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• One critical factor in demand creation is the point of decision for vaccination in the health care setting. Health care workers (HCW) including doctors, nurses, and community-based HCW must demonstrate that they have been vaccinated and support vaccine uptake in the population in order to build public trust.

Evans, William Douglas, and Jeff French. "Demand Creation for COVID-19 Vaccination: Overcoming Vaccine Hesitancy through Social Marketing." Vaccines 9.4 (2021): 319.

• Evidence from Pakistan indicates that a vicious cycle can occur when health-care providers do not have the tools or counter-narrative to address disinformation during vaccine encounters, and therefore hurry interactions with patients that may benefit from lengthy discussions.

Khan, Mishal S., et al. "Rethinking vaccine hesitancy among minority groups." The Lancet 397.10288 (2021): 1863-1865.

• South Africa: the rapid assessment survey of HCW (n=22,751), found that 19% were unsure they would take the vaccine and 74% would be willing to recommend the vaccination to their patients.

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• Some health workers in South Africa have also questioned the safety and efficacy of the COVID-19 vaccine. For instance, the Indaba nurses’ union has advised its 17,000 members to boycott the vaccine because they do not trust its safety. Among the HCW study undertaken by the Department of Health and partners, 57.5% of the reasons for concern were also related to safety and effectiveness of the vaccine, while only 2% were related to mis- and dis-information.

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SSHAP 20201. PERCEPTIONS OF COVID-19 VACCINES IN SOUTH AFRICA

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• The determinants of vaccine uptake across the globe show strong consistency, with being male or having fewer years of education associated with decreased chances of uptake. Positive information-seeking behaviours and trusting health-care workers more than other sources such as one’s social circle for medical and health advice were associated with increased chances of uptake. 

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De Figueiredo, Alexandre, et al. "Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study." The Lancet 396.10255 (2020): 898-908.

• Three studies found very low reported acceptance of a hypothetical COVID-19 vaccine among healthcare workers in DRC, Uganda and Zambia –these studies were conducted in mid-2020 and may not be representative of current perceptions and beliefs, although it should be noted that DRC and Zambia generally reported lower levels of acceptance. There were important data from the DRC and Zambia which suggested low levels of acceptance from healthcare workers. Understanding and responding to vaccine hesitancy by healthcare workers, where it exists, will be crucial.

SSHAP. 2021. DATA SYNTHESIS: 

COVID-19 VACCINE PERCEPTIONS IN AFRICA: SOCIAL AND BEHAVIOURAL SCIENCE DATA, MARCH 2020-MARCH 2021 

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• Information on its own has shown a limited impact on facilitating vaccination uptake, but adding other strategies – such as reducing barriers (1), using reminders (2) and planning prompts (3), and training and building confidence in health workers (4, 5) – has been shown to be effective.

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• Multiple groups influence uptake of vaccination, including health workers. These actors can facilitate or discourage vaccination by creating more or less enabling environments. It is, therefore, important to consider how the behaviours of actors in the system might influence the behaviours of the general population.

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• Studies have shown that health professionals are more likely to recommend vaccination if they themselves have been vaccinated (26). Hence, targeting efforts to facilitate the vaccination of health professionals can in turn lead to greater acceptance and uptake by the general population. These efforts can include improving health professionals’ knowledge about the vaccine and increasing their co-workers’ support for the vaccine.

WHO. 2020. BEHAVIOURAL CONSIDERATIONS FOR

ACCEPTANCE

AND UPTAKE OF

COVID-19 VACCINES

• Vaccine hesitancy among health care providers probably ranges from those who are overtly anti-vaccination to those who have doubts and concerns around the science of some vaccines to those who support vaccination. Research has shown that a significant proportion of health care providers, including those who administer vaccines, are vaccine hesitant in their personal and professional lives.

• Dubé, Ève, et al. "Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health." Annu. Rev. Public Health 42 (2021): 175-191.