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Fighting vaccine hesitancy: This is one curve we don’t want to flatten

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Melene Rossouw is the leader of Siyabuya. She was selected by the Obama Foundation as an Obama Leader in Africa (2018) and as a Mandela Washington Fellow by the US Department of State in 2019. She was selected as one of the 100 Most Influential Young Africans in October 2020 and made the Top Ten list of Most Influential Young Africans by Africa Youth Awards. She was recently named as one of the 100 Most Influential South Africans. An attorney with 13 years’ experience, she is the founder of the Women Lead Movement in South Africa.

What lies on the other side of South Africa’s rising tide of vaccine hesitancy, if not managed properly, is too ghastly to contemplate: a nation split between vaccine ‘haves’ and ‘have-nots’ or ‘will-nots’ trying to live in a world where everyone is a loser and where many will pay with their lives.

South Africa’s late-to-start Covid-19 inoculation drive is drifting perilously close to the jagged rocks of vaccine hesitancy and threatening to create a social divide more devastating than that between rich and poor.

Weekend news reports justifiably heightened concern over a trend which began to emerge several weeks ago – the vaccination drive in which nine million people have received at least one dose might be faltering. The Sunday Times reported that daily vaccinations had fallen to 153,999 compared to a high of 273,000 only a month earlier.

As usual there is much finger-pointing, which does little to solve the looming crisis. Understanding the problem and acting quickly and decisively would do more to help.

It is incontrovertible that what lies on the other side if we do not manage this properly is too ghastly to contemplate: a nation split between vaccine “haves” and “have-nots” or “will-nots” trying to live in a world where everyone is a loser and where many will pay with their lives.

Is this a communication problem, as some suggest? Or is it something far more fundamental? It cannot be a communications issue alone because, despite the Digital Vibes scandal which cost our former health minister his job, South Africa is awash with messaging about the vaccine.

Our cell phones ping with SMSes urging us to get the jab; radio and television are relentless in exhorting us to get vaccinated, and mass media platforms share powerful accounts of vaccine-hesitant citizens who almost died and who are now advocates for the life-saving vaccine. You would have to be living in a cupboard not to know about the vaccine, so something else must be driving the decline in the number of people getting jabbed.

There are some glitches in the correlation between what formal and respected research is showing, and what is being documented in the field.

For example, in July the latest NIDS-CRAM (National Income Dynamics Study – Coronavirus Rapid Mobile Survey which surveyed 7,000 South Africans in a broadly representative sample) produced some encouraging findings. It said that 47% of those who, in an earlier round of research, said they would not or didn’t know if they would be vaccinated, now said they would be or even had been vaccinated.

It found that one in five South Africans worried that the vaccine was not safe, but only one in 10 strongly believed it.

So, with those recent views it is hard to understand why, for example, we are now seeing dropping daily vaccination rates, or why in the vulnerable 50-59 age group only 14% of women and 10% of men have been jabbed.

The NIDS-CRAM study further showed that two-thirds of those it surveyed “strongly agreed” that they would get vaccinated should it be available, up from only 55% in the early round only months earlier.

However, the researchers warned that belief does not necessarily translate into action. They offered advice on how to translate intent into reality, such as messaging illustrating that vaccine acceptance is the norm and not the minority view, a tactic that has been successful elsewhere in the world.

But even with this evidence of apparent acceptance, there were still significant numbers in the research who needed to be convinced.

What is playing out in our vaccine campaign suggests that either thousands of South Africans lied to the researchers, which is unlikely, or something else is afoot.

There can be no doubt that there are serious issues of trust in the state and its institutions. This is a population battered by years of government malfeasance, highlighted at the Zondo Commission by exhaustively documented corruption. 

This is a citizenry confronted with the astounding reality that hundreds of millions of rands intended to keep us safe during the pandemic were stolen by the very officials and elected leaders who were supposed to keep us safe.

Against such a backdrop, it is perhaps not surprising that people are hardly rushing to register and stand in line for vaccinations in a campaign being spearheaded by the government.

There is clear evidence that when the state invited the private sector to help with the vaccine roll-out, things started happening quickly.

