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