Mistrust and fear are the major drivers of Covid vaccine hesitancy, says market research firm

6 Sep 2021

With one in three people indicating that they are unwilling to get vaccinated against Covid-19, it has emerged that mistrust in government and a fear of side effects are among the main barriers to people getting the jab, according to research done by Ask Afrika.

The research project, commissioned by the government and conducted in the weeks before and after the start of the third wave of coronavirus infections (May and June), found that 28% of respondents were unwilling to get vaccinated and half of these did not know much about the government’s roll-out plans.

Minister of Health Joe Phaahla has repeatedly said in the past few weeks that the goal was to have 70% of the country’s adult population vaccinated by December.

Andrea Rademeyer from Ask Afrika said the vaccine roll-out to the adult population was taking place at a time when communities were under extreme emotional stress. Their research, for instance, showed that the emotional distress among communities in the country was highest in KwaZulu-Natal, with fear levels being very high among young people in the Eastern Cape and KwaZulu-Natal. The research was conducted before the July unrest in parts of KwaZulu-Natal and Gauteng.

Overall distress was measured as a combination of financial, food and emotional distress. The survey found that about a third of people believe the worst is yet to come.

Rademeyer explained that between May and June, they spoke to 2,000 South African citizens in 28-minute interviews about getting the Covid-19 vaccine. Participants were chosen to reflect population demographics.

She said they found 62% of respondents were willing to get the vaccine but that many of these were merely aspirational, and that their recall of public health messages on the importance of getting the vaccine was very low. Only 21% could recall that it was important in minimising the infection rate and only 15% recalled messages that it remained important to wear masks, wash hands and practice physical distancing.

One in three people indicated that their hesitancy to get vaccinated was fuelled by a mistrust in government, Rademeyer said.

Other findings include:

At least 65% of respondents said they will take the vaccine to protect themselves;

Only 11% said they will get the vaccine to protect others;

At least 23% cited a fear of side effects as a reason not to get the vaccine;

Only 34% were aware of the electronic vaccine data system where the national roll-out is being coordinated; and

At least 70% of the respondents said they wear their masks daily.

Their research found that nationally only 55% of people were aware of the vaccine roll-out plan.

Of those who were willing to get the vaccine, the smallest numbers were those living in cities. Young people (between 18 and 24) were least willing to get the vaccine, while those older than 60 were most keen.

Rademeyer said the lowest willingness to get the vaccine was measured in coloured communities, with white people second lowest, and Indian people and black people most willing to get it.

She said they found the main reason why people were keen to be vaccinated was to protect themselves, and not to protect others.

Researchers found that of those who decided not to get the vaccine, a third of respondents had a general mistrust in the government. Another 23% were afraid of side effects.

She said another significant finding was that doctors and nurses, followed by the health department and then organisations like the World Health Organisation were seen as trusted sources when it came to Covid-19 vaccines. Rademeyer said people did not have much trust in celebrity influencers and traditional healers.

Researchers further found large differences in vaccine attitudes between the residents of different provinces. The Western Cape had the highest number of people who were unwilling to be vaccinated. Rademeyer said this could be linked to the finding that coloured communities were the least willing to get the jab.

Rademeyer said that people were also not particularly motivated to get the vaccine to protect others. “The assumption of ubuntu is incorrect,” she said.

In the 18 to 24 age group, 54% were willing to get the vaccine and 74% of respondents said they will do it to protect themselves – only 6% said they want to protect others. Five percent of respondents in this age group said they will take it “so that everyone can get back to normal”.

In the 25-34 age group, 59% of respondents were willing to get vaccinated. Of those who were keen, two-thirds said it was for their own protection, 11% were willing to do it for the protection of others, 4% said they will do it to stop the spread of the virus, and 3% believed they have no choice in the matter.

Those between 35 and 49 showed a 58% willingness to be vaccinated. Of those who were keen to get the jab, 58% said they wanted to protect themselves, 11% to protect others and 4% said they were still unsure.

The highest levels of enthusiasm for the vaccine (65%) were found in the 60+ age group, where 63% of respondents said they wanted to protect themselves and 12% said they wanted to protect others.

The main reasons people gave researchers for being hesitant to get the vaccine included:

About one in three said they did not trust the vaccine;

23% were worried about the side effects;

7% said they have heard or read worrying information about the vaccine;

4% said they were afraid;

4% said they were not yet sure;

3% said they haven’t received enough information;

3% believed they were taking enough precautions to be safe from the virus;

3% believed themselves not to be at risk of contracting Covid-19; and

3% said they “just didn’t want it”.

Rademeyer said that satisfaction with the roll-out was relatively high, but that 63% of pensioners described the registration process as tricky, while those between the ages of 18 and 24 raised concerns over data privacy.

Wendy Tlou from the Solidarity Fund said this research was of critical importance as the vaccine roll-out took place in a very unpredictable environment.

Prof Mosa Moshabela from the University of KwaZulu-Natal’s Faculty of Health Sciences said he had learned from his work in rural areas that it was important to be relational.

“Health workers are trained to provide care. They are not scientists. They must be empowered with information,” he said. DM/MC

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