Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, 27 St Andrew's Road, Parktown, Johannesburg 2193, South Africa.
DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, 27 St Andrew's Road, Parktown, Johannesburg 2193, South Africa.
Health Policy Plan. 2022 Oct 12;37(9):1167-1176. doi: 10.1093/heapol/czac060.
As South Africa debates the implementation of mandatory vaccination policies to address coronavirus disease 2019 (COVID-19) vaccine hesitancy, many adults remain unpersuaded of the need and benefits of vaccination. Several surveys suggest that this is particularly true for younger adults and for those living in low-income communities. Therefore, we sought the views of youth training to become community health workers (CHWs) as a youth group at the intersection of the community and the health system. This research was conducted in a township of South Africa, a country with a long history of political mistrust. Using semi-structured interviews and an interview guide, we explored young CHWs' perceptions (n = 20) of vaccine hesitancy for themselves, their peers and the community. Audio-recorded interviews were transcribed, and thematic analysis was undertaken. Findings suggest widespread COVID-19 vaccine hesitancy in this community, especially amongst young people. Reported reasons for this hesitancy appear linked to a complex interrelated network of factors, including 'uncertainty' about the outcome and effectiveness of the vaccines; 'fear' of the vaccines, driven by a myriad of rumours and conspiracy theories within the community; a 'lack of control' over other people's behaviour and a desire not to be controlled especially by the government but at the same time a resignation towards impending mandatory vaccine policies and a 'lack of trust' particularly in the government's intentions with vaccine roll-out and their health messaging. While mandatory vaccination policies in several organizations have shown success, with South Africa's complex social history and recent civil unrest, the roll-out of any mandatory vaccination policy will require careful health messaging with a focus on trust-building between communities, health systems and authorities through more personalized approaches that consider contextual nuances.
随着南非就实施强制疫苗接种政策以应对 2019 年冠状病毒病（COVID-19）疫苗犹豫问题展开辩论，许多成年人仍然对疫苗接种的必要性和益处持怀疑态度。多项调查表明，这在年轻成年人和生活在低收入社区的成年人中尤为明显。因此，我们征求了即将成为社区卫生工作者（CHW）的青年培训人员的意见，他们是社区和卫生系统交叉点的青年群体。这项研究是在南非的一个城镇进行的，南非是一个政治不信任历史悠久的国家。我们使用半结构化访谈和访谈指南，探讨了年轻 CHW 对自己、同龄人以及社区的疫苗犹豫看法（n=20）。对录音采访进行了转录，并进行了主题分析。研究结果表明，该社区普遍存在 COVID-19 疫苗犹豫情绪，尤其是在年轻人中。这种犹豫的原因似乎与一个复杂的相互关联的因素网络有关，包括对疫苗的结果和有效性的“不确定性”；对疫苗的“恐惧”，这是由社区内无数谣言和阴谋论驱动的；对他人行为的“缺乏控制”，以及对政府控制的渴望，但同时对即将实施的强制性疫苗政策和对政府疫苗推广意图及其健康信息传递的“缺乏信任”。虽然一些组织的强制性疫苗接种政策取得了成功，但由于南非复杂的社会历史和最近的内乱，任何强制性疫苗接种政策的实施都需要精心进行健康信息传递，重点是通过更具个性化的方法，在社区、卫生系统和当局之间建立信任，这些方法考虑到背景细微差别。
