Attitudes Towards COVID-19 Vaccines In Three African Countries
Vaccinations are seen as the best weapon in our arsenal to fight the COVID-19 pandemic. The rise of the ‘antivax’ movement threatens the efficacy of a large-scale vaccination campaign in various wealthy countries, but the impact of these movements is not well understood in countries like South Africa, Nigeria, and Kenya. This study adds nuanced data derived from open-source media to the understanding of the local sentiment regarding vaccinations in these countries.
The data shows that the themes that drive the sentiment towards vaccination are more nuanced than mere hesitancy. In particular, unequal access to vaccines and limited vaccine procurement and rollout strategies are derived as major themes in these countries that drive sentiment.
The study was done as part of the VoxCroft Monthly Data Insight for the CSIS Africa Program newsletter.
For the study, collected data were in the form of tweets from the three selected countries: South Africa, Kenya, and Nigeria. A snapshot of tweets was collected from January to February 2021 in each country, based on location data. All tweets with the keyword "vaccine" or "vaccination" were included. A random representative sample was produced from the raw data for each country. The sample size was determined based on a 95% confidence interval for the full dataset.
The categories included in the vaccine infographic — namely, vaccine hesitancy, equal access, procurement/rollout, and variant — were derived from themes identified from South African open-source media (Read more about what Open Source Intelligence is). Below is a description of each category/theme along with more detailed references as rationales for inclusion. Note that these articles were collected on 25 January, and themes may have developed in different directions since then.
Vaccine Hesitancy: South Africa has a high COVID-19 vaccine hesitancy rate. Several recent surveys indicate a range of results, with the highest rate of acceptance at 67%.
According to a recent Ipsos survey, only 64% of South Africans would accept a COVID-19 vaccine; the number one reason for rejecting a Covid-19 vaccine was fear of adverse events followed by concerns about vaccine effectiveness. South African falls in the group of countries with the least intention to get vaccinated (below 70%). Distrust in vaccines mirrors low confidence in public institutions, with 32% of South African citizens saying they had no confidence in hospitals/clinics compared to 27% in Africa and 24% globally (link).
A recent University of Johannesburg study found 67% of adults would be willing to take the COVID-19 vaccine. The study also found that race, level of education and age played a role in how people responded. Blacks (69%) were more likely than whites (55%) to accept the vaccine; those with a matric education (72%) were more likely than those with tertiary education (59%) to accept the vaccine; and older adults (over 55) (74%) were more likely than younger adults (18-24) (63%) to accept the vaccine (link)
Another survey conducted by CompariSure found that 52% of South Africans would not be willing to take the vaccine, citing side effects (34%), religion (13%), cost/price (16%), and other (40%) - with reasons like fear of needles and government tracking (link)
Equal Access: Concerns around equal access to vaccines are prevalent in South Africa, and across the continent.
South Africa ($5.25) is paying 2.5 times more than European countries ($2.16) for the Oxford-AstraZeneca vaccine. According to Anban Pillay, South Africa’s deputy director-general of health, “the explanation we were given for why other high-income countries have a lower price is that they have invested in the [research and development], hence the discount on the price” (link)
Maverick Citizen opinion piece: “Rich countries have pre-ordered enough doses to cover their populations several times over, leaving us in the global south with insufficient supplies for our populations in greatest need and at high risk. In South Africa, this is exacerbated by our two-tiered health system which often benefits those with private health insurance, unless of course, the government steps in to develop an equitable access and allocation plan or framework” (link)
Follow-up Daily Maverick opinion piece: “The lack of planning by global institutions, governments and big business, including the pharmaceutical corporations responsible for bringing vaccines to market, to address equity, early on, based on health and epidemiological needs, rather than nationalism, is now having a dire impact on the world’s ability to achieve, rapid, widespread, global population immunity” (link)
Vaccine Procurement/Rollout Strategies: Perceived slow vaccine procurement, national government seen as having delayed vaccine acquisition; questions over centralized versus decentralized/privatized procurement and rollout strategies - Western Cape seeking to procure its own vaccines citing mismanagement at the national level.
