South Africa’s COVID-19 vaccine rollout amid the
emergence of Omicron

Suleman, Mohamed Hoosen; Lucero‐Prisno, Don Eliseo

doi:10.18332/popmed/145772

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…Our results indicate the potential value in carefully framing public education campaigns [ 11 , 24 ] and clear communication [ 7 , 12 , 19 , 25 , 38 ]. These findings accord with other literature that remaining barriers to access need to be addressed [ 6 , 13 , 19 , 21 – 23 , 33 , 37 , 43 ]. Community appreciation and mobilisation are associated with increased trust and uptake [ 16 , 22 , 33 ], as well as emphasis on pro-social norms [ 28 ].…”

Section: Discussionsupporting

confidence: 92%

“…In May 2021 70% of South African adults were willing to get a vaccine [ 9 , 18 ]. In contrast, by March 2022, only a small proportion of a large and diverse sample of unvaccinated South African adults intended to be vaccinated as soon as possible, despite the reduction in barriers to access [ 43 ]. This finding highlights the need for continuous surveillance as rapid changes in the profile of vaccine hesitancy among populations unvaccinated need to be accompanied by rapidly adapting demand creations strategies.…”

Section: Resultsmentioning

confidence: 99%

“…For COVID-19 vaccines specifically, many of the factors above have amplified due to the speed of vaccine development [ 3 – 5 , 19 ], which have resulted in perceptions that the vaccines are insufficiently tested, unsafe, and ineffectual [ 7 – 9 , 11 , 12 , 14 , 18 , 27 , 35 , 37 , 40 ]. Despite high initial rates of COVID-19 vaccine acceptance in early to mid 2021 [ 9 , 21 , 24 , 28 ], hesitancy increased as milder variants of COVID-19 [ 4 , 16 , 41 – 43 ] have been more easily transmitted, even among the vaccinated [ 2 , 3 , 19 , 40 , 42 , 44 , 45 ]. Perceptions of low vaccine efficacy have persisted, despite the continued effectiveness of vaccines against serious illness [ 4 , 21 , 42 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey

Eyal,

Njozela,

Köhler

et al. 2023

BMC Public Health

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Introduction Despite a high number of recorded COVID-19 infections and deaths in South Africa, COVID-19 vaccine coverage remained low in March 2022, ten months into the national vaccine roll-out. This study provides evidence on the correlates of vaccine intentions, attitudes towards vaccination and opinions about mandates. Methods We used data from the second COVID-19 Vaccine Survey (CVACS), a telephone survey conducted February-March 2022 among 3,608 South African adults who self-reported not being vaccinated against COVID-19. The survey instrument was designed in consultation with government, policymakers, and civil society; and segmented the sample into four distinct groups with different vaccine intentions (synonymous with vaccine hesitancy levels). Kruskal-Wallis and Mann-Whitney tests were used to examine the sociodemographic characteristics, attitudes and behaviours associated with the different vaccination intentions groups. Thematic coding of responses to open-ended questions elicited insights on reasons for not being vaccinated and attitudes towards mandates. Results Intentions to get vaccinated were greater among individuals with lower socio-economic status (Mann–Whitney Z = -11.3, p < 0.001); those believing the vaccine protects against death (Kruskal–Wallis Χ2 = 494, p < 0.001); and those who perceived themselves at risk of COVID-19-related illness (Χ2 = 126, p < 0.01). Vaccine intentions were lower among individuals who believed that the vaccine causes death (Χ2 = 163, p < 0.001); believed that the vaccine is unsafe for the babies of pregnant/breastfeeding mothers, or the chronically ill (Χ2 = 123, p < 0.01); those not trusting government health information about COVID-19 and the COVID-19 vaccine (Kendall’s τ = -0.41, p < 0.01); and those in opposition to mandates (τ = 0.35, p < 0.001). Only 25% supported mandates, despite 48% thinking mandates would work well, with 54% citing individual rights as their main reason for mandate opposition. Conclusion The profile of individuals not vaccinated against COVID-19 as of March 2022 varied markedly by self-reported vaccination intentions, underscoring the importance of tailored demand-creation efforts. This paper highlights several factors which differ significantly across these groups. These findings could inform the design of future vaccination campaigns, potentially increasing their likelihood of success. This is an important policy objective given widespread vaccine hesitancy, and further work is required on this topic. Mandates remain an option to increase coverage but need to be carefully considered given extensive opposition.

