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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

Prof Jonathan Jansen bids farewell to Kovsies

2016-08-31

Dear Kovsie staff and students

This is my final message to you all.

I wish to use this opportunity for some brief reflections, share a word of gratitude, and convey a sense of the future for our beloved university.

Since the announcement of my departure, I have had more than a dozen breakfasts with mainly students, but also staff, to offer an opportunity for the final sharing of thoughts and, of course, goodbyes. The most common questions asked at those breakfast sessions were the following, with my responses. I repeat them here, since these might also be of interest or concern to you.

What are your proudest achievements?
Two things. The increase in the academic standard for the UFS, both in terms of admission standards and pass rates, but also in relation to the requirements for appointment and promotion especially of professors. This is important because in a globally competitive world, a university stands or falls by the quality of its degrees. And for this you need the best students and the best professors.

What would you do differently, given another chance?
Nothing. I believe that leadership is about doing the best you can with the cards you are dealt in the circumstances in which you are placed. There is no point in second-guessing past decisions. I have always been ambitious as a leader, knowing that most of my goals would be met, and that some would not. That is normal in large and complex organisations, and so, I do not sit around pondering regrets, only remembering with gratitude the things we could achieve together.

What did you learn?
A lot. I learnt that our students have tremendous capacity for greatness both in their academic pursuits but also in their ability to live, and learn, and love together. I have learnt never to underestimate the capacity of our youth to excel in whatever they do. Sometimes I felt I was more ambitious for our students and staff, than they were for themselves. But I have constantly been surprised by the capacity of young students to rise above bitterness and division, and to make great our campus, country, and continent.

I learnt, again, that the overwhelming majority of our staff and students are good people, respectful of each other, and determined to work together to heal our broken past and build a more just society. And I learnt that it is much more fulfilling to build up than to break down, to embrace than to exclude, and to love than to hate.

Were you frustrated with the pace of transformation?
Sometimes, yes. But fortunately I studied educational organisations all my life, mainly schools and universities. Universities are called institutions for a reason, and on century-old sites like the historic Bloemfontein Campus of the University of the Free State, there are core beliefs, values, and practices deeply ingrained in the culture of the place.

Anyone, therefore, who believes that transformation is easy, has obviously never tried to change an old university. It is difficult. You will get blowback. You will get bad press. You will, sadly, lose the support of some people. Some believe the university is changing too fast while others will tell you it is not changing fast enough. As you press for change, you find the university going two steps forward and one step back; in these circumstances, the solemn duty of the leader is simply to ensure that the overall momentum is always forward.

For such a time as this –
a commemorative journey:
2009-2016 (PDF book)

I therefore budget for disappointment even as I relish the many changes we have experienced together over the past seven years. If you want to obtain an objective sense of the scale of the changes at the UFS, ask those students and staff who were here in 2009, not those who came recently. They will tell you that we have a very different university, even though we all acknowledge that there is still some distance to travel. Our remarkable story of change is told in the recent Transformation Audit of the UFS, chaired by Prof Barney Pityana; that Audit Report will be released after it is read and studied by the University Council at its November meeting.

At an individual level, I learnt that most campus citizens change quickly and others more slowly, and that one has a duty to constantly push for change, but also to be patient about change. And I learnt that the ideal change retains the best of our past even as we embrace a more just and inclusive future in which all campus citizens feel that the university truly belongs to each and every one of them.

Are you optimistic about the future of our university?
Yes. The UFS is a very well-managed university thanks to the exceptional talent in the management of our finances, human resources and information technology environments. By the end of 2016, we will have record enrolments, from undergraduates to doctoral students, which is good for our future income. We run a tight ship with regard to the university’s finances, and we have greatly improved the academic standard of our qualifications; in this regard, I am very proud of my senior management team, and the talented middle management personnel, and those who make things work at the coalface of our operations.

I am very concerned, however, about future funding of the 26 public universities and the extremely vulnerable situation of at least 10 higher-education institutions. The economy is not growing and the costs of running a modern university are escalating. The delays in government commission reports on tuition fees do not help, and there seems no urgency ‘higher up’ to make the tough decisions.

We have to ensure free education for the poorest students — that is the position of your senior management – but we also need to guarantee the financial sustainability of our universities. The task of the UFS leadership, in this period of uncertainty, is to manage those two expectations as best we can. But this cannot happen without your assistance, and I do ask that you provide the new Rector and his or her team with the same understanding and support which I have enjoyed from you.

In conclusion
I am grateful.

To the many hundreds of students who have passed through my office and our home, and who sat in my many lectures and engaged me in your residences – thank you for enriching my sense of life and leadership. I am grateful that Grace and I could support and mentor many of you over the years and see you graduate. I am a better leader because of you.

To the staff of the three campuses – there is no university Rector, I can assure you, who enjoyed more love and support than what you offered me since the day I arrived here. Students come and go, but you have been my foundation year after year, and I thank you for that.

To parents, friends, and followers off-campus, in South Africa and abroad – thank you for hundreds of letters, emails, phone calls, prayers and ‘packages of support’ (from biltong to books). In the most difficult times, you rallied from everywhere with a word of support, often on social media. Know this: your words kept me calm in the storm.

Thank you, everyone.

Goodbye.

Prof Jonathan Jansen
Vice-Chancellor and Rector
University of the Free State

Description: Prof Jansen saying goodbey Tags: Prof Jansen saying goodbey

Prof Jonathan Jansen steps down as UFS Vice-Chancellor and Rector (16 May 2016)

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