University of Johannesburg: South Africa is on day 250 of the vaccine rollout, but vaccine attitudes are still trending downwards

Receiving the COVID-19 vaccine is the most successful measure to combat the disease and set world economies back on a growth path. However, according to the World Health Organisation, vaccine hesitancy is growing and one of the major threats to global health. Therefore, it is of utmost importance to nurture a Positive Attitude towards the COVID -19 vaccine. The Gross National Happiness.Today Project investigated this problem: thus, the trend in Positive Attitudes towards the COVID-19 vaccine.

The GNH.today project is an ongoing study by a team of well-being researchers, namely Prof Talita Greyling (University of Johannesburg), Dr Stephanie Rossouw (Auckland University of Technology) and Afstereo. They developed the first real-time GNH (Happiness Index), which measures the mood of a nation (see www.GNH.today). The team construct the index by extracting live tweets and using Natural Language Processing (Machine learning methods) to analyse the underlying sentiment and the emotions of tweets.

They extended this project also to construct indices related to specific topics, such as the COVID-19 vaccine. To construct a Positive Attitude index towards the COVID-19 vaccine, they extracted all tweets related to vaccines and analysed the sentiment and emotions of these tweets. To analyse the data, they derive high-frequency daily data, for example, a time series that captures the positive sentiment towards vaccines per day.

The study is done across ten countries; three in the Southern hemisphere (South Africa, New Zealand and Australia) and seven in the Northern hemisphere (Belgium, Germany, Great Britain, France, Italy, the Netherlands, and Spain). Considering the sample as a whole, the Positive Attitude has been trending downwards and decreased by more than eight per cent from 1 February 2021 until 1 August 2021. (In analysing the South African data, the trend was still ongoing in October 2021). The date 1 February was selected as the starting date of the study as all countries in the sample have started their vaccine rollout by February. South Africa started the rollout on 17 February, exactly 250 days ago.

Figure 1 shows the negative trend in Positive Attitudes towards vaccines in the whole sample. In figure 2, the sample is split between the Northern and Southern hemispheres, indicating that the trend is downwards in both hemispheres.

When we analyse the different countries (see a selection of the countries in Figure 3), the team finds the trend downwards in all countries except Belgium, with South Africa showing the highest downward trend with 13 per cent. Interestingly Belgium (at the time of the study) was the country with the highest vaccination rate. Initially, the vaccine rollout in Belgium was very slow, and Belgium had high losses of life. But the Belgium government set up a COVID-19 task force responsible for logistics and capacity issues and turned around the initial negative attitudes.

This downward trend is against expectations, as we expected that as the vaccine rollout continues, people’s fear to be vaccinated will decrease and make them more positive towards vaccine uptake.

The question then is: why are countries experiencing the decrease in Positive Attitudes towards the vaccine? Analysing the tweets, the team found that the fear towards vaccines is indeed decreasing, but other factors contribute to negative emotions related to vaccines.

The team analysed the tweets per country. For example, see figure 4, a Word Cloud of the tweets related to the negative emotions towards the COVID-19 vaccine in South Africa. (The word “vaccine” was removed from the word cloud, as only tweets that included vaccine-related words were initially extracted; thus all tweets had the word).


When analysing the words with the highest frequency, the team found that although people still fear the vaccine and fake news plays a role, often the negative emotions are not directed at the vaccine itself but rather at the rollout process, the procurement of the vaccine and corruption related to the procurement.

See examples of these tweets below:

“With an incompetent government, a Minister of Health without a medical degree, NDZs dictatorial tendencies & a rural population still totally unaware of what a pandemic is added to a vaccine shortage, we are doomed”

We are bored about 1) corruption 2) poor vaccine strategy 3) terrible national government 4) incompetent cabinet 5) stealing during a pandemic!”

“The problem is procurement AND the 1st thing, government has to agree that NO CLAIMS for vaccine injury or death will be allowed. THATS why it’s impossible for the private sector to get vaccines otherwise Discovery & G of G could do it 4 us”

We found similar results across all countries under investigation. Thus the decreasing trend in the Positive Attitude is not only related to a negative attitude towards the vaccine itself but also due to other factors. In the European countries, the restrictions brought in place to limit the freedom of those not vaccinated also played a role in decreasing Positive Attitudes.

The team used different econometric techniques and models to determine which factors are significantly related to Positive Attitudes towards vaccines. If policymakers address these factors, the probability is very high that the attitudes towards vaccines will improve.

The team found:

People still fear the side-effects of the vaccine (though fear is decreasing), therefore it is of utmost importance to continue informing people about the vaccine to build trust.
It seems that people are weighing up the benefits of being vaccinated and complying to regulations introduced to curb the spread of the disease. Those feeling at risk to contract COVID-19 and unwilling to comply, opt to be vaccinated.
Dissatisfaction with governments in handling the rollout of the vaccine and in the Northern hemispheres, limiting the freedom of those not vaccinated, plays a big role in decreasing the Positive Attitude towards vaccines.
The more liberal the vaccine policies, thus the more groups that are allowed to be vaccinated, the more positive are the attitudes towards vaccines.
A decrease in the number of COVID cases increases the attitude towards the vaccine.
An increase in the number of vaccines administered increases the Positive Attitude.
Addressing fake news and messages by anti-vaxxers on social media increases Positive Attitudes towards vaccines.
These results give policymakers the necessary information on how to increase Positive Attitudes towards the COVID-19 vaccine. Policymakers should focus on improving trust in the COVID-19 vaccines. They could more openly disseminate information regarding the vaccine, do it in layman’s terms, and acknowledge people’s fears, anger, and other negative emotions while emphasising the stringent safety and efficacy standards of the COVID-19 vaccine development process, thus fostering individuals’ self-efficacy through vaccination. All of this may increase vaccine confidence.

Additionally, policymakers should implement policies to increase people’s sense of collective responsibility. This can be done by raising awareness of emotional manipulations by anti-vaccine disinformation efforts and activating positive emotions such as altruism and hope as part of vaccine education endeavours. Another potential strategy is to elicit positive emotions toward helping one’s community restore health and well-being, when deciding to vaccinate against what is called the most consequential disease of our time.

These interventions are of utmost importance to increase the uptake of the COVID-19 vaccine to combat the disease and create global economic growth.

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