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They who hesitate are lost – the psychology of vaccine hesitancy and refusal

08 October 2021 | Story Angie Vorster | Photo Supplied

AngieVorster copy — Angie Vorster is a Clinical Psychologist in the School of Clinical Medicine, University of the Free State (UFS), and believes that the only way to get rid of COVID-19, or at least to continue our lives alongside it, is for all of us to be vaccinated against this deadly virus

Opinion article by Angie Vorster, Clinical Psychologist in the School of Clinical Medicine, University of the Free State.

The World Mental Health Day campaign has chosen ‘Mental Health in an Unequal World’ as the theme for 2021. This is partly to raise awareness of the distinct polarisation between countries and individuals that has been highlighted by the COVID-19 pandemic over the past two years. Access to health-care resources is significantly impinging the ability of countries across the world to address the effects of the pandemic, and stark inequality regarding pivotal elements such as access to vaccines has become visible. Obtaining, storing, and distributing vaccines has proven to add another burden to countries that are already financially and resource-impeded. Yet, once South Africa was lucky enough to secure adequate amounts of vaccines, we were faced with a baffling dilemma. How to get our residents to actually take it? In trying to understand the psychology behind vaccine hesitancy, it is interesting to note that the World Health Organisation listed vaccine hesitancy (delaying or refusing vaccination) as one of the top ten threats to global health – well before the outbreak of the COVID-19 virus.

Understanding why people refuse or resist vaccination

To understand why people – who are otherwise reasonable, conscientious, and informed individuals – would refuse or resist vaccination, it is helpful to look at the 5C model. The first aspect is confidence – the extent to which the person trusts that the vaccine is safe and will in fact do what it is said to do. Confidence is also affected by the level of trust that the individual has in the system that dispatches the vaccine – consequently, individuals who are hesitant to vaccinate are likely to be suspicious of authority figures and structures. Another factor is the number of constraints that individuals face in accessing the vaccine. If there are many barriers (e.g., unable to afford transport to the vaccination site, unable to take time off work, etc.) in terms of the calculation of costs versus benefits, obviously it would be easier to delay or refuse vaccination. Interestingly, perceived scarcity makes items/events more desirable. Perhaps it is the very fact that the vaccine is free and available that makes people not interested in receiving it.

Having a sense of collective responsibility and altruism are important characteristics in those who submit to vaccination. People who refuse vaccination tend to be more individualistically orientated and less motivated by the greater good of all, than by their own personal preferences. And this brings us to the final C, which is complacency. People who perceive the risk of COVID-19 as low tend to feel less urgency to vaccinate. Unfortunately, these are the patients who admit to COVID ward front-line workers that they now regret not getting vaccinated when they had the chance; instead, they frequently come to this realisation once their prognosis is terminal and they are facing the harrowing reality of dying, separated from their loved ones.

And then we all know someone who believes in an ‘alternative’ explanation for the COVID-19 virus and its vaccine. There are many hypotheses as to why people prefer conspiracy theories over scientific truth – some of which include the fact that the science behind understanding viruses and their prevention is quite abstract and too complicated for lay people to understand. Unless they witness the devastating impact of the virus first-hand – it may be difficult to comprehend that an invisible entity can do so much damage. Another explanation is that the truth of a natural disaster such as a pandemic, which can occur at any time, randomly, and without warning, catching humanity off guard, is just too frightening to accept. So, it makes us feel safer to believe that humans ARE in fact in control and actually created COVID-19 for some larger sinister goal. Otherwise, we are left to contemplate how utterly vulnerable we all really are. Instead, we deny reality and substitute it with something that makes us feel a bit better.

