Understanding the motivations for COVID-19 vaccine hesitancy in South Africa: Narrative literature review

Abstract

While efforts to promote vaccine knowledge and acceptability in the global and local communities are applauded, affordability of the vaccines to the public is inadequate thus strategies that promote vaccine access and uptake will lead to increased usage of COVID-19 vaccines. To review the relevant literature obtained from a computerised database search that focuses on vaccine hesitancy in order to understand motivations for vaccine hesitancy with a view to address within a South African context. A comprehensive search from different databases, namely, Google Scholar and North-West University Library through the e-Link Catalogue, with journal and conference publications from 2010 to 2021, yielded qualitative, quantitative and mixed-method studies that addressed various topics on vaccine hesitancy. Inclusion and exclusion criteria were set and 25 publications met the inclusion criteria for the review. The motivations for COVID-19 vaccine hesitancy are described as complacency: anti-scientific attitude (unbelief in evidenced-based information) caused by conspiracy beliefs and distrust in information sources leading to lack of compliance to COVID-19 restrictions such as wearing of masks, social distancing and lack of hand hygiene: convenience/lack of access to COVID-19 vaccines; caused by delays in the distribution and use of vaccines till expiry dates were reached and lack of confidence and trust: caused by concerns on safety and effectiveness of vaccines. COVID-19 vaccine hesitancy can be addressed by ensuring that there are no constraints related to the supply and system that administers vaccines; building trust in the safety of vaccines, health services and government authorities and avoiding delays in distribution and use of vaccines. Future studies need to address the root causes of conspiracy beliefs that lead to complacency (anti-scientific attitudes) resulting in delays/refusal of COVID-19 vaccines and noncompliance to evidence-based information that if observed could curb the spread of COVID-19.