Understanding the extent of vaccine hesitancy and the factors driving lack of uptake is critical to preventing further deaths, infections and continued damage to the economy.
This article first appeared in The conversation.
South Africa is currently facing a new wave of infections related to the much higher transmissibility of the omicron COVID variant and its subvariants. The most recent peak showed similar characteristics to the fourth wave in January 2022: the increase in infections was not accompanied by similar increases in hospitalizations and deaths.
These changes represent a challenge for policy makers trying to improve immunization coverage, especially in vulnerable groups. Those most vulnerable to serious illness with COVID include the elderly and those with underlying medical conditions.
The South African government has set a target to have 67% of the population vaccinated by the end of 2021. But the rates are well below that. As of May 22, 2022, only 31.4% of the population had been vaccinated.
Understanding the extent of vaccine hesitancy and the factors driving lack of uptake is critical to preventing further deaths, infections and continued damage to the economy. Vaccination coverage is particularly crucial for the country due to the HIV prevalence rate of 13% as well as the fact that it has the highest TB and TB/HIV incidence rate link in the world. Both are known correlates of Mortality related to COVID-19.
We have participated in research to understand the levels of vaccine hesitancy in the country with a view to providing insights into how vaccination can be boosted, particularly among high-risk groups.
Two polls of unvaccinated South Africans were conducted. The first took place from November 15 to December 15, 2021. The omicron variant had been announced a few weeks earlier. The second survey included 3,608 unvaccinated people, about half of whom were re-interviewed from survey 1, as well as 386 people who were vaccinated between surveys 1 and 2.
The dataset cannot be considered a prevalence survey or nationally representative. Nonetheless, this was a diverse sample with broad coverage on race, vaccine-eligible age categories, province, income levels, and geographic area.
We found that vaccine hesitancy in our sample was high and had taken root since December 2021.
We also tested the likely success of messaging and information campaigns, and how information should be framed and distributed. Understanding the specific drivers of vaccine hesitancy is critical to the design of these interventions.
Most people we spoke to did not want to be vaccinated. A small part was still undecided. Less than one in five intended to get vaccinated as soon as possible, half the number reported in December 2021.
More than a third did not intend to be vaccinated.
A quarter of respondents said they would only be vaccinated if required by a warrant. Worryingly, those with chronic conditions were no more likely to get vaccinated than others. Vaccination refusal was very high among older respondents. And we found that access did not rank as a reason for not getting vaccinated at all among the most hesitant (a large group).
Our results showed that it is imperative to raise awareness of the need for the vaccine, despite the current context of omicron.
Few of the respondents we spoke to thought they needed the vaccine and many cited a very low personal risk of getting very sick from COVID.
Many also believed that the vaccine did not work and that it could kill them.
Few thought it would protect them from death.
Few believed the vaccine was safe for pregnant women or nursing mothers, or the chronically ill. And only one in four of our entire sample say they trust government information about COVID-19 a lot.
A very large number of respondents opposed a vaccination mandate (nearly 75% of the entire sample), although about half thought mandates would work well. Opponents have overwhelmingly cited that it is the right of the individual to decide, with some claiming the president said vaccination would not be mandatory.
Since warrants are likely to be used at work or school, with South Africa’s high unemployment rates, warrants may not significantly improve vaccination rates and will need to be approached with caution.
Email campaigns are a tool often used to improve adoption and are attractive due to their low cost.
We tested two vaccine promotion messages (being part of the solution to end the pandemic or getting vaccinated to enjoy greater freedoms) and found some small impacts on vaccination intentions.
The project also involved a proof of concept of testing policy messages and receiving results quickly.
Our results showed that targeted campaigns would be needed among the most hesitant or at-risk groups.
The surveys allowed us to identify some key determinants of vaccination levels and established that political action should not stop after vaccination – further communication should ensure people come back for reminders and share their experiences positive vaccinations with others.
Fears about vaccine safety need to be allayed and improving belief in its effectiveness is essential if vaccination rates are to increase. This information will need to come from innovative sources given the low confidence in government information on COVID-19.
Unvaccinated South Africans explain why they are not interested in the COVID jab
Source link Unvaccinated South Africans explain why they are not interested in the COVID jab