Vaccine hesitancy is widespread in Africa despite the continent being on course to miss the urgent global goal of vaccinating the most vulnerable 10% in every country by the end of September 2021. As of June 2021, Africa had only administered roughly 56% of its COVID-19 vaccine supply. Only 1.86% and 0.51% of the African population have received the first and second doses of the vaccine, respectively.
Malawi, South Sudan, Liberia, Mauritania, The Gambia, Sierra Leone, Comoros, and the Democratic Republic of Congo have disposed of 450,000 expired doses of the COVID-19 vaccine since the vaccine rollout began in March 2021. Few other countries have returned some of their vaccines because they will be unable to use them before they expire.
Even before COVID-19, vaccine mistrust was a typical occurrence in Africa. The Polio vaccine was also greatly distrusted, but the vaccine distrust in Africa is not wholly misplaced. Africa has served as a testbed for medical research in the past. In Kano State, Nigeria, Pfizer conducted an unapproved and unethical meningitis vaccine trial which led to the death of children. In the early 2000s, HIV vaccine trials in South Africa were halted due to concerns about the trials. Nonetheless, according to World Health Organisation studies, the advantages of COVID-19 vaccination outweigh the risks.
Vaccine hesitancy is majorly a by-product of misinformation surrounding the pandemic and the vaccines. Some of the myths that have been peddled are that the vaccines cause infertility and that Africans are being used as guinea pigs—videos claiming that Bill Gates-funded the speedy vaccine production to depopulate Africa have circulated on social media. Also, claims of microchip surveillance on vaccination have received a large audience in Africa.
These myths have reached a vast audience through social media, and debunking these myths on the same level of publicity is one way to counter the falsehoods.
This publicity can be accomplished by mobilising communities like religious leaders and youth leaders to drive a house-to-house campaign and use conventional media such as the radio and television to help people understand the vaccine correctly. African countries can employ tactics that have worked in the past to combat disease epidemics. During the Ebola virus outbreak, community leaders’ involvement and input were crucial in disseminating misconceptions about the virus. The method also aided in understanding the virus.
Production of local vaccines with efficient storage and distribution needs to be put in place. If Africa produces its vaccines, the issue of distrust might be solved. While it is unlikely that vaccine manufacturing can kick-start in time with the current pandemic, African leaders must intensify efforts on vaccine production in Africa. The pandemic has driven nationalism; that countries will take care of their people first. Africa must also develop confidence and strength to take care of its people in coming pandemics.
Vaccines should not be made officially mandatory, but vaccine-related campaigns should be convincing enough to spur people. No African country has made immunisation mandatory. However, African countries are under increasing pressure to emulate countries like Australia and Russia in mandating vaccination for specific roles and functions.
Vaccinations should be optional rather than mandated. Using coercion to force people to be vaccinated against their will, such as making vaccination a condition of free movement, employment, or access to education or services, will undoubtedly erode public trust. The London School of Hygiene and Tropical Medicine study showed that COVID-19 vaccine refusal is higher among health and social care workers who feel pressured by their employers.
Mandating vaccines would fail to deal with challenges of adequate supply and accessibility. Inadequate vaccine supply and inaccessibility would not only make such a policy ineffective in increasing vaccine uptake, but it would also create an unjust burden on individuals who are required to be vaccinated but cannot. Such policy could worsen social inequalities in healthcare access.
Governments and the private sector must prioritise public trust building above everything else. Efforts should be made to demonstrate the advantage and safety of vaccines. Low public trust in vaccines and government has been a significant hurdle to vaccine rollout worldwide, particularly in Africa.