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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 hikers to Cape Town reflect on their journey

2014-05-26

For the four volunteers from the university who are currently on their way to the Cape on foot, every hour of every day is a victory.

It is three weeks since two employees from the University of the Free State (UFS), Adéle van Aswegen and Ntokozo Nkabinde, together with two other Bloemfontein residents, Nico Piedt and Ronel Warner, left Bloemfontein on fóót for the Cape, in order to highlight the problem of food insecurity among students.

On Sunday 18 May they crossed the halfway mark at Beaufort West and will conclude their journey on Tuesday 3 June in Cape Town.

This is what the hikers have to say after three weeks on the road:

Adéle van Aswegen
It isn’t only a physical journey, but rather an emotional journey you undertake. You learn what it means to be truly thankful for basic things like clothes, a place to sleep and food.

Nico Piedt
I know what it feels like to survive on only a glass of water in your stomach – a cup of weak tea if you’re lucky – for the whole day. If I can help (through the hike) to give someone a better chance in life, then it is worthwhile.

Ronel Warner
You think and grow simultaneously. As you plan every stride ahead of you, you also plan your life ahead.

Ntokozo Nkabinde
You don’t walk for yourself. You undertake this journey, maybe because you want to help someone, but this journey is actually in honour of something bigger and you just have to endure.”

These boots are made for walking ... to Cape Town (Article of 02 May 2014)
“Aren’t auntie and them hungry yet?” Country folk worried about NSH hikers (15 May 2014)

Daily updates:
(You can also follow us on @UFSweb for daily tweets)

Day 33: 2 June 2014
13:40
20 km
Sunset Beach, Cape Town

Day 32: 1 June 2014
16:05
26 km
Mervyn and Sanet Wessels, Belville

Day 31: 31 May 2014
16:31
39.6 km
Rhonell and Gavin Julain, Paarl

Day 30: 30 May 2014
14:00
16 km
Monte Rosa, Rawsonville

Day 29: 29 May 2014
13:16
31 km
The Habit, Worcester

Day 28: 28 May 2014
11:00
22.4 km
Monte Roza, De doorns

Day 27: 27 May 2014
17:00
21.1 km
Karoo Hotel

Day 26: 26 May 2014
18:27
43.3 km
Tows river

Day 25: 25 May 2014
12:18
Lord Milner Hotel, Matjiesfontein

Day 24: 24 May 2014
16:30
42 km
Laingsburg Country Lodge

Day 23: 23 May 2014
17:32
41.8 km
Vergenoeg

Day 22: 22 May 2014
16:42
43 km
Assendelft Lodge and Bush Camp, Prins Albert

Day 21: 21 May 2014
15:09
42 km
Leeu Gamka Hotel

Day 20: 20 May 2014
13:39
20 km
Alida, Springfontein

Day 19: 19 May 2014
12:31
27.6 km
Teri Moja Game Lodge

Day 18: 18 May 2014
First rest day
Nagenoeg Guesthouse, Beaufort West

Day 17: 17 May 2014
19:30
62.3 km
Nagenoeg Guesthouse, Beaufort West

Day 16: 16 May 2014
13:00
14 km
Taaibochfontein

Day 15: 15 May 2014
16:03
32 km
Travalia, Three Sisters

Day 14: 14 May 2014
18:33
43 km
Joalani Guest Farm

Day 13: 13 May 2014
17:30
33 km
Die Rondawels

Day 12: 12 May 2014
16:49
40 km
Aandrus B&B in Richmond

Day 11: 11 May 2014
39 km
Wortelfontein (Magdel and Christiaan)

Day 10: 10 May 2014
15:44
34 km
Hanover Lodge

Day 9: 09 May 2014
40.8 km
Camping between Colesberg and Hanover

Day 8: 08 May 2014
15:25
33.7 km
Colesberg, The Lighthouse Guesthouse

Day 7: 07 May 2014
15:08
23 km
Orange River Lodge

Day 6: 06 May 2014
15:57
51.06 km
Gariep Forever Resort

Day 5: 05 May 2014
12:18
28 km
Rondefontein

Day 4: 04 May 2014
15:27
35 km
Trompsburg: Fox Den

Day 3: 03 May 2014
17:30
46.74 km
Edenburg Country Lodge (Hotel)

Day 2: 02 May 2014
11:44 am
15.3 km
Tom's Place

Day 1: 01 May 2014
32 km
Leeuwberg

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