Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa
Abstract Background We investigated how social and contextual factors, including a pandemic, shape vaccine perceptions and attitudes among people living in KwaZulu-Natal in South Africa. We assessed how participants’ views, acceptance, and uptake of vaccines for a range of infectious diseases, may b...
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BMC
2025-03-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22181-w |
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| author | Kingsley Stephen Orievulu Sally Frampton Philippa C. Matthews Nondumiso Mpanza Thabisile Mjilo Samukelisiwe Nxumalo Joshua Hordern Janet Seeley |
| author_facet | Kingsley Stephen Orievulu Sally Frampton Philippa C. Matthews Nondumiso Mpanza Thabisile Mjilo Samukelisiwe Nxumalo Joshua Hordern Janet Seeley |
| author_sort | Kingsley Stephen Orievulu |
| collection | DOAJ |
| description | Abstract Background We investigated how social and contextual factors, including a pandemic, shape vaccine perceptions and attitudes among people living in KwaZulu-Natal in South Africa. We assessed how participants’ views, acceptance, and uptake of vaccines for a range of infectious diseases, may be influenced by experiences and events linked to the COVID-19 pandemic. Methods We conducted 30 in-depth face-to-face and telephonic interviews with participants living in diverse rural and urban communities in two districts within KwaZulu-Natal. Participants were adults (≥ 18 years) consisting of ordinary citizens, traditional healers, and nurses. We combined non-representative convenience, snowballing and purposeful sampling techniques to recruit participants. Data collection was conducted in IsiZulu, and we used both inductive and deductive thematic analysis approaches to identify key themes linked to participants’ perceptions and attitudes towards vaccines. Findings Our study participants were mostly those who had accepted vaccination. The main reasons given for vaccine uptake included understanding the importance of vaccines for disease prevention and survival, and securing the health of family members, the fear of death, government campaigns, vaccine mandates and penalties. Older participants (≥ 40 years) demonstrated more positive attitudes towards vaccines. Most participants downplayed the role of culture and religion in attitudes towards vaccines. However, some of the drivers of vaccine hesitancy were having an ancestral calling, medical pluralism, or local myths around the treatment of infections such as influenza and mumps, and a perceived depopulation agenda couched in mistrust and the use of incentives and penalties to force people to accept COVID-19 vaccines. Conclusion Exploring what shapes attitudes towards vaccines in communities provides opportunities to understand the reasoning behind how people make decisions about whether to take a vaccine in different geographical and cultural spaces. The exploration of contexts, exposures and circumstances provide insights into perceptions and behaviour. Deeper engagement with local communities is crucial to develop evidence that can inform vaccine interventions. Assumptions about how culture and religion affect vaccine hesitancy or acceptance should be avoided in the process of developing such evidence. |
| format | Article |
| id | doaj-art-98f14dcce0344a55b6ae7d01f3884047 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-98f14dcce0344a55b6ae7d01f38840472025-08-20T03:40:06ZengBMCBMC Public Health1471-24582025-03-0125111310.1186/s12889-025-22181-wInfecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South AfricaKingsley Stephen Orievulu0Sally Frampton1Philippa C. Matthews2Nondumiso Mpanza3Thabisile Mjilo4Samukelisiwe Nxumalo5Joshua Hordern6Janet Seeley7Africa Health Research Institute, KwaZulu-NatalFaculty of History, University of OxfordDivision of Infection and Immunity, University College LondonAfrica Health Research Institute, KwaZulu-NatalAfrica Health Research Institute, KwaZulu-NatalAfrica Health Research Institute, KwaZulu-NatalFaculty of Theology and Religion, Harris Manchester College, University of OxfordAfrica Health Research Institute, KwaZulu-NatalAbstract Background We investigated how social and contextual factors, including a pandemic, shape vaccine perceptions and attitudes among people living in KwaZulu-Natal in South Africa. We assessed how participants’ views, acceptance, and uptake of vaccines for a range of infectious diseases, may be influenced by experiences and events linked to the COVID-19 pandemic. Methods We conducted 30 in-depth face-to-face and telephonic interviews with participants living in diverse rural and urban communities in two districts within KwaZulu-Natal. Participants were adults (≥ 18 years) consisting of ordinary citizens, traditional healers, and nurses. We combined non-representative convenience, snowballing and purposeful sampling techniques to recruit participants. Data collection was conducted in IsiZulu, and we used both inductive and deductive thematic analysis approaches to identify key themes linked to participants’ perceptions and attitudes towards vaccines. Findings Our study participants were mostly those who had accepted vaccination. The main reasons given for vaccine uptake included understanding the importance of vaccines for disease prevention and survival, and securing the health of family members, the fear of death, government campaigns, vaccine mandates and penalties. Older participants (≥ 40 years) demonstrated more positive attitudes towards vaccines. Most participants downplayed the role of culture and religion in attitudes towards vaccines. However, some of the drivers of vaccine hesitancy were having an ancestral calling, medical pluralism, or local myths around the treatment of infections such as influenza and mumps, and a perceived depopulation agenda couched in mistrust and the use of incentives and penalties to force people to accept COVID-19 vaccines. Conclusion Exploring what shapes attitudes towards vaccines in communities provides opportunities to understand the reasoning behind how people make decisions about whether to take a vaccine in different geographical and cultural spaces. The exploration of contexts, exposures and circumstances provide insights into perceptions and behaviour. Deeper engagement with local communities is crucial to develop evidence that can inform vaccine interventions. Assumptions about how culture and religion affect vaccine hesitancy or acceptance should be avoided in the process of developing such evidence.https://doi.org/10.1186/s12889-025-22181-wCOVID-19Medical pluralismPublic engagementVaccine confidenceVaccine hesitancySouth Africa |
| spellingShingle | Kingsley Stephen Orievulu Sally Frampton Philippa C. Matthews Nondumiso Mpanza Thabisile Mjilo Samukelisiwe Nxumalo Joshua Hordern Janet Seeley Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa BMC Public Health COVID-19 Medical pluralism Public engagement Vaccine confidence Vaccine hesitancy South Africa |
| title | Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa |
| title_full | Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa |
| title_fullStr | Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa |
| title_full_unstemmed | Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa |
| title_short | Infecting minds: socio-contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in KwaZulu-Natal, South Africa |
| title_sort | infecting minds socio contextual drivers of vaccine perceptions and attitudes among young and older adults living in urban and rural areas in kwazulu natal south africa |
| topic | COVID-19 Medical pluralism Public engagement Vaccine confidence Vaccine hesitancy South Africa |
| url | https://doi.org/10.1186/s12889-025-22181-w |
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