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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

Guest lecture: Mr Pretorius, CEO of McCarthy Limited

2004-11-05

The challenges facing business leaders in a rapidly changing South Africa

“The world we used to know does not exist anymore. Leaders are continually dealing with crisis and opportunities, in a high-pressure environment,” said Mr Brand Pretorius, honorary professor from the University of the Free State , delivering his 13th guest lecture on the challenges facing business leaders in a rapidly changing South Africa .

Mr Pretorius, CEO of McCarthy Limited, identified certain trends which are responsible for changes to the South African business environment. He said the South African business environment is ever-changing, fast moving, complex and unpredictable. “As business people we have to deal with the impact,” he said.

“Years ago we were globally isolated. Now we live in a shrinking borderless world with crumbling trade barriers. Globilisation of our economy is accelerating. For South African business leaders this creates a sea of export opportunities,” he said.

Although there are ongoing demands for substantial profit growth from shareholders, the days of focussing only on their interests are gone, said Mr Pretorius. Stakeholder commitment now enjoys high priority and business leaders have to deal with the challenges accompanying black economic empowerment and employment equity.

Customers are also well-informed and demanding. Business leaders could easily loose the loyalty of their customers because of a hyper-competitive environment with an oversupply of goods and services.

Mr Pretorius stated that staff want to be involved and are looking for meaning in their workplace. Employers also have to deal with HIV/Aids in their workplaces. Trauma, absenteeism and financial implications could have a great effect on the viability of a business.

Against these changes Mr Pretorius pointed out the challenges business leaders are facing. In doing so a number of questions arise. The external business climate is characterised by turbulence and change. Internally there is a need for stability and meaning. How do we handle both challenges effectively?

Because of changes strategy decay is taking place and past strategies become irrelevant. Mr Pretorius said that business leaders need to modify their business models to prevent the downfall of their companies.

It is important for leaders to know what is happening in their world. “Continuous innovation is a critical success factor. The reality is that innovation is the only insurance against irrelevance,” he said.

Because of a changed environment leaders must perform and transform, simultaneously. How do we strike a balance between focused transformation and the achievement of world class performance, asked Mr Pretorius? “We need to bring about meaningful and sustainable empowerment, in order to create an inclusive economy and society. Leadership and management profiles should reflect the diversity of our teams, however at the same time every effort should be made to stop the brain drain and retain the expertise of experienced white managers.”

He also stated that leaders have an important role to play in terms of employment creation and corporate caring. “Sustainable stability and prosperity will not materialise without efforts in this regard.”

Mr Pretorius said that above challenges could be addressed by developing the ability to focus on creating a better future, rather than defending the past, a long-term vision, facing new realities, enhancing the value of brands and mobilising IT and the Internet to serve the business and customers better.

Retaining a positive vision of the future, embracing change and transformation, building your business according to the right principles and values and aspiring to be the best are some of the guidelines, according to Mr Brand, for future business success. He stated that creating a value advantage above one’s competitors, customer satisfaction and retention and inspirational leadership will add to the success of one’s business.

“We are indeed living in the era of the ultimate challenges, but also the ultimate opportunities. Let me clearly state that I have hope – in my view the tide has turned. Every day I experience small miracles inspired by ordinary people making an extraordinary difference,” said Mr Pretorius.

Media release
Issued by: Lacea Loader
Media Representative
Tel: (051) 401-2584
Cell: 083 645 2454
E-mail: loaderl.stg@mail.uovs.ac.za
5 November 2004

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