Why have governments struggled to influence masses towards COVID-19 vaccine uptake?
Source: GovernmentZA, Deputy President David Mabuza leading vaccination community mobilization campaign at the Mbombela Taxi Rank, Mpumalanga.
Vaccination rates remain stubbornly low in Africa despite massive improvements in the supply largely through the COVAX facility (WHO, 2022). People vividly recall videos of government leaders seated on illuminated stages being injected with COVID-19 vaccines in the hope of influencing fellow citizens to emulate such well-publicised positive vaccine action. Fast forward several months, large proportion of masses still remain unvaccinated. Does this mean that politicians as represented leaders do not possess sufficient influence to convince the individuals to protect themselves against COVID-19? Could there be a far more complex psycho-behavioural dynamic informing the decision-making process and persuasion for millions of unvaccinated individuals in Africa?
A publication by Bloomberg suggests that an online ad by the former President of the US, Donald Trump led to an increase in vaccinations in rural counties where he commands a strong support base (Armstrong, 2022). It is understood that, YouTube algorithms propelled the ad to be aired to conservative subscribers in areas with low vaccination rates. Thousands of miles away, a march in South Africa demanding access to vaccines led by a political leader Julius Malema is alleged to have increased vaccinations among his supporters (Kyle,2022). From these articles it would appear that understanding the demographic, and their political preference may increase vaccination rates, but we believe it is more complex and these observations are more of a correlation than causation. Messages and communication need to resonate with the unique psychological and behavioural attributes of the audience. We like to think of this as the "fingerprint" of that segment of the population -distinct and sophisticated features define it. So the question we need to ask is - How did the messages hack into the distinct and sophisticated neuro-behavioral pathways and successfully move them from a state of vaccine hesitancy and inaction to positive vaccine action?
During our psycho-behavioural segmentation work in Cote D’ Ivoire, Burkina Faso, Kenya, and Pakistan we see that vaccine confident individuals are influenced by multiple factors and that televised vaccination of presidents and government leaders did not make it to that list. After all banking on government actions as positive reinforcement and myth busters is a rational approach to demonstrate the government’s confidence in the safety and efficacy of the vaccines with its willingness to put its first citizen on the line, right? Or the misinformation alleging the inoculations being nothing more than water injections or to the extent that some alternative videos showing partial penetration of needles, has overshadowed the government's confidence building efforts.
A myriad of demographic, preferential, psychological, and behavioral factors influence an individual’s journey towards vaccination with numerous potential drop-off points. In the larger complex sphere of social and political dynamics individuals seemed to lack trust in government. Could it be a mis-calculated stance for political leaders to be influencers in COVID-19 vaccination campaigns given the context of mistrust? While this may be a global phenomenon, the situation is potentially exacerbated in the global south countries where poverty, inequality and corruption feature prominently and populations have experienced perverse incentives being harboured by the public officials and leaders in the past. Participants in our study demonstrated trust in health authorities but were skeptical when politicians shared messages.
In-group influencers for example are more impactful, since they are more familiar to their followers and command trust. Renowned behavioural scientist Robert Sapolsky (2017) suggests that merely grouping people activates parochial biases, no matter how tenuous the basis of the grouping. In general, minimal group paradigms enhance our opinion of us rather than lessening our opinion of them (Sapolsky, 2017) . He contends that the exercise of forming groups about “us” and “them” based on minimal shared traits is a psychological effect rather than a genetic one. We feel positive associations with people who share the most meaningless traits with us. More-so, group definitions raise a larger issue, namely our sense of obligation and loyalty to “us” as a whole and translates to action such as defying government proclamation on the basis of religion, social status, tribe, age, political affiliation and race. All these affiliations are incubation grounds for concocting an “Us and Them.”
In our quest to understand why governments had limited success in influencing citizens, we need to deconstruct who is an “influencer” in the context of these countries. The answer is potentially more diverse than has been explored yet, for example religious leaders are trusted information channels in certain communities. A diverse portfolio of “influencers” encompassing multiple political formations, religious groups, race, age, gender, sexual minorities, locations, cultures and tribes stands a better chance when messaging is consistent with decision making processes influenced by individual psycho-behavioral attributes.
Armstrong, D (2022). Trump Helped Boost Vaccine Use After Endorsement in Online Ads. Available online https://www.bloomberg.com/news/articles/2022-04-04/trump-recommends-vaccines-in-ad-that-helped-boost-uptake. Bloomberg US edition. Accessed on 5 June 2022
Sapolsky, R (2017). Behave: The Biology of Humans at Our Best and Worst, Penguin Random House, London
Kyle, Z (2022). Did Malema’s comments about the Covid-19 vaccine lead to more people getting the jab?Available online: https://www.timeslive.co.za/news/south-africa/2022-05-26-did-malemas-comments-about-the-covid-19-vaccine-lead-to-more-people-getting-the-jab/. Times Live Newspaper. Accessed on 10 June 2022
WHO (2022). New push to drive up Africa’s COVID-19 vaccination. Available online https://www.afro.who.int/news/new-push-drive-africas-covid-19-vaccination. WHO Africa. Accessed on 10 June 2022