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Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey

Eyal,

Njozela,

Köhler

et al. 2023

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…The age and gender distributions of respondents was 55% (18-34), 29% (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), 9% (50-59) and 7% (60plus); 47% of respondents identi ed as female. 47% of respondents lived in township or informal areas.…”

Section: Sample Characteristicsmentioning

confidence: 99%

“…(5,7,12,28,39) For COVID-19 vaccines speci cally, many of the factors above have ampli ed due to the speed of vaccine development, (3)(4)(5)19) which have resulted in perceptions that the vaccines are insu ciently tested, unsafe, and ineffectual. (7-9, 11, 12, 14, 18,, 27, 35, 37, 40) Despite high initial rates of COVID-19 vaccine acceptance in early to mid 2021, (9,21,24,28) hesitancy increased as milder variants of COVID-19 (4,16,(41)(42)(43) have been more easily transmitted, even among the vaccinated. (2,3,19,40,42,44,45) Perceptions of low vaccine e cacy have persisted, despite the continued effectiveness of vaccines against serious illness.…”

Section: Introductionmentioning

confidence: 99%

Correlates of COVID-19 Vaccination Intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: Evidence from a large national survey

Eyal

Maughan-Brown

Njozela

et al. 2023

Preprint

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Introduction Despite a high number of recorded COVID-19 infections and deaths in South Africa, COVID-19 vaccine coverage remained low in March 2022, ten months into the national vaccine roll-out. This study provides evidence on the correlates of vaccine intentions, attitudes towards vaccination and opinions about mandates. Methods We used data from the second COVID-19 Vaccine Survey (CVACS), a telephone survey conducted February-March 2022 among 3,608 South African adults who self-reported not being vaccinated against COVID-19. The survey instrument was designed in consultation with government, policymakers, and civil society; and segmented the sample into four distinct groups with different vaccine intentions (synonymous with vaccine hesitancy levels). Kruskal-Wallis and Mann-Whitney tests were used to examine the sociodemographic characteristics, attitudes and behaviours associated with the different vaccination intentions groups. Thematic coding of responses to open-ended questions elicited insights on reasons for not being vaccinated and attitudes towards mandates. Results Intentions to get vaccinated were greater among individuals with lower socio-economic status (Mann-Whitney Z=-11.3, p<0.001); those believing the vaccine protects against death (Kruskal-Wallis 𝛸2=494, p<0.001); and those who perceived themselves at risk of COVID-19-related illness (𝛸2=126, p<0.01). Vaccine intentions were lower among individuals who believed that the vaccine causes death (𝛸2=163, p<0.001); believed that the vaccine is unsafe for the babies of pregnant/breastfeeding mothers, or the chronically ill (𝛸2=123, p<0.01); those not trusting government health information about COVID-19 and the COVID-19 vaccine (Kendall’s 𝜏=-0.41, p<0.01); and those in opposition to mandates (𝜏=0.35, p<0.001). Only 25% supported mandates, despite 48% thinking mandates would work well, with 54% citing individual rights as their main reason for mandate opposition. Conclusion The profile of individuals not vaccinated against COVID-19 as of March 2022 differed markedly by self-reported vaccination intentions, underscoring the importance of tailored demand-creation efforts. To achieve comprehensive vaccination coverage, interventions to instill trust in government health information, and in the safety and efficacy of vaccines are required early in a vaccination program given the rapid emergence of pervasive vaccine hesitancy. Mandates remain an option to increase coverage but need to be carefully considered given widespread opposition.

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The burden of SARS-CoV-2 Infection and Severe Illness in South Africa March 2020-August 2022: A synthesis of epidemiological data

Bolton,

Tempia,

Walaza

et al. 2024

Preprint

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Introduction Data on burden of SARS-CoV-2 infections by age group and for different severity levels are lacking. We estimated the South African SARS-CoV-2 disease burden and severity, describing changes in the shape of the disease burden pyramid with successive waves. Methods We estimated SARS-CoV-2 medically and non-medically attended illness stratified by severity (mild, severe non-fatal, and fatal) during the initial five waves, spanning 1 March 2020 through 13 August 2022. We utilised individual-level national surveillance, healthcare-utilisation and serosurvey data to calculate wave-specific hospitalisation-fatality (HFR) and infection-fatality ratios (IFR). We estimated wave-specific incidence rates per 100,000 population with 95% confidence intervals derived from bootstrapping the individual-level data. Results On 13 August 2022, the estimated cumulative number of SARS-CoV-2 infections in South Africa was 105 million, of which 399,886 (0.38%) were severe non-fatal and 258,754 (0.25%) fatal. 29% of severe non-fatal illness and 55% of deaths occurred outside hospital. The highest burden of severe and fatal illness was during the Delta wave (wave 3), and the HFR across the initial three waves was similar (range 31%-34%). Although there were more infections during the Omicron BA.1 wave (wave 4), there was a substantial reduction in HFR (14%). Successive waves saw a reduction in the rate of increase in mortality and hospitalisations with increasing age. Conclusions The substantial South African national burden of SARS-CoV-2 for the initial five waves contradicts the belief of minimal impact in Africa. A high proportion of severe non-fatal and fatal illness occurred outside of hospital, highlighting the importance of studies of health-seeking and vital registration systems to document the full burden of illness. Highest burden of severe illness and death was in the Delta wave. Following Omicron emergence severe illness reduced, and age-distribution for the incidence of medically attended severe non-fatal illness shifted to a J-shape, possibly reflecting the shift from widespread transmission to an endemic pattern.

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South Africa’s COVID-19 vaccine rollout amid the emergence of Omicron

Cited by 4 publications

References 8 publications

Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey

Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey

Correlates of COVID-19 Vaccination Intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: Evidence from a large national survey

The burden of SARS-CoV-2 Infection and Severe Illness in South Africa March 2020-August 2022: A synthesis of epidemiological data

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