“Even if I’m well informed, I will never get it”: COVID-19 vaccine beliefs, intentions and acceptability among adolescents and young people in South Africa

Abstract

Vaccines are an essential public health intervention in response to global emerging infectious diseases such as COVID-19. South Africa aims to vaccinate 67% of its population in 2021 to contain the transmission and effects of COVID-19. While evidence suggests that younger South African adults may be less likely to accept vaccines than older adults, little is known about vaccine hesitancy among South African adolescents and young people. This chapter discusses findings on vaccine-related beliefs, intentions and acceptability from participatory work with South African adolescents and young people ages 17 to 29 years, conducted through online closed-group activities. Findings highlight vaccine hesitancy among adolescents and young people that, if not addressed, may undermine the effectiveness of the vaccine-based COVID-19 response. Reasons provided for reluctance to use vaccines include: mistrust of government and scientists; low illness vulnerability perceptions; conspiracy-related beliefs; fear of injections and potential side-effects, and a preference for non-biomedical (traditional and/or natural) remedies. Potential enablers of vaccine acceptability and uptake include: receiving information from trusted sources; the desire for safety; perceived vaccine effectiveness, and observing the safe uptake among trusted people such as peers and family members. Access to accurate information is important, but may in itself be insufficient. We suggest a multi-dimensional approach aimed at addressing perceptions of low vulnerability to disease, mistrust and the perceived effectiveness and safety of vaccines. Ensuring accurate information from trustworthy sources, meaningfully engaging traditional and alternative health practitioners, developing family- and peer-based initiatives, and building trust in government and international health infrastructure may support vaccine uptake, thus strengthening social and health outcomes for South Africa’s next generation.