South Africans are more likely to get vaccinated. But many still have to be convinced

The number of people vaccinated against COVID-19 in South Africa is on the rise after a chaotic start. But the most positive attitudes aren’t always reflected in vaccine records and vaccinations, according to the latest results from the Coronavirus Rapid Mobile Survey. The survey follows a nationally representative sample of South Africans. The same people are contacted each month and asked questions on a wide range of issues such as their income, household well-being, and their knowledge and behaviors related to COVID-19. The research was carried out by experts from the universities of Stellenbosch and Cape Town. Ronelle Burger, one of the survey’s lead researchers, told The Conversation Africa about the results.

How is South Africa?

Our survey found an increase in the proportion of adults ready to be vaccinated from 71% in March 2021 to 76% in May 2021.

Vaccine acceptance in South Africa is now comparable to that of high-income countries like Australia and Germany.

But nearly one in four participants were still hesitant to get the vaccine. About one in 15 people strongly opposed vaccination. This group may not be open to persuasion.

What are the gaps between intention and action?

We also found a significant gap between the proportion of people who said they were ready to vaccinate and those who actually took action. In the survey, we used electronic vaccination registration as a proxy to measure people’s ability to convert intention into action.

In the age group of people over 60, 78% said they were ready to be vaccinated. Nationally, by early July 2021, only 55% of this group had registered for vaccination. This shows that there are a lot of people who say they are ready to get the vaccine but still have not taken steps to register. It is important to understand this gap between intention and action. International literature suggests that this is most likely due to underlying uncertainty and mistrust, requiring more assurance or due to the high cost in time or money of registrations and vaccinations.

This interpretation is consistent with the large discrepancies that we see in vaccine registrations between provinces and the strong lead of Limpopo at 77% compared to the average of 55%. Limpopo is the poorest province in the country and has a large population of elderly people who are mostly illiterate and live in rural areas. It also has the lowest proportion of people covered by medical plans. To ensure equitable and efficient deployment of the vaccine, the province has chosen a different path. Community health workers received smartphones and traveled to communities to help older people register for immunization. Royal and religious leaders were among the first to receive the vaccine, which helped encourage people to get the vaccine. And vaccination sites have been set up in easily accessible areas.

What needs to be done?

The international literature and the Limpopo case study suggest that closing this intention-action gap requires a three-pronged strategy.

The first is to provide specific information on vaccine safety and side effects. The safety of vaccines was a major concern among respondents. People have expressed concerns about possible side effects and that vaccine testing may have been rushed. Such communication must take place in languages ​​that people understand, on easily accessible platforms.

Communication campaigns must be adapted to reach those who are still afraid. For example, vaccine acceptance was higher among people living in traditional neighborhoods, among IsiZulu, isiTsonga and Setswana speakers, and black respondents. It was significantly lower among respondents living in urban formal residential dwellings who speak Afrikaans, and white and mixed-race respondents. Acceptance of the vaccine also remains low among young people.

The second thing is to build trust by working with community leaders and networks to disseminate the correct vaccine information. In our survey, more than half of those surveyed who were on the fence said they would get vaccinated if a trusted community leader gets vaccinated and stays healthy.

The third thing to do is to remove the barriers for those who want to be vaccinated. Some of these barriers are accessing the internet and other resources needed to register for vaccination, distance from vaccination sites, and lack of time to get to a vaccination point during the working day. .

What about immunization inequalities?

The worst-case scenario of uneven vaccine distribution would be a localized version of global events where rich countries have vaccinated a large part of their population and poor countries face a constant resurgence. The same could happen if there is not a concerted effort to ensure that people who do not have access to private health services are vaccinated at the same rate as their richer counterparts. South Africa could see continued COVID-19 hospitalizations and deaths among poorer communities. Currently, the proportion of people over 60 years of age receiving medical assistance who have been vaccinated is about double those who do not.

But the national health ministry has shown increased awareness of this situation and seems willing to take action to address it. For example, COVID-19 vaccinations will also take place on weekends and plans are underway to set up mobile vaccination sites at old age benefit payment points.

Ronelle Burger does not work, consult, own stock or receive funding from any company or organization that would benefit from this article, and has not disclosed any relevant affiliation beyond her academic position.

By Ronelle Burger, Professor of Economics, University of Stellenbosch