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The first batch of COVID vaccines touched down in South Africa in February 2021. Health workers were the first to get a jab under the Sisonke study. But even before the country had bought any jabs, our reporters were writing about the logistics and the politics of the project. If you want to know how well the vaccines work, how the different jabs compare or what it takes to create a vaccine from research, to regulation, to rollout, you’re at the right place.

HomeArticlesWhen empathy meets evidence: Tackling COVID vaccine hesitancy in SA

When empathy meets evidence: Tackling COVID vaccine hesitancy in SA

  • There are many reasons why someone may be hesitant to get a vaccine, such as a long history of mistreatment and negative healthcare experiences.
  • Myths and conspiracies about vaccines may seem silly to you, but it causes real fear in people who don’t know how the jabs work.
  • The best way to help address these concerns is not to dismiss people’s fears, but rather hear them out.

The scenario: Your best friend, or sibling, isn’t sure if they want to get vaccinated against COVID. They’re not completely against vaccines, but they have concerns, such as worries about side effects and safety. How do you convince them to go for a jab?

On Health Hub, Bhekisisa and Newzroom Afrika’s television programme on Sunday mornings, we asked an expert on vaccine hesitancy and someone who was hesitant, but then changed their mind and got vaccinated, about the best ways to approach someone who is uncomfortable about getting a jab.

Kanya Ndaki is the communications director at the Aurum Institute. She had COVID earlier this year and it hit her really hard. “I had the whole nine yards hospital rehab afterwards. So with all of that, that ordeal, I was really concerned about the side effects. I thought to myself, ‘I’ve had COVID, I’m worried about the side effects, how are these going to interact with my body, and affect my comorbidities?’” she says. 

“Also with all the long COVID symptoms that I was struggling with, I thought to myself, these side effects could also just cause havoc, more havoc. So I was really concerned, I was scared.”

Mia: What changed your mind and made you decide to get vaccinated?

My friends, colleagues and family, started taking the vaccine. They were open about it — the side effects and the process and no fearful things happened to them after they had taken the vaccine. I thought to myself, maybe it’s not so bad. 

But I think the cherry on top was my daughter saying, if granny can take it, why can’t you? My mom is a 68-year old health worker. She took her jab  in the morning and by the afternoon she was back at work. She didn’t have any side effects. That really pushed me and I thought,  okay, let me let me try, let me actually go and confront my fears.

Mia: How did you feel after taking your vaccine? 

Kanya: I took the Johnson & Johnson vaccine. I took it on a Friday thinking I was going to have all these side effects over the weekend. I was tired, yes, and my arm was painful. But I took some Panado and by the Sunday, I was up and about.

Mia: When friends and family spoke to you about vaccines, what worked for you?

Kanya: The most important thing is empathy. You’ve got to really put yourself in people’s shoes, because people are scared — don’t dismiss their fears. People are really scared about the side effects. It’s the fear of the unknown, so arm yourself with information to be able to deal with it. Don’t dismiss hesitant people as crazy. I have a lot of family members and friends who are still grappling with all of that, so my experience is not unusual. But I think the main thing is empathy.

[WATCH] Kanya Ndaki’s full interview

The director of Cochrane South Africa at the South African Medical Research Council, Charles Shey Wiysonge, says most vaccine hesitant people are ordinary people with valid concerns about jabs. They just want to make the right choices for themselves and their families, so listening respectfully to their concerns is crucial.

Wiysonge has five tips:

  1. Begin with empathy, not evidence: In the scientific community we are used to simply having the right answer and delivering it with precision. But evidence is not enough in itself to reduce vaccine hesitancy. One of the reasons is that evidence without empathy can feel intrusive — no matter how many data charts you have or how many infographics you use, it will fall on deaf ears if empathy is missing in the way you deliver that evidence. 
  2. Don’t dismiss people’s realities: Vaccine hesitancy in some communities is rooted in a long history of social exclusion and negative healthcare experiences. If we are to truly address hesitancy in such communities, we must take the time to understand the reason for the hesitancy. We may not always agree, and that is okay, but we must try to understand it.
  3. Focus on the positive: You should begin the conversation with a vaccine hesitant person by acknowledging that it’s admirable that someone cares so much about his or her family and wants to make the best choices for them. For example, if someone were to say that on a scale of one to five, their willingness to take a COVID-19 vaccine is two, you should congratulate them and say it is fantastic that it is not one. This positive approach makes a person more receptive to information. Once a person feels heard, validated and understood, they are  more likely to listen to you.
  4. Be nice: There are plenty of conspiracy theories and myths about jabs that some people are too embarrassed to talk to their doctors about. These ideas may seem silly to you, but they remain a real fear for someone who is unsure about the mechanism of these vaccines altogether. You should ask about and even elicit some myths; by bringing them to light, you don’t give such misrepresentations further credence, but rather show someone that you are aware of their fears and that there are real answers to the issues that they are wondering about.
  5. Be honest about side-effects: Many people who are hesitant have real fears about side effects. Don’t dismiss side effects, rather highlight that mild side effects, such as pain at the injection site is common, and serious side effects are extremely rare. Remember, honesty builds trust.

