An extensive online survey undertaken by the Centre for Health Systems Research & Development at the University of the Free State last September revealed that most of South Africa’s unvaccinated people lived in North West Province (70%), while more women (67%) than men (56%) opted not to get the jab.
The survey also showed that fewer educated people (70-75% of persons with no formal education, primary or secondary education) had not vaccinated, compared with 44% of people with tertiary education. And when it came to reasons for not getting the vaccine, 26% said they were worried about side-effects.
The survey, said Professor Michelle Engelbrecht, Dr Gladys Kigozi and Professor Christo Heunis, was aimed at determining people’s abilities to understand information about vaccinations so they could make an informed choice.
They advertised the survey, which was accessible on a data-free platform, on social media and via the Moya App, and it was available in Zulu, Xhosa, Afrikaans, English, Sepedi, Setswana and Sesotho. A total of 10 466 completed questionnaires were included in the analysis.
A total of 60% of respondents were not vaccinated and geographically, two thirds of people living in North West (70%), Mpumalanga (68%), and Northern Cape (64%) had not had their shots. The Free State had the lowest percentage of unvaccinated citizens (46,1%).
Age-wise, 75% of people aged 18-34 were not vaccinated compared with 35% of those 35 years and older. Results also revealed that 74% of unemployed people, 55% of students and part-time employees had not been jabbed, compared with 35% of full-time employees and 18.9% of retirees.
They found a significant association between higher scores on the vaccine literacy scale and being vaccinated. More people with higher vaccine literacy scores were vaccinated compared with those with lower scores.
Approximately 30% of unvaccinated people were unsure if they would vaccinate in the future and 16% said that they would definitely not do so. Apart from their concerned about side effects, the main reasons for not vaccinating or being unsure whether to vaccinate included perceptions that vaccines had been developed too rapidly (12%); desire to obtain natural immunity (10%); fear of needles (10%); questioning whether vaccines are effective (8%); and being against vaccines in general (7%).
Most people had heard about COVID-19 vaccines via social media (21%), television (21%) or radio (18%), with 12% indicating that they had heard from healthcare workers. Research has found that the spread of misinformation on social media and other channels can influence COVID-19 vaccine confidence.
These findings highlight the importance of vaccine literacy when making a decision whether or not to vaccinate, said the study’s three authors.
They also suggest that when advertising COVID-19 vaccines there should be a concerted focus on the following groups: women, younger people, less educated people; the unemployed, part-time employees and students. They said people needed access to accurate information from reputable sources that tackled issues like concerns about the side effects of COVID-19 vaccines; how the vaccines were developed and why it was possible to develop vaccines so quickly; as well as the effectiveness of the vaccines.
Vaccine-literate people should be able to identify misinformation about vaccines and assist in spreading accurate information that can assist their family, friends and colleagues in making decisions about the vaccines, they added.
A limitation of this study was that only people with access to a smartphone, tablet or computer could complete the online questionnaire. Furthermore, the survey was open during September, which was when people 18 years and older had just become eligible for COVID-19 vaccines. This may partially account for the low number of vaccinated people in the 18-34 year age group.
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