The first week of February 2021 was a momentous one in the Covid-19 pandemic. It was the week when the number of people globally who had received a vaccine overtook the numbers of people who have contracted the virus thus far. Bahrain currently has the second-highest vaccination rate in the world, while by Saturday, 6 February, the US was vaccinating over a million people a day.

As our health system gears up to embark on a mass vaccination programme in the coming months, it is necessary for the uptake of a vaccine to be as high as possible. A recent survey conducted by researchers at the University of Johannesburg and the Human Sciences Research Council has shown that two-thirds of South African adults would definitely or probably accept a vaccine if one were available, 15% stated they did not know, and 18% said they would not accept a vaccine.  

We need a huge national effort to convince members of the public who are eligible to receive a vaccine to accept one. A high level of immunity provided by wide vaccine coverage is the best chance we have to reduce the number of new infections; to reduce symptoms, hospitalisation, and deaths among those infected; and thus to ensure that health services can be freed up to serve people with other health conditions. We need to ensure high enough uptake of the vaccine to provide herd immunity to South African society.

There is, unfortunately, a sense among some in the public that vaccines may cause more harm than good and that vaccines will actually infect people with the Covid-19 virus. This kind of misinformation must be countered from a range of sources – government, the medical establishment and the media.

Vaccine hesitancy or vaccine refusal has a long history – inevitably tied to charlatans such as Andrew Wakefield, who did serious damage to public understanding of the effectiveness of the MMR vaccine. Wakefield’s now-discredited study, suggesting that the MMR vaccine was associated with autism in children, was withdrawn from The Lancet because his data were simply false.

We need to guard against baseless claims about any of the available Covid-19 vaccines that are not supported by science. The credibility bestowed on pseudoscience and quackery unfortunately also has a long history in South Africa. Former president Thabo Mbeki argued that HIV does not cause Aids, entertained the quackery of vitamin salesman Matthias Rath, who peddled vitamins to cure HIV, and appointed a minister of health (Manto Tshabalala-Msimang) who believed that beetroot, olive oil and garlic could cure Aids. 

Some people are genuinely worried and concerned that a vaccine may harm them. To allay such fears we need accurate information, clear messaging, and excellent science. Lies and misinformation can only be countered by facts, data and solid evidence. Baseless claims and conspiracy theories about the Covid-19 vaccine should be met by these means.

It is likely that all of the 18% of people in the survey mentioned above, that have said they would not take the vaccine, have in fact had numerous vaccines in their life (MMRI, tetanus and others). Far from being sick or disabled from these vaccines, they are likely to be alive today because of them. They need to be reminded of this.

There are a few ways to create conditions for widespread uptake of the Covid-19 vaccine.

In the face of vaccine hesitancy, trust is a key component of making the decision to take the vaccine. South African public figures – politicians, celebrities and sportsmen and women – have an important role to play as role models and examples to others that receiving the Covid-19 vaccine is imperative for their own health as well as the health and wellbeing of our society. When the public sees leaders and those in the public eye receiving a vaccine, they will be more likely to abandon scepticism and accept a jab themselves.

However, we also know that trust in many politicians in South Africa is currently quite low among the public. In this regard, the role that religious leaders play is key. Every minister, imam and rabbi must publicly be vaccinated and make discussions on the importance of vaccines part of their religious services and ceremonies – on an ongoing basis. 

Traditional healers have a unique role to play in the effort to ensure the uptake of vaccines. Traditional healers enjoy the trust and confidence of those who seek their services. To this extent, they can help to publicly encourage credulity, acceptance, and trust in the national effort to vaccinate the public.

Social marketing and public service announcements need to start in earnest to create awareness and interest among the public in receiving a vaccine. The fact that the majority of South African adults would accept a vaccine if one were available is encouraging and should be publicised as widely as possible. Doing so will convince those (who are more circumspect) that a vaccine is acceptable to most others, that it is an important social and public health good, and that they should receive one themselves when presented with the opportunity.

We need science journalists on radio, television and print and social media to encourage scientific mindedness in society so that the public can become active readers and consumers of scientific information. Doing so will actively enable people to understand scientific concepts such as prophylaxis, randomised trials and the placebo effect. Understanding the basics of vaccinology is also helpful, as it will help the public to understand that a vaccine cannot actually infect anyone with the virus or change their DNA. Accurate and clear information of this nature can go a long way to counter conspiracy theories about vaccines — theories which have no basis in fact.

South African public figures such as President Cyril Ramaphosa, Archbishop Desmond Tutu, Stephen Grootes and Siya Kolisi have a duty to publicly and unequivocally endorse and accept the coming Covid-19 vaccine and thus encourage all of us to do the same. 

And if community leaders and the professors of the street in every corner of South Africa can do the same, we will stand a chance of vaccinating the numbers of South Africans needed to move through this awful pandemic. DM

Professor Mark Tomlinson is co-director of the Institute for Life Course Health Research in the Department of Global Health, Stellenbosch University. Professor Ashraf Kagee is Distinguished Professor in the Department of Psychology at Stellenbosch University. Tomlinson and Kagee are both members of the Western Cape Department of Health Vaccine Advisory Committee.

Information pertaining to Covid-19, vaccines, how to control the spread of the virus and potential treatments is ever-changing. Under the South African Disaster Management Act Regulation 11(5)(c) it is prohibited to publish information through any medium with the intention to deceive people on government measures to address Covid-19. We are therefore disabling the comment section on this article in order to protect both the commenting member and ourselves from potential liability. Should you have additional information that you think we should know, please email [email protected]