Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study

IntroductionDuring the pre-pandemic era, negative vaccine sentiments did not feature in South African publications reporting on infant vaccination uptