Widespread vaccine acceptance is key to achieving herd immunity through vaccination against COVID19, especially because the available vaccines do not have 100% efficacy. Based on the fourth wave of the National Income Dynamics Study-Coronavirus Rapid Mobile (NIDS-CRAM) survey, vaccine acceptance in February 2021 was estimated at 70.8% (with 95% confidence interval of 70%-72%) amongst the adult South African population. The reasons cited for vaccine hesitancy are primarily due to concerns regarding the side-effects and efficacy of vaccine. Using the Health Belief model and the Extended Parallel Process model, the study has identified perceived risk of infection with the mediating role of efficacy as a key predictor of vaccine intention. Apart from vulnerability to infection, those perceiving higher severity of risk (those with chronic illness) have lower hesitancy compared to their younger and healthier counterparts. Higher awareness of COVID19 related information and higher household income are correlated with lower vaccine hesitancy.
There are other significant differences across socio-economic and demographic variables in vaccine hesitancy. The non-black African population group has significantly high vaccine hesitancy compared to black Africans. Males on average have lower hesitancy compared to females, and unmarried/unpartnered individuals are found to have higher hesitancy. From a communication perspective, it is imperative to continue risk messaging, hand in hand with clearer information on the efficacy of the vaccines. The risk messaging needs to be targeted at younger age and low-income groups who perceive the lowest risk. Those who are less informed on COVID19 are also found to be those who perceive low-risk, therefore this reinforces the need to have in place a communication plan to educate and create awareness on the pandemic. There is an all-around need to enhance vaccine efficacy related messaging, particularly targeting non-blacks and religious individuals. Concerns regarding the side-effects of vaccines need to be addressed with more transparent scientific information together with the associated risk-benefit analysis.
Uma Kollamparambil is a Development Economist, and the Head of the School of Economics and Finance (SEF) at the University of the Witwatersrand. Her areas of research interest are: Subjective Wellbeing, Mental health, Migration and Inequality in the South African context. She has published widely in esteemed international journals like the PLOS ONE, Journal of Development Studies, Journal of Happiness Studies, Development Policy Review, International Migration, South African Journal of Economics, Development Southern Africa, Journal of Public Health, African Development Review etc. She is on the editorial board of the African Review of Economics and Finance. She holds membership of the Economics Society of South Africa (ESSA) and The Society for the Study of Economic Inequality (ECINEQ). She lives in Johannesburg with her husband and seven-year old son.
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