How to encourage all citizens to get vaccinated

So, how do we encourage all citizens to get vaccinated in order for our society to regain some pre-pandemic normality? Force, anger, and frustration (which are undoubtedly justified, particularly by those who work on the front line, and by those who have lost loved ones due to this virus) are not going to get us there. Instead, we need religious and other leaders to set the example and publicly advocate for vaccination. We need to tailor the information to the vast majority of South Africans who are not science-literate, making it accessible and understandable in their home language. Unfortunately, there is a significant percentage who will not be swayed by these actions, and for these fellow South Africans I have the following message:

It does not matter anymore whether or not COVID-19 is in fact the product of a global conspiracy and whether or not the companies that create vaccines do so only for financial gain. It does not matter that this all happened very fast and that we all realised how terribly weak and vulnerable the human body is. What does matter is that this virus is here. In our homes, our schools, cities, and country. And the only way to get rid of it, or at least to continue our lives alongside it, is for all of us to be vaccinated. We have science – facts, not opinions or feelings or theories or beliefs – to tell us that vaccines are safe and effective. In ten years from now, this will be the plague of 2020. I hope that you will be able to say that you were brave, even though you were scared, even though you were unsure, even though you might have been fine without the vaccine, but that you were strong enough and kind enough and human enough to do this small thing for the greater good of humanity. And our children will thank you for restoring connection and hugs, concerts, and playtime at school without distancing and sanitiser and masks. You will have done something important. For your community and your country and in fact, the world. This is your chance to be part of a great victory of humanity over a seemingly insurmountable tide of death and suffering. Our hope lies in you. Take this great responsibility, wear it with pride and importance, and meet us at the other side of COVID-19.

News Archive

UFS can lead SA in race relations - Ramphele

2010-08-06

Pictured are: Dr Boesak and Dr Ramphele
Photo: Mangaliso Radebe

The University of the Free State (UFS) could well be a perfect model of excellence in race relations that the whole of South Africa could emulate.

This was said by Dr Mamphela Ramphele, the first African to be a Managing Director of the World Bank, during the Anti-Racism Network in Higher Education (ARNHE) Colloquium held at the UFS recently.

“Healing circles need to be constructed on this campus to address issues raised by the Reitz incident,” she said.

“You might yet be the pioneer of what needs to happen on a nation-wide level.

“Can we confidently commit today to go on this quest for a true humanity and walk together as fellow citizens and strive for a more human face for our society? That is our challenge. That is what the UFS is called to give leadership to.”

“It is this human face which has the power to liberate us from the body of death and strengthen us in our struggle for meaningful life together in South Africa,” added one of the main speakers, Dr Allan Boesak, a cleric and former anti-apartheid activist.

However, said Dr Ramphele, this could only be achieved if all South Africans, black and white, abandoned the fear for each other that was hindering, if not stalling, progress in this regard.

“Fear of each other is the most important impediment to the sustainability of our journey into a society united in our diversity,” she said.

“People in this country are afraid to stand up and be counted, including many vice-chancellors and clerics. They are afraid of being seen to be difficult, and that is a major problem. Fear is the most destructive emotion that you can have because it makes you really incompetent and unable to respond to challenges.”

She said the biggest impediment, though, to ending racism was denial. “White people deny vehemently that they are or have ever been racist,” she said.

“We need to go through a process of acknowledging our wounds and scars from our racist past and present missteps in public policy.”

“Instead of saying they are sorry, those who are conscious of their whiteness should rather say what they are sorry for,” said another main speaker, Prof. Dennis Francis, the Dean of the Faculty of Education at the UFS.

On the other hand, according to Dr Boesak, blacks were and still are, to a large extent, also to blame for their own ongoing oppression. “The key here was the acknowledgement of our sheepish timidity, our complicity,” he said.

The Chairperson of ARNHE, Prof. Norman Duncan, had this to say: “If we are to confront and eradicate racism in higher education institutions, we should not do so to create comfort zones for ourselves.”

The theme of this ARNHE Colloquium was Black consciousness and those conscious of their whiteness. It was presented by the International Institute for Studies in Race, Reconciliation and Social Justice at the UFS.

Media Release:
Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za
6 August 2010

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