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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

Dr Oprah Winfrey praises our university

2011-08-24

Dr Oprah Winfrey after receiving her honorary doctorate degree.
Photo: Rian Horn

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Transcription (pdf document)

“I came 8 000 miles to say, thank you, Vrystaat!” and “God bless South Africa,” were the words Dr Oprah Winfrey used yesterday to respectively open and close her address to an overflowing Callie Human Centre on our Bloemfontein Campus.

Our university awarded an honorary doctorate in Education to Dr Winfrey during a stately, yet warm and cheerful affair yesterday, which saw the 4 500 seater Callie Human Centre packed to the rafters with adoring fans, staff members and students.

The honorary doctorate is in recognition of her unparalleled dedication to improving the lives and futures of so many by improving education and ensuring that it is accessible to all. Through her award-winning show, The Oprah Winfrey Show (which concluded this year after 25 years of entertainment and service), and the various charity organisations she has established, Dr Winfrey has harnessed the power of her iconic stature in the struggle to eradicate poverty and make education accessible to all.

The ceremony’s audience was entertained by South African music legend, Ms Sibongile Khumalo, the Bloemfontein Children’s Choir, Bartimea School for the Deaf and Blind’s Sign Language Choir, and several other musical performers as well as dancers.

Dr Winfrey could not hold back her tears when Mr John Samuel, interim Director of our International Institute for Studies in Race, Reconciliation and Social Justice, described her as an “honorary daughter of South Africa”. She proved just how much the country means to her when she joined in the singing of the South African national anthem, Nkosi Sikeleli, despite struggling with the words in some parts.

According to Dr Winfrey, her interest in our university began after she had read an article by Prof. Jonathan Jansen, Vice-Chancellor and Rector, in which he emphasised the need for South Africans to stop accepting mediocrity, if ever the country is to develop to its full potential.

She asked Mr Samuel to convey her message of support to Prof. Jansen and the wheels, which led to today’s great event, were set in motion.

She also expressed her admiration of the transformation process at our university and our commitment to “reconciliation, peace and harmony”. “What has happened at the University of the Free State is nothing short of a miracle and this is truly what the New South Africa is about,” she said to loud cheers from the audience.

To emphasise her point, she called the five workers from the Reitz video to the stage and used their forgiveness and acceptance of the students responsible for the video as an example of the healing achieved at the UFS.

“Having seen this forgiveness has allowed me to expand my vision of what we can be.” She also delivered a message of encouragement and reminded students that anyone, despite their circumstances and background, could become successful and grow to overcome their obstacles, as she had done.

“Anyone can be successful if they put their mind to it, work hard and are diligent,” she said. “We must all strive for more than success, though, and fulfil the highest expression of ourselves as humans by realising who you are and what you are meant to be.”

Following her address, Dr Winfrey answered several questions from our students, giving them advice on, among other things, how to choose a career that is right for them, and good characteristics to look for in leaders and peers.

She also mentioned that several learners from the Oprah Winfrey Leadership Academy, which has its very first group of Grade 12 learners this year, would be visiting our university next month in order to help them select a university to attend next year.

Media Release
25 June 2011
Issued by: Lacea Loader
Director: Strategic Communication
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: news@ufs.ac.za

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