Vaccine nationalism and vaccine imperialism are posing a major challenge to the progress of mass vaccination in most countries across Africa. These countries are struggling to secure enough doses for their populations, while rich nations stockpile and buy multiple times over from the big pharmaceutical companies producing the vaccines. Capitalist policies around patents also prevent poorer countries from producing existing vaccines at home at a lower cost for the public budget.
But even when larger amounts of vaccines will eventually become available to most African countries, there might be many people who will refuse to take the vaccine or have doubts that might lead to delaying their acceptance of vaccination – a phenomenon referred to by scientists as “vaccine hesitancy”. There are already worrying reports that vaccine hesitancy is slowing down vaccination campaigns. In Malawi, for instance, authorities publicly burned thousands of expired doses of AstraZeneca in May this year, in order to reassure the public that they will only get safe inoculations.
There are multiple factors that can lead to vaccine hesitancy, including issues of trust in government and in the health system, and the history of malevolent medical experiments carried on specific groups without their consent – something that people in nations which have experienced the brunt of colonialism and neocolonialism are sadly well acquainted with.
But one major factor that is fuelling scepticism about vaccines is the spread of fake news on social media. The Covid-19 pandemic has led to an infodemic, which, the WHO reminds us, occurs when there is “too much information, including false or misleading information in digital and physical environments, during a disease outbreak”. Incorrect information can spread quickly due to the high penetration of social media and the internet, and can overshadow accurate and verified information.
This highlights the paradoxical role of social media: they can spread vital information to save lives and manage the pandemic, but they can also be a source of harmful content that increases suffering and deaths. The pandemic has also intensified the extent of people’s reliance on digital communications. When the Covid-19 pandemic broke out and societies went into lockdowns, social and physical distancing and self-isolation became the norm. Many people kept abreast of the pandemic through their mobile devices, the internet and social media.
Despite attempts by major tech companies to curb the spread of health-related fake news, the largely unregulated online environment enables the rapid spread of conspiracies, rumours and hoaxes. These circulate rapidly to unsuspecting audiences who are already vulnerable from the anxiety and fears caused by Covid-19.
Vaccines and conspiracies
Recently, while taking an Uber in Cape Town where I live and work, the news of the vaccination plans by the South African government came on air. The driver quickly went on a heartfelt rant about how the vaccines are dangerous, can make people sick, and are part of broader conspiracies led by powerful people such as Bill Gates who are bent on reducing the population of the world which they consider overpopulated. He proclaimed that he would not take the jab nor would his family. When I inquired about the source of his information, he was quick to mention that he follows the news on social media, and receives updates from others through WhatsApp.
This is one of many conspiracy theories regarding the coronavirus and the vaccines. Other hoaxes are more religiously inclined, including those suggesting that the vaccines are part of an anti-Christ agenda. Some Christian preachers in African countries are taking to their pulpits to mount anti-vaccine campaigns, warning their followers of the dangers of getting the jab and, in some cases, giving specific instructions not to take the vaccines at all.
Such conspiracy theories and religious interventions on sensitive, especially health, issues are not uncommon. Many Pentecostal church leaders and preachers over the years have prided themselves for having the power to heal any kind of disease. Often, this puts them and their unfounded claims of miraculous healing at loggerheads with science and governments’ attempt to improve healthcare.
While fake news travel online, their drivers are socio-cultural, political, and ideological in nature. Political leaders such as former US President Donald Trump were instrumental in the dissemination of unverified Covid-19 information. Trump made several public statements with misleading information about the origin, infectivity and fatality of coronavirus.
Rumours, hoaxes and disinformation around vaccines continue to rise, with many of them highlighting the anxiety around the possibility of adverse effects.
For example, there are unfounded claims that vaccines could change people’s DNA or kill in great numbers – in reality, serious side effects or deaths from Covid-19 vaccines are very rare. In an informal interview I had with him in April 2021, Professor Digby Warner, a medical microbiologist at University of Cape Town’s Faculty of Health Sciences, linked this sort of misinformation to the history of chronic diseases in Africa. He mentioned the instance of polio immunisation in Nigeria and how this was stalled by rumours and misconceptions around unverified claims that people suffered from infertility as a result of vaccination. In South Africa, discourses around HIV/AIDS denialism during President Thabo Mbeki’s administration equally blighted efforts to fast-track healthcare around the disease.
Another potential driver of vaccine hesitancy in African countries is the distrust of vaccines produced in foreign contexts. This distrust could stem from a widespread perception, this time supported by evidence, that African countries are at best passive recipients of technologies and medicines produced elsewhere, and at worst dumping and testing grounds for scientific experiments which might be harmful, and would not be carried out in rich countries. A locally made vaccine therefore might be better trusted and accepted than those produced overseas.
What can be done?
To solve the problem created by health-related misinformation and disinformation in African countries and move from vaccine hesitancy to vaccine confidence in Africa, a number of efforts has to be initiated and driven.
More science communication efforts should be rolled out and this must be championed by scientists and healthcare professionals in African countries. A good example of this is already happening in South Africa with Eh!Woza, a transdisciplinary organisation initiated by biomedical experts and artists at the University of Cape Town. The initiative uses high impact biomedical research to produce health-related media that counters false information, encourage positive health-seeking behaviour, engender trust, and ultimately decrease stigma.
Media studies scholar Herman Wasserman outlines a number of ways this can be done. Apart from methods such as identification responses (debunking, fact-checking, investigative reports) and formal research, Wasserman recommends the creation of spaces for dialogue, discussion, and questions, by engaging civil society, faith communities, and family networks.
In addition, bad information will need to be increasingly countered with good information, although it is important to establish efficacy within context (issues of trust, access, mode of delivery). Enlisting citizens’ help to spread accurate science-based information as a form of civic responsibility is crucial. This means that top-down, one-directional communication will not work especially when people are already skeptical of state authority.
My conversation with the Uber driver is an example of such civic dialogue. My engagement with him provided the opportunity for him to learn about the benefits of vaccination and the dangers of not taking it. As I disembarked from the vehicle that day, the driver was full of thanks for providing scientifically accurate information, with promises that he and his family would take the vaccine when it becomes available.
Chikezie E. Uzuegbunam is a postdoctoral research fellow at the Institute for Humanities in Africa (HUMA), University of Cape Town. His current project explores the ecosystem of medical misinformation and digital health communication amongst youth in Nigeria.
This publication benefited from a grant by the Carnegie Corporation of New York, which supports the author's current work at HUMA. The views expressed in this article are those of the author and do not necessarily reflect Corona Times' editorial stance, or the position of any institution or association.