COVID-19 Vaccination intentions and related factors in South Africa: results from a large-scale public survey

ABSTRACT

Introduction/ Background: Despite COVID-19 vaccines being ubiquitous in South Africa, 30% of the population are vaccinated. Understanding socio-behavioural determinants of vaccination intention can inform interventions to improve vaccination uptake. We assessed the intentions and attitudes regarding the COVID-19 vaccinations and the socio-behavioural factors associated with intention to vaccinate among South African adults. Methods: Data was analysed from a large-scale public survey conducted in South Africa from 25 June-15 September 2021. The survey was administered online using a data-free platform and telephonically. Invitations to participate were widely distributed on social media platforms. Vaccination intention was based on the question “When available, would you take the COVID 19 vaccine?” Data were benchmarked using the general population demographics. Bivariate analyses examined the association between vaccination intentions and explanatory variables that included attitudinal, behavioural, and sociodemographic variables. Results: 73.8% reported they would definitely/probably take the vaccine, 16.4% were uncertain and 9.9% reported they probably or definitely would not (N=14,419). 63.4% thought vaccines are useful to protect communities from disease;over 60% were concerned about vaccination-related side-effects;72.9% heard conflicting information about COVID-19 vaccinations and 18.7% felt their religion/culture would discourage them or their families from being vaccinated. Vaccination intentions were significantly lower for 18-29-year-olds, women;those concerned about side-effects;who felt their religion/culture discouraged them, who thought there was inadequate safety information about the vaccines, and who questioned their effectiveness due to fast development. Impact The study identifies subgroups of individuals for whom targeted public health interventions and health communication should be prioritised and tailored in order to improve intentions to vaccinate. Behavioural interventions can be tailored to address the identified determinants of vaccination intentions. Conclusion: Young age, gender;concerns about side-effects, safety information and effectiveness due to the rapid development of the COVID-19 vaccines, and cultural or religious concerns were determinants of the intentions to receive a vaccine among South African adults.