COVID-19 vaccine hesitancy and barriers to vaccination in South Africa

Abstract

The COVID-19 pandemic created significant social, economic and health-related challenges. The rapid development of vaccines that could help curb transmission and mortality from the virus were vital. The University of Johannesburg/Human Sciences Research Council (UJ/HSRC) COVID-19 Democracy survey was established as an online cross-sectional online and telephone survey designed to provide rapid response data to inform the pandemic response. Between December 2020 and November 2021, the survey fielded questions about vaccine acceptance, hesitancy and structural barriers to vaccination. Drawing from the SAGE Vaccine Hesitancy Determinants Matrix, this article explores the intersection of contextual and individual reasons for COVID-19 vaccine hesitancy. We find that young people, particularly those aged 18-24 years, were the most vaccine-hesitant. In addition, white adults exhibited more than double the odds of hesitancy than Black African adults, yet were also much more likely to be vaccinated. The article explores this seeming paradox by analysing explanations for vaccine hesitancy as well as considering structural barriers to vaccination. Explanations for vaccine hesitancy mostly related to concerns about side effects, the effectiveness of the vaccine and distrust in the vaccine and/or government. While structural barriers, such as a lack of information about where to receive a vaccination and vaccination sites being inaccessible, may have deterred those who were broadly favourable about vaccination from accessing one. Overall, our analysis illustrates the importance of understanding health crises as more than medical problems but as fundamentally social problems. It is therefore vital that social science research informs future responses to public health emergencies.

Rights

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/'>http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. http://creativecommons.org/licenses/by-nc-nd/4.0/'>http://creativecommons.org/licenses/by-nc-nd/4.0/

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DOI

https://doi.org/10.1080/21528586.2025.2553922

Repository URI

https://www.research.ed.ac.uk/en/publications/ae145314-7e7e-4e5d-945b-e232e9405226