Parallel vaccine discourses in Guinea: ‘grounding’ social listening for a non-hegemonic global health

ABSTRACT

Misinformation has been identified as a major threat to public confidence in vaccines, particularly during epidemics. As a response, social listening has become a popular and heuristic public health tool for detecting misinformation and adapting vaccine communication. In this article, we take a critical stance on the normalised approach to social listening which solely relies on the analysis of online discourses. We highlight that the current social listening paradigm inherited a reductionist and utilitarian approach from commercial marketing that struggles to grasp – and even misrepresents – the complexity of health-related perceptions and knowledge. This study draws from online COVID-19 vaccines discourses in Guinea and ethnographic fieldwork among Guinean healthcare workers. While the online social listening showcased a predominance of individual and collective safety concerns, distrust towards African elites and Western actors, fieldwork revealed that healthcare workers’ vaccine perceptions were more nuanced and largely shaped by complex kinship relations spanning across online and offline social landscapes. Furthermore, healthcare workers often displayed frontstage and backstage vaccine discourses, their vaccines related representations and claims could evolve depending on the context of enunciation. We advocate for grounding social listening in global health to avoid disconnection from the public. Failure to accomplish this could result in a detached and hegemonic form of ‘social hearing’, rather than authentic social listening. In light of this, the transdisciplinary methodology exemplified in this paper represents one possible solution.

KEYWORDS:

• Vaccine hesitancy
• Guinea
• health care workers
• social listening
• global health

Acknowledgements

We wish to thank the healthcare workers and other participants who shared their anxieties, hopes, and experiences. We are also grateful to the Guinean team who took part in the data collection: Fanny Attas, Amadou Tidiane Barry, Marie-Yvonne Curtis (PhD), Pr Moustapha Keïta-Diop, Laurent Gnouma Koniono, and Gassim Sylla.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data used in this study is held at the Institute for Tropical Medicine in Antwerp, Belgium. Interview data is not publicly available given difficulties in fully anonymizing transcripts of participants in depth interviews. The Facebook online public data can be accessed through the Facebook CrowdTangle platform.

Ethical review

Approved by the Institutional Review Board of ITM (Ref: 1437/20). This fieldwork was part of both this ITM project and the project “The shadow cast by Ebola on the SARS-CoV2 epidemic. Analysis of public policies, actors’ practices and popular representations relating to COVID-19 for a better Guinean response to the pandemic” (carried out in partnership between the CERFIG, the UGLSC, the CNFRS and the IRD). It received the Ethics Committee validation 068/CNERS/20.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09581596.2023.2245964.

Notes

1. https://ourworldindata.org/coronavirus/country/guinea#what-is-the-cumulative-number-of-confirmed-cases consulted on June 21 2023.

2. National Agency for Health Security of Guinea (ANSS) weekly epidemiological update, November 2022 (Réunion hebdomadaire d’information épidémiologique, 17 novembre 2022, ANSS, Conakry).

3. In Guinea Malaria death rate was nearly 30 times higher than COVID-19 (83,6 and 2.8 deaths per 100,000 individuals respectively using latest 2019 data for malaria and 2021 data for Covid which bore the greatest burden for the country during the pandemic to date. Source: https://ourworldindata.org/covid-deaths; https://ourworldindata.org/malaria, consulted on June 21 2023

4. Consider the disparity in the number of clinical trials conducted in Guinea versus France, as seen on clinicaltrials.gov. This discrepancy underscores the pharmaceutical industry’s limited interest in the African market and reinforces the call to treat vaccines as ‘global common goods’ (Cassier, 2021).

5. The scientific council echoed WHO’s concerns regarding availability and integrity of clinical data, which led to WHO suspending the prequalification of the vaccine in September 2021, see https://www.euronews.com/next/2021/09/16/sputnik-v-who-suspends-approval-process-for-covid-vaccine-due-to-manufacturing-concerns, consulted on June 22 2023.

6. State arrangements like the trade-off of Bauxite mining access for road infrastructure, vaccine provision, and public health funding exemplify this trend. Cases in point include the Sino-Guinean hospital in Conakry, the Russian research centers in Kindia, and the complete renovation of the National Road N1 - Guinea’s main road – by a Chinese company.

7. LW Heyerdahl unpublished field notes from the reactive cholera vaccination campaign in Conakry and Forécariah, 2012.

8. AstraZeneca was temporarily suspended in mid-March 2021 in several countries including European following cases of blood clots https://time.com/5947134/astrazeneca-covid-vaccine-stopped/ consulted June 23 2023

9. AstraZeneca’s reputation was further damaged when Health professionals from Mamou questioned the trustworthiness of AstraZeneca’s vaccine due to concerns about its expiry date. This mistrust stemmed from the African Union’s delivery of outdated stock, which, despite manufacturer assurance of extended validity, compromised AstraZeneca’s reputation.

Additional information

Funding

This project has been funded by the British Embassy Brussels under project code [INT 2021/BEB C19 02] and by AFD (French Development Agency) COVID-19 Health in Common initiative through the ARIACOV program (ariacov.org).