancer and the COVID-19 vaccine with some people on Telegram shared that they got Breast Cancer due to COVID19 vaccines:
- “Got breast cancer on vaxed arm side. breast was swollen after vax. Only got 1 vax because of severe allergic reaction and blood clotting Got breast cancer on vaxed arm side. breast was swollen after vax. Only got 1 vax because of severe allergic reaction and blood clotting problems. The doctor says the tumour was at least -+ 2 years old. discovered the Tumour at -+exact time I had the Vax. -+2 years later. I discovered the Tumour at -+exact time I had the Vax.2 years after vax.”
- “The COVID-19 mRNA vaccine killed 24% more people in the vaccine group than the placebo group in the actual Pfizer trial, including 250% more cardiac arrests. It doesn’t prevent infection or spread but it does flood the body with free-circulating spike proteins which damage the heart and cause cancer”
Luckily the number of people in these groups did not exceed an alarming amount (less than 2000) and these conversations never made it onto other social media platforms. Other people engaged with conversation on National Nutrition week on Twitter conveying the importance of choosing healthy food for overall health:
- “This National Nutrition Week, let’s start making health our priority. Making the right food choices will have a great impact on your overall physical and mental health, so choose wisely”
- “The quality of nutrition children receive during their early years affects their future health, learning and productivity. By investing in children’s early health and well-being, we can create a future where every child is given the opportunity to thrive.”
- “National Nutrition Week aims to create awareness about the importance of healthy eating and proper nutrition to maintain a nutritious lifestyle. Nutrition is a critical part of health and development.”
Important concerns were raised about the health education surrounding nutrition in children, especially during their formative years.
KEY TRENDS | NATIONAL HEALTH HOTLINE, WEBCHAT, WHATSAPP
COVID-related calls. Vaccine codes requests have consistently been the top call driver. This includes citizens who have either lost their vaccination code, lost their vaccination card, can’t access the code, changed phones and are unable to retrieve codes and people who require their codes to download Vaccination certificates.
People continue to seek assistance with locating vaccination sites. Agents use FindMyJab to assist with locating the most accessible sites as well as directing callers to the FindMyJab App. Two main FAQ’s searched were “What should I do if I lost the EVDS vaccination code that was sent via SMS?” and “How do I access my Covid-19 Vaccine certificate?”
General health queries. All platforms (voice calls, web chat, email, and WhatsApp) handle calls and enquiries around the different health services which includes non-health related queries, such as;
- Information request around circumcision
- Questions around STI symptoms and treatment.
- Information around symptoms and treatment for TB as well as steps to take when one of the household members have tested positive for TB but are not on treatment.
- Seeking more information around Covid-19 particularly an interest in the benefits of getting vaccinated i.e. how to isolate, period of isolation, booster dosage for immunocompromised, registering 5-11-year-olds for pediatric vaccination.
- Questions about mental health and depression.
- Pregnancy related questions which include where to go for TOP, when to take morning after pill, complications with pregnancy etc
- A Canadian citizen seeking information around travelling to SA with personal medication.
Other enquiries include applications for ICSP program, internships, job seekers, SASSA applications & processes. There is also an increase in the amount of SASSA queries for past week, with citizens unhappy with the unpaid grants.
There was a query around the Daplameds system where a caller had registered but the details did not appear on the system when collecting meds. Others were seeking advice on how to register to receive their meds from Clicks. Some complained that their meds were not available when collecting at different points,
There have been requests for home visits to provide medication, vaccinations, and medical assistance to disabled and elderly. A caller wanted to volunteer as an HIV counsellor.
The have also been complaints related to treatment at the health facility and unresolved EVDS issues which include complaints of negligence and bad service delivery at health sites. This includes EVDS issues which related to unresolved back capturing of medical records.
KEY TRENDS | GENERAL HEALTH ENQUIRIES
There have been questions about TB, someone asking for proof of TB treatment they underwent, “I was diagnosed with Tuberculosis in 1993 at Mamelodi East clinic, of which I received treatment for 6 months until I was cleared of the illness. I recently applied for a new job, and upon medical check-up, I found that I still had scars from my previous TB infection. Now I am in a foreign country. If only I can get proof of the dates.”
KEY TRENDS | COMMUNITY FEEDBACK
Volunteers from SARCS continue to monitor public sentiment and address community concerns, specifically related to health issues arising from discussions or engagement with communities.
The Health and HIV Testing Services (HTS) have taken centre stage in responding to the community’s queries, primarily about infectious diseases including cholera and polio.
While the pace of cholera response activities has witnessed a noticeable deceleration, alongside collaborative partners, the volunteers maintain an ongoing presence to educate the affected communities within Gauteng (GP) and the Free State.
There are concerns surfacing within affected communities. Specifically, these communities have expressed a compelling need for heightened awareness campaigns, particularly concerning cholera and other infectious diseases. This candid feedback underscores the need for continual dialogue, transparent information sharing, and a steadfast community engagement process.
The robust collaboration on awareness campaigns and inclusive community engagement endeavours with the United Nations Children’s Fund (UNICEF) has notably augmented SARCS’ capacity to execute community response measures.
MISINFORMATION
MISINFO: Vaccines for the flu, measles, mumps and rubella were developed decades ago, yet the diseases haven’t been eradicated, proving that the immunizations don’t work. TRUTH: Vaccines for measles, rubella, flu and mumps have helped drastically reduce the incidence of serious illness and death from those diseases.
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. (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
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
PROPOSED ACTIONS FOR RISK COMMUNICATION & COMMUNITY ENGAGEMENT
- Sustained awareness efforts: In response to community concerns and the persistent presence of cholera and related issues, SARCS is well-advised to perpetuate its emphasis on awareness. The continuous and accurate sharing of information remains paramount to effective community engagement and addressing queries.
- Collaborative engagement strengthening: The collaborative synergy shared among stakeholders, including UNICEF, serves as a strategic linchpin for optimizing resource allocation and the seamless coordination of awareness campaigns and community engagement initiatives. A united front heightens the resonance and impact of response efforts.
- Customized Messaging Approach: The crafting of culturally sensitive communication materials tailored to each unique community context is recommended. Such tailored materials enhance resonance, understanding, and engagement among diverse communities.
- People are searching for breast cancer services during breast cancer awareness month. Public health communicators can use this opportunity to align other related health campaigns with breast cancer awareness such as the promotion of the HPV vaccine in women under the age of 20 years; promoting the regular checks for prostate health in males; and/or that a healthy lifestyle reduces the risk for developing certain types of cancer.
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:
| National Health Hotline: 0800 029 999 WhatsApp: 0600-123456| https://medsafety.sahpra.org.za/ https://findmyjab.co.za/ https://www.real411.org/Report Misinfo WHO/AIRA ViralFacts |
- SA National Department of Health
- National Health Hotline: Reports from the national callcentre
- 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 drafted by 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:
Peter Benjamin, HealthEnabled peter@healthenabled.org 082 829 3353
Charity Bhengu, National Department of Health charity.bhengu@health.gov.za 083 679 7424
