Johannesburg - Millions of South Africans are joining the queues to get vaccinated against the Covid 19 virus, but high levels of vaccine hesitancy persist and threaten the lives of many.
Across the globe there are warnings of future pandemics of the unvaccinated but scientists believe that a multi-pronged approach could get more people to opt for a Covid-19 vaccine.
In a paper that appeared recently in the journal Expert Review of Vaccines, South African researchers examined the issue of vaccine hesitancy in the country and what could be done to combat it.
They did this by examining different surveys that have been conducted over the period of the Covid-19 pandemic. What they found was that the results of these studies varied, which they put down to small sample sizes and the changing dynamic of the pandemic.
“We looked at some of these surveys and it did show that there is more vaccine hesitancy in South Africa than in some countries,” says Professor Charles Wiysonge of the South African Medical Research Council, who was an author on the paper.
However vaccine hesitancy is not static, Wiysonge stresses.
“The percentage of people willing to take the vaccine, depends on what is going on. Maybe the government stops the AstraZeneca roll out, for example, then changes to the Johnson and Johnson, then that is suspended.
“These things may resonate with people and make them hesitant,” Wiysonge explains.
As increasing numbers of people are being vaccinated, the director for the US Centers for Disease Control and Prevention Dr. Rochelle Walensky warned last week about the increased numbers of those who are unvaccinated, becoming infected and seriously ill.
This as the US over the last couple of weeks saw an increase in the number of Covid 19 infections particularly in states with low vaccination rates.
Parts of the US and Russia, Wiysonge points out, have more vaccine hesitancy than many low income countries.
In South Africa higher education and race has been found to play an important role in vaccine hesitancy.
The Covid-19 Democracy Survey that was conducted in the first week of January, found that white adults with higher levels of education were less accepting of vaccines than other race groups.
Research has found that vaccine hesitancy has been a developing phenomena in South Africa.
Vaccine hesitancy was identified as one of the main challenges facing vaccination programmes in a study conducted in 2009. The study highlighted it as playing a role in a number of measles outbreaks in South Africa between 2003 and 2011.
But while anti vaxxers have used social media to disseminate their messages, it is the same medium that is now helping combat vaccine hesitancy.
Images on Facebook and Twitter of people celebrating being inoculated has a knock on effect, believes Professor Francois Venter of Ezintsha in the Wits Reproductive Health and HIV Institute.
“It has improved,(vaccine hesitancy) and I think a lot of it is people telling their families and friends to go and get vaccinated,” says Venter who was not a part of the study.
While word of mouth and the power of social media is fuelling the vaccine drive, the problem, according to Wiysonge, is that the government’s communication strategy has not been very effective.
The need, he says, is to have a communications strategy that involves timely and accurate information about vaccines, while also including other participants, including churches and other influential organisations and personalities.
To better understand and to measure vaccine hesitancy, Wiysonge and his colleagues are in the process of developing a vaccine hesitancy instrument.
Such instruments are used overseas, but South Africa’s unique demographic and circumstances, believes Wiysonge, requires its own.
“Most of the instruments that are used for collecting data on vaccines are based on research conducted in high income countries, so we have tried to adapt some of them," explains Wiysonge."We have also added something like religion as it is very important in South Africa in terms of people’s decision making.”
Venter’s concern is that while the vaccine roll-out is going well, with ten percent of the population vaccinated, hesitancy is going to slow the programme down.
“The problem is when they hit 25% that is when it is going to slow down, and that is what scares me. Now is the time to put foot, and get everybody vaccinated, and you can start setting the scene for when you have to tackle the hesitancy.”
But vaccine programmes and Covid are likely to have a major impact on vaccine hesitancy in the future. Just what that impact is, says Wiysonge, is unclear.
“It could go either way. You have all these conspiracy theories and they might apply to other vaccines. But I feel that it might have a positive effect, because people are now becoming more literate around vaccines and we could use this in future programmes,” he says.