The South African government is targeting a minimum of 67% of the population to achieve herd immunity and the approach will be a phased rollout of the vaccine, beginning with the most vulnerable in the population. The first phase targets frontline health care workers, with a target population of about 1,250,000. Phase two will accommodate essential workers, persons in congregate settings, the elderly, and those over the age of 18 who have comorbidities. The third phase will target South Africans over the age of 18 (link)
Western Cape premier Alan Winde says the province plans to procure its own Covid-19 vaccines as it cannot rely on the government as the sole supplier: “We are already seeing that the supply that we are getting as a country doesn’t look good, and it looks like we won’t get sufficient vaccines for this whole year. So I have got to find another supply.” According to the article, the national government has faced criticism in recent weeks for its slow procurement of vaccines, calling the procurement process “haphazard”. The article also includes a quote from a South African researcher stating “It was poor planning on the part of the government...They failed the country” (link)
Editorial written by several prominent South African public health experts and researchers: "For the rest, mainly the poorest nations on the planet, the global Covax facility offers the only hope of receiving an adequate vaccine supply sometime in the next six to nine months, only after which can the months-long vaccination programs begin. It beggars belief that South Africa, against all reasonable expectations, finds itself in this group, since it is not a poor country, despite the best efforts of a corrupt political class to ensure that moniker. The stunning reality is that it has neither a secured vaccine supply nor a plan for mass inoculation in the foreseeable future that can withstand scrutiny. This portends for this country the worst ravages of Covid-19 in the year ahead" (link)
Variant: There is some discussion surrounding the South African variant, and the effectiveness of vaccines with regards to the SA variant and other variants.
South African Covid-19 variant 501Y.V2 has quickly become "dominant" among multiple variants circulating in the South African population, suggesting a transmission advantage. Concern vaccines may not be as effective against this variant; current evidence indicates vaccines will be effective against the variant, those research on the issue is underway (link)
A recent announcement by Moderna stating that its vaccine was founded to retain its efficacy against both the UK and South African variants; the South African variant had a sixfold reduction in the neutralizing antibody level, but remained above the quantity that was shown to be protective - will this be the case for other vaccines? Particularly the J&J and O-AZ vaccines? (link)
The random representative samples for each country were coded by theme as sentiment according to the following framework:
· Vaccine Hesitancy: Positive = Pro-vaccine; Negative = Anti-vaccine
· Equal Access: Positive = Vaccine distribution has been fair; Negative = Vaccine distribution has not been fair
· Procurement/Rollout: Positive = Procurement/rollout has been good; Negative = Procurement/rollout has been bad
· Variant: Positive = No concern over vaccine effectiveness for variant/vaccine will be effective against variant(s); Negative = Concern over vaccine effectiveness for variant/vaccine will not be effective against variant(s)
Each tweet included in the sample was manually coded. Irrelevant tweets were discarded — for example, tweets discussing vaccine rollout in the United States with no apparent mention of one of the three selected countries. Tweets in languages not available on Google Translate were also discarded.
After the tweets were coded, the theme/sentiment data for each country were charted to produce the infographic.
About the Author
Rebecca Hotchner Blaser is an OSINT analyst at VoxCroft Analytics. She is an expert in Public Health, having studied for her Masters of Public Health at the University of Cape Town and The George Washington University Milken Institute School of Public Health. She works as part of a multidisciplinary team to develop OSINT solutions to provide insights to decision-makers.
VoxCroft specializes in automated intelligence solutions that combine machine learning and human tradecraft. The company specializes in the use of open-source media, such as social media, news, blogs, and broadcast media. The VoxCroft products are used by government agencies, industrial contractors, humanitarian organizations, and private companies to get insights that are timely, accurate, and relevant.
For more information on OSINT or this study, contact firstname.lastname@example.org
Download the PDF of the infographic below: