COVID-19 vaccine hesitancy in South Africa: how can we maximize uptake of COVID-19 vaccines?

Figures & data

Table 1. Summary of studies included in the review

	COVID-SCORE Global Survey	Africa CDC Survey	Ipsos online surveying (3 rounds)	COVID-19 Democracy Survey [	Ask Afrika COVID-19 Tracker study	South African Social Attitudes Survey	CMS COVID-19 Vaccine Survey
Study reference	[9,41]	[42,43]	[44–46]	[47–50]	[51–53]	[40]	[54]
Lead study organization	Emerson College,United States of America	Africa Centres for Disease Control and Prevention (Africa CDC)	Ipsos	University of Johannesburg and the Human Sciences Research Council, South Africa	Ask Afrika	Human Sciences Research Council, South Africa	Council for Medical Schemes, South Africa
Peer reviewed publication	Yes	No	No	No	No	Yes	No
Date conducted	16–20 June 2020	17September-16 October 2020	24 July – 7 August 2020 (round 1); 8–13 October 2020 (round 2); 17–20 December 2020 (round 3)	29 December 2020–6 January 2021	3–11 February 2021	February – March 2020 and November 2020-February 2021	4 February – 8 March 2021
Sample size	619	1056	± 500 (round 1) ± 1000 (round 2) ± 500 (round 3)	10,618	403	2844	75,518
Nationally representativesample	No	Yes	Yes	Yes	Yes	Yes	No
Willingness to accept COVID-19 vaccination	82%	76%	64% (round 1); 68% (round 2); 53% (round 3)	67%	52%	Not assessed	82%
Other key findings	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	Belief that vaccinations can lead to severe health conditions increased by 8% percentage points and belief that infection-acquired immunity preferable to vaccine-acquired immunity increased by 11% percentage points between March 2020 and February 2021	Not assessed
Main reasons for COVID-19 vaccine hesitancy or refusal	Not assessed	Not assessed	Worry about vaccine side effects (53%; 30%; 65% rounds 1–3 respectively); Opposed to vaccines in general (23%; 21%; 23% rounds 1–3 respectively)	Concerns about vaccine side effects (25%); Doubts in the effectiveness of the vaccine (18%);	Not assessed	Not assessed	COVID-19 vaccines too new (34%); Worry about vaccine side effects (21%); Distrust in government to ensure COVID-19 vaccines are safe and effective (14%)
Factors influencing COVID-19 vaccine acceptance	Not assessed	Age, employment status, urbanicity, geographical location	Not assessed	Age, race, education, political discontent	Age, gender	Not assessed	Employment status, urbanicity, geographical location
Key novel or significant findings as interpreted by review authors	High discrepancy between reported COVID-19 vaccine acceptance (82%) and whether one would follow employer’s recommendation to get the vaccine (46%)	Negative effect of pandemic on vaccine acceptance more generally – at least one in five respondents less inclined to vaccinate in general than before the pandemic	Relatively high rates of opposition to vaccines in general	Those with more education, less accepting of the COVID-19 vaccine; Political factors contribute to hesitancy; Belief in conspiracy theories low	Men less trusting of COVID-19 vaccine than women; Government decision to stop AstraZeneca vaccine rollout reduced trust in vaccine safety and confidence in the process	Relatively high rates of vaccine hesitancy in general	Preferences for specific COVID-19 vaccines; Political factors contribute to hesitancy

Africa CDC: Africa Centres for Disease Control and Prevention.

CMS: Council for Medical Schemes.

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