Research on Socio-Economic Policy, Department of Economics, Stellenbosch University, Stellenbosch, South Africa.
Development Policy Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa.
BMC Public Health. 2022 Mar 2;22(1):422. doi: 10.1186/s12889-022-12826-5.
COVID-19 vaccine hesitancy has threatened the ability of many countries worldwide to contain the pandemic. Given the severe impact of the pandemic in South Africa and disruptions to the roll-out of the vaccine in early 2021, slower-than-expected uptake is a pressing public health challenge in the country. We examined longitudinal changes in COVID-19 vaccination intent among South African adults, as well as determinants of intent to receive a vaccine.
We used longitudinal data from Wave 4 (February/March 2021) and Wave 5 (April/May 2021) of the National Income Dynamics Study: Coronavirus Rapid Mobile Survey (NIDS-CRAM), a national and broadly representative panel survey of adults in South Africa. We conducted cross-sectional analyses on aggregate and between-group variation in vaccination intent, examined individual-level changes between waves, and modeled demographic predictors of intent.
We analysed data for 5629 (Wave 4; 48% male, mean age 41.5 years) and 5862 (Wave 5; 48% male, mean age 41.6 years) respondents. Willingness to get a COVID-19 vaccine significantly increased from 70.8% (95% CI: 68.5-73.1) in Wave 4 to 76.1% (95% CI: 74.2-77.8) in Wave 5. Individual-level analyses indicated that only 6.6% of respondents remained strongly hesitant between survey waves. Although respondents aged 18-24 years were 8.5 percentage points more likely to report hesitancy, hesitant respondents in this group were 5.6 percentage points more likely to change their minds by Wave 5. Concerns about rushed testing and safety of the vaccines were frequent and strongly-held reasons for hesitancy.
Willingness to receive a COVID-19 vaccine has increased among adults in South Africa, and those who were entrenched in their reluctance make up a small proportion of the country's population. Younger adults, those in formal housing, and those who trusted COVID-19 information on social media were more likely to be hesitant. Given that stated vaccination intent may not translate into behaviour, our finding that three-quarters of the population were willing to accept the vaccine may reflect an upper bound. Vaccination promotion campaigns should continue to frame vaccine acceptance as the norm and tailor strategies to different demographic groups.
COVID-19 疫苗犹豫已威胁到全球许多国家遏制大流行的能力。考虑到该大流行在南非造成的严重影响，以及 2021 年初疫苗推广的中断，该国面临着疫苗接种速度缓慢的紧迫公共卫生挑战。我们研究了南非成年人 COVID-19 疫苗接种意愿的纵向变化，以及接种疫苗意愿的决定因素。
我们使用了南非国家收入动态研究：冠状病毒快速移动调查（NIDS-CRAM）第四波（2021 年 2 月/3 月）和第五波（2021 年 4 月/5 月）的纵向数据，这是一项全国性的、具有广泛代表性的南非成年人小组调查。我们对疫苗接种意愿的总体和组间差异进行了横断面分析，研究了两次调查之间个体层面的变化，并对意向的人口统计学预测因素进行了建模。
我们分析了 5629 名（第四波；48%为男性，平均年龄为 41.5 岁）和 5862 名（第五波；48%为男性，平均年龄为 41.6 岁）受访者的数据。愿意接种 COVID-19 疫苗的比例从第四波的 70.8%（95%CI：68.5-73.1）显著增加到第五波的 76.1%（95%CI：74.2-77.8）。个体层面的分析表明，只有 6.6%的受访者在两次调查之间仍然强烈犹豫。尽管 18-24 岁的受访者更有可能报告犹豫，但该组中犹豫不决的受访者在第五波时改变主意的可能性高 5.6 个百分点。对仓促检测和疫苗安全性的担忧是犹豫的常见且强烈的原因。
南非成年人接种 COVID-19 疫苗的意愿有所增加，而且该国人口中坚定拒绝接种的比例很小。年轻成年人、居住在正规住房中的成年人以及信任社交媒体上 COVID-19 信息的成年人更有可能犹豫不决。鉴于表明的疫苗接种意愿可能不会转化为行为，我们发现四分之三的人口愿意接受疫苗，这可能反映了上限。疫苗推广活动应继续将疫苗接种接受作为常态，并针对不同的人口群体制定策略。