It is important to work around this trust deficit to give the vaccine roll-out more impetus. There needs to be closer involvement by institutions people trust. Some, like Distell and others have already begun, but there needs to be more large companies offering workplace vaccinations and the scope of approved workplaces needs to be widened dramatically.

Introducing incentives from the private sector for those who are vaccinated – such as Game offering 10% discount on Wednesdays – should be applied creatively and widely. The government might dream up some material incentives of its own, too. 

Unions, religious groupings and other civil society institutions which enjoy high levels of trust need to be brought even closer into play. The registration process, as simple as it is, remains too complex for many. We must make it easier and, as some are suggesting, we need to go door-to-door if at all possible.

This is one curve we do not want to flatten. 

We must get that vaccination trendline moving up like a rocket taking off, and this will only happen if those of us who believe in a future without this job-destroying, life-taking virus are prepared to fight like activists of old to make it happen.

If the nine million people who have had at least one dose make it our mission to help just one other person get vaccinated, we will be back on track – and we may well have saved that person’s life too.

The other scenario is unthinkable. We will face a future of fighting a mutating virus which will force us into repeated lockdowns, economic meltdowns, endless waves of infections and the heartbreaking deaths of those we love. DM

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"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]"

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  • R S says:

    Actions speak louder than words. Nobody said they would vote for Trump back in 2016, but look what happened come election time. Polling is just not what it used to be.

    When it comes to getting jabs in arms, if we have to bribe people, let’s bribe them. I’m tired of arguing with people as to why the anti-vax nonsense they believe is utter hogwash.

  • Rory Macnamara says:

    simple. the next family meeting the Pres must announce that anyone without vaccinations first and overdue on second one will not be allowed in public places. squeeze these anti vaccers out of the system. there has been no credible evidence that any vaccine will harm one. think of polio -that vaccine saved millions from being caught by that terrible disease. one can carry on naming the many vaccines that have saved people. it is not their RIGHT not to have the vaccine. it is our right to be protected from those who choose not be vaccinated.

    • Glenne Meldrum says:

      I don’t understand. If someone has been vaccinated they’re protected. So where is this panic psychosis coming from that demonises people based on a threat against which we are protected? What will ‘squeezing these anti-vaxxers out of the system’ come to mean – are we to imagine lynch mobs like in the American South, or a scenario like the ghettos and concentration camps enforced by the Nazis, or the land confiscations and removals under the Apartheid regime?

  • Sandra McEwen says:

    Some very creative South African action required here. Like going to the night clubs and townships with mobile units. I am a privialeged 76 year old fully vaxed with some hesitant and anti family members. What can you say without it becoming a divisive and vexing conversation?

  • James Francis says:

    “This is a citizenry confronted with the astounding reality that hundreds of millions of rands intended to keep us safe during the pandemic were stolen by the very officials and elected leaders who were supposed to keep us safe.”

    I don’t quite buy this point. The majority of South Africa still gobble up ANC doctrine and promises. If the people are truly jaded towards the state, we’d see the difference in polls. I think this has more to do with misinformation making it convenient to avoid the choice of vaccination.

    Honestly, these vaccines need to be mandatory. We cannot expect global populations pampered by consumerism without a balance of civic responsibility to suddenly start acting in an enlightened fashion. I’m big on humanism, individual rights, capitalism and egalitarianism. But the severe lack of personal responsibility threatens to devalue those concepts entirely if we try to enforce them so dogmatically in the face of irrational resistance.

    If adults want to act like children, then it’s time to treat them like children and force them to take their medicine.

  • TERRY VAN ACKER says:

    James Francis please go and read the Nuremberg code of 1947 and stop WHINING!

    • James Francis says:

      Terry, you seem to confuse experimentation with a matter of public health. Cherrypicking something because it suits your narrative is not constructive. I regard your view as both intellectually bankrupt and morally dubious.

      Unless you bring solutions to the table, you’re part of the problem. And when another worse pandemic hits us (and it will – just look at the rate of new diseases surfacing over the past 20 years), such objections as yours will be academic. You’ll be begging for a vaccine.

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