Safe and effective vaccines against COVID-19 are seen as a critical path to ending the pandemic. This synthesis brings together data related to public perceptions about COVID-19 vaccines collected between March 2020 and March 2021 in 22 countries in Africa. It provides an overview of the data (primarily from cross-sectional perception surveys), identifies knowledge and research gaps and presents some limitations of translating the available evidence to inform local operational decisions. The synthesis is intended for those designing and delivering vaccination programmes and COVID-19 risk communication and community engagement (RCCE). 5 large-scale surveys are included with over 12 million respondents in 22 central, eastern, western and southern African countries (note: one major study accounts for more than 10 million participants); data from 14 peer-reviewed questionnaire surveys in 8 countries with n=9,600 participants and 15 social media monitoring, qualitative and community feedback studies. Sample sizes are provided in the first reference for each study and in Table 13 at the end of this document. The data largely predates vaccination campaigns that generally started in the first quarter of 2021. Perceptions will change and further syntheses, that represent the whole continent including North Africa, are planned. This review is part of the Social Science in Humanitarian Action Platform (SSHAP) series on COVID-19 vaccines. It was developed for SSHAP by Anthrologica. It was written by Kevin Bardosh (University of Washington), Tamara Roldan de Jong and Olivia Tulloch (Anthrologica), it was reviewed by colleagues from PERC, LSHTM, IRD, and UNICEF (see acknowledgments) and received coordination support from the RCCE Collective Service. It is the responsibility of SSHAP.

As of April 19, 2021, South Africa has recorded 1.56 million COVID-19 cases and almost 54,000 deaths - more than any other country on the African continent. The country has begun the national rollout of the Johnson & Johnson (J&J) COVID-19 vaccine, with over 292 thousand doses administered it aims to achieve herd immunity by vaccinating at least 67 percent of its population (around 40 million people) by the end of 2021. The government suspended its initial rollout of the AstraZeneca (AZ) vaccine due to concerns over its effectiveness, particularly against the new B.1.351 variant, which accounts for 90% of the infections in South Africa. The J&J vaccine was put on temporary hold in April due to concerns about rare clotting disorders. Although data show that expected acceptance of COVID-19 vaccines is relatively high, the suspension of two vaccines in South Africa, where fear of infection is decreasing, will likely influence public reactions. Understanding how individuals and population groups perceive and make sense of COVID-19 vaccines is critical to inform the design and implementation of risk communication and community engagement (RCCE) strategies, and guide interventions aiming to promote and sustain acceptance of COVID-19 vaccines, while encouraging compliance with other COVID-19 preventive measures. This review syntheses community perceptions of COVID-19 vaccines in South Africa to inform RCCE strategies and policies and provides examples of successful practice. It draws on multiple secondary data sources: scientific literature, qualitative and quantitative studies, grey literature, and mainstream and social media. The review was supported by consultation with four local expert key informants from different fields. It is part of the Social Science in Humanitarian Action Platform (SSHAP) series on social science considerations relating to COVID-19 vaccines. It was written for SSHAP by Tamara Roldan de Jong and Anthrologica on request of the UNICEF South Africa Country Office. Contributions were made from the RCCE Collective Service East and Southern Africa (ESAR) Region. The brief is the responsibility of SSHAP.

Safe and effective vaccines against COVID-19 are seen as a critical path to ending the pandemic. This synthesis brings together data related to public perceptions about COVID-19 vaccines collected between March 2020 and March 2021 in 22 countries in Africa. It provides an overview of the data (primarily from cross-sectional perception surveys), identifies knowledge and research gaps and presents some limitations of translating the available evidence to inform local operational decisions. The synthesis is intended for those designing and delivering vaccination programmes and COVID-19 risk communication and community engagement (RCCE). 5 large-scale surveys are included with over 12 million respondents in 22 central, eastern, western and southern African countries (note: one major study accounts for more than 10 million participants); data from 14 peer-reviewed questionnaire surveys in 8 countries with n=9,600 participants and 15 social media monitoring, qualitative and community feedback studies. Sample sizes are provided in the first reference for each study and in Table 13 at the end of this document. The data largely predates vaccination campaigns that generally started in the first quarter of 2021. Perceptions will change and further syntheses, that represent the whole continent including North Africa, are planned. This review is part of the Social Science in Humanitarian Action Platform (SSHAP) series on COVID-19 vaccines. It was developed for SSHAP by Anthrologica. It was written by Kevin Bardosh (University of Washington), Tamara Roldan de Jong and Olivia Tulloch (Anthrologica), it was reviewed by colleagues from PERC, LSHTM, IRD, and UNICEF (see acknowledgments) and received coordination support from the RCCE Collective Service. It is the responsibility of SSHAP.

Disparities in vaccine equity exist on a global scale, but also within countries. While in high income countries slightly more women than men tend to be vaccinated, the opposite is true in low income countries. In South Sudan, as of September 2021, 28% of people who had received a COVID-19 vaccine were women. This rate then increased markedly, reaching 41% by January 2022. This brief explores some of the reasons behind the low uptake amongst women during the initial phases of the roll-out and the contributing factors to the increase over time. This brief draws on evidence from academic and grey literature, dashboards and datasets on COVID-19 vaccine uptake, and consultations with partners working in the COVID-19 response. It also reviews some of the interventions to increase uptake amongst women and provides considerations for partners working on vaccine demand promotion. It is part of the Social Science in Humanitarian Action Platform (SSHAP) series on social science considerations relating to COVID-19 vaccines and was developed for SSHAP by Anthrologica (led by Nadia Butler). Contributions and reviews were provided from response partners in South Sudan and international experts (UNICEF, IFRC, South Sudan Red Cross, Internews, Anthrovisions Productions, WHO, WFP, and the Humanitarian Country Office and Anthrologica). It was requested by the UNICEF East and Southern Africa Regional Office (ESARO). This brief is the responsibility of SSHAP.