Vaccination hesitancy in South Africa, a reality

September 27, 2021

Our World in Data statistics reflects that over 7.7 million of the 60.14 million people in South Africa have been fully vaccinated. This makes up only 13,2% of the population, and over 11.2 million have received at least one dose to date. Considering this and the fact that all adult persons over the age of 18 currently qualify for the COVID-19 vaccine, it cannot be denied that vaccine hesitancy is a challenge that our country faces.

What the surveys found

A survey conducted by National Income Dynamics – Coronavirus Rapid Mobile (NIDS CRAM) in July from a sample of about 5 000 respondents indicated that vaccine acceptance had risen from 71% to 76% compared to surveys conducted earlier this year. University of Johannesburg’s (UJ) Centre of Social Justice collaborated with the Human Sciences Research Council (HSRC), and their survey looked at vaccine acceptance and hesitancy in SA. The overall vaccine acceptance rate was 72%, an increase from 67% on their previous survey in late December 2020.

The Afrobarometer survey run by the Institute of Justice and Reconciliation, on the other hand, found that vaccine acceptance was far lower than the figures reported by NIDS or UJ/HSRC, with 43% of respondents indicating they were either very likely or somewhat likely to get the vaccine, 12% of the people were somewhat unlikely to get it, and 42% were very unlikely to get the vaccine. This survey only had 1600 respondents who were carefully selected as a representative of SA’s geographic, age and gender distribution.

Incentivising Vaccines

The Health Department said the government is exploring different ways of ramping up its vaccination drive. Some of the identified problems are access to transportation and basic information on how one can get the vaccine, and scepticism about the side effects being underreported. The Western Cape has been running various campaigns to address vaccine hesitancy with various initiatives, including communication campaigns sharing information on COVID-19 and the vaccines.

President Cyril Ramaphosa announced two weeks ago his intention to introduce a “vaccine passport”. The “passport” is one of the tools currently used in other countries to encourage vaccine uptake; in its simplest form, it would be used as a method to verify the vaccine status of an individual.

Retails companies such as Game are introducing incentives in the form of discounts on purchases for the vaccinated persons.

Mandatory vaccinations in the workplace

We have witnessed private companies such as Discovery, which has led the pack in announcing the introduction of mandatory vaccinations for their employees.
The Employment and Labour Department issued a directive in June 2021 with key principles of the guidelines on the workplace. This is contained in the new consolidated direction on occupational health and safety measures in certain workplaces, which was gazetted by the Minister of Employment and Labour, Thulas Nxesi.

When formulating a vaccination policy, employers must consider constitutional grounds, such as the right to bodily integrity, the right to freedom of religion, belief, and opinion; as well as medical grounds – issues of an immediate allergic reaction of any severity to a previous dose or a known (diagnosed) allergy to a component of the COVID-19 vaccine.

The Consolidated OHS Direction requires an employer to include in its risk assessment whether it intends to make vaccinations compulsory, a three-step enquiry:

  1. A risk assessment to be conducted, considering the operational requirements of the workplace.
  2. If the employer decides to make it mandatory, once the risk assessment has been conducted, the employer must identify those employees whose work poses a risk of transmission or a risk of severe COVID-19 disease or death due to their age or comorbidities.
  3. It must then amend its plan to include the measures to implement the vaccination of those employees as and when COVID-19 vaccines become available in respect of those employees.

We will certainly witness more collaborations between the public and private healthcare industry sectors, hopefully resulting in innovative solutions that will encourage South Africans to vaccinate. Importantly, the key to making an informed decision is the sharing of verified information that is easily accessible and transparent.


Article written by

Simphiwe Mofokeng

Senior Healthcare Consultant

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