Mia: Let’s say I’m vaccine hesitant. I have fears about the safety of vaccines and side-effects. I’m concerned vaccines may change my DNA. Convince me to get vaccinated.

Thank you for sharing your concerns about COVID-19 vaccination with me.

Vaccines cannot change your DNA. Personally, I have taken the vaccine. I want to be around for my children and I want to make sure I do not contribute to a new variant of the virus that causes COVID-19. Variants are forms of the virus that can, for instance, be more infectious or more deadly.  

COVID-19 vaccines do not change or interact with your DNA because the vaccine never enters the part of your cells where the DNA is kept. 

I understand that you are not sure if the vaccines are safe or not, but can I ask you a question? 

Do you know of anyone with a disease called smallpox? No? The main reason you don’t is because smallpox was eradicated by vaccines

This was a terrible disease, which like COVID-19, was caused by a virus. It also spread from one person to another. People who had smallpox had a fever and a distinctive skin rash — many were left blind and with permanent scars on their bodies and faces. Because of vaccines, there have been no smallpox cases since 1977. Because of vaccines, we also no longer have cases of polio and yellow fever in South Africa. 

In our country we have very strict laws and regulations that make sure that vaccines or any medicines that we use are safe and that they work. Remember how when the first batch of COVID vaccines arrived in South Africa there was a delay of a few days to get them out? This is because our medicines regulator, the South African Product Health Products Regulatory Authority, Sahpra, had to quality check samples to make sure they contained the right ingredients in the correct quantities. This was even after Sahpra spent months reviewing data from trials for the vaccine to make sure manufacturers interpreted it correctly.  

After you get your vaccine you might have some side effects, like we do with so many treatments – antiretroviral drugs for HIV, TB medications, antibiotics and even paracetamol.

You may feel “fluish” for about 24 hours afterwards or have a headache. This is the vaccine’s way of announcing to you “I am here, I am working, I am ready to help you fight!” You may also have a sore arm or feel a little dizzy or nauseous, but this won’t last for longer than two or three days. Serious side effects, such as severe allergic reactions, are extremely rare. So far, no deaths have been linked to COVID vaccines in South Africa

The misconception that COVID-19 vaccines may affect someone’s DNA probably comes from the fact that some vaccines, such as the one made by Pfizer, which we use here in South Africa, use mRNA technology. 

 mRNA technology has been rigorously tested for safety, and clinical trials have shown that mRNA vaccines provide a long-lasting immune response. mRNA vaccine technology has been studied for decades, including in the context of vaccines against the Zika virus, rabies and influenza. mRNA vaccines are not live viral vaccines and do not interfere with human DNA.

Such vaccines work by using pieces of man-made genetic material instructing the body to produce a protein found on the surface of the coronavirus. The immune system then learns how to recognise and produce antibodies against that protein, and these antibodies protect us against COVID-19.

The materials that make up the coronavirus vaccine are based on ribonucleic acids (RNA, or small pieces of genetic material that act as messengers), and when they enter the body, they do not penetrate the nucleus at all (DNA is based in the nucleus). So, the RNA molecules do not have a chance of coming into contact with the hereditary material contained in your DNA. Vaccination therefore cannot change your DNA.

[WATCH] Charles Wiysonge’s full interview

Mia Malan is the founder and editor-in-chief of Bhekisisa. She has worked in newsrooms in Johannesburg, Nairobi and Washington, DC, winning more than 30 awards for her radio, print and television work.