China has reported an increase in new COVID cases and deaths in recent weeks. As a result, some nations have imposed travel restrictions. However, the majority, including South Africa, have not.
Instead, the South African government will enhance testing, strengthen surveillance, and, most critically, revitalize its COVID immunization drive.
South Africa introduced COVID vaccines for the first time in February 2021. It aimed to fully vaccinate 67% of the population (40 million people) by the end of the year. By mid-January 2023, over two years later, only 35% (21 million individuals) had been properly immunized.
Soweto is one area with a troublingly low voter turnout. The area is a huge cluster of approximately 30 ethnically divided, underdeveloped townships in the south of Johannesburg. The majority of Soweto’s roughly 1.7 million residents are black. Only approximately 20% have completed their vaccination at a vaccination site.
This vaccination rate is in sharp contrast to what Sowetans told us as part of a study we conducted in August 2020, before to the nationwide availability of vaccines. The study was conducted in Africa’s largest hospital, Chris Hani Baragwanath Academic Hospital in Soweto. More over fifty percent of those we surveyed stated they would embrace a vaccine. This was far lower than national surveys at the time, which predicted an average acceptance rate of over 75%.
This demonstrates that hypothetical vaccination intentions cannot be utilized to forecast vaccination uptake. To plan an efficient rollout, it is essential to comprehend the societal causes of vaccine reluctance in Soweto. Such insights would likely be applicable to locations throughout South Africa with comparable demographic and socioeconomic profiles.
There is always a “field of suspicion” in attitudes and views around sickness and vaccination. People may harbor ambiguities and doubts regarding, for example, negative side effects, symptoms, or disease outcomes. This is especially true for a novel, fast spreading, potentially lethal virus like COVID-19.
In Soweto, we observed a number of elements that exacerbated this atmosphere of distrust.
One such issue was the random manner in which the media reported on the sickness. The messages from health and government agencies were contradictory. Wild conjecture, rumors, “fake news,” and whispers over COVID-19’s true nature and origins circulated via local social media networks and some journalists. Some concepts were not explained in a way that was accessible to non-specialist audiences (or in languages that the vast majority of people in Soweto speak).
Mistrust of the involved institutions was also a role. Suspicion and uncertainty create a space for persistent false or erroneous statements and conspiracy theories inside society. Some individuals claimed that COVID-19 fatalities had been increased on purpose and that “Big Pharma” was behind the scam. Some individuals felt the virus did not exist. Others asserted that Bill Gates implanted a microchip in the vaccine in order to “control” the populace, or that the 5G network was somehow to blame.
Various Africanized counterfactual statements circulated in Soweto. Some feared, for instance, that COVID-19 was a man-made virus designed to wipe out black African communities. Or, in a contradicting account, blacks were immune and only whites were infected with COVID-19.
When such false information proliferates, people become even more worried, uncertain, and reluctant to receive vaccinations.
Together, structural, social, economic, and political constraints reduce participation in immunization programs. This is especially visible in Soweto and other townships with histories of colonization, marginalization, and racism. During apartheid, for instance, the white government evicted thousands of people and reduced financing for non-whites’ social services such as education and healthcare. This led in economic and healthcare discrimination against black individuals due to their lack of medical coverage. Even now, these historical and structural health inequities continue to have an impact on South Africa’s healthcare system as a whole.
Another element was related to and in some ways comparable to the mistrust issue. Similar to the present HIV epidemic, the pandemic caused a social mechanism referred to by medical anthropologists as “othering.” This time, othering took on its most dangerous form: racialization.
Othering can be perceived as scapegoating and stigmatization — for example, believing that the virus exclusively affects the wealthy, the white population, or foreigners.
Othering and racialization also promote artificial divisions: the mkhukhu (shack) dweller versus the wealthy, black people versus white people, and vaccine proponents versus vaccine skeptics. All of these tensions have the potential to undermine the authorities’ legitimacy as they attempt to implement vaccination programs.
IEB matriculants of 2022 outperform with a 98.42% pass rate despite COVID difficulties.
During vaccination rollouts, it remains crucial to investigate and resolve factors that influence vaccine trust and selectivity.
Proper media coverage of vaccination and refutation of false “information” are essential for advancing immunization.
Recognizing the social, historical, and cultural origins of vaccination reluctance is as important as addressing its clinical aspects in reducing vaccine reluctance. These are lessons that should be remembered for future epidemics, and they are even more crucial to understand now, as the South African government wants more individuals to receive the COVID-19 vaccine.
»Vaccination reluctance in South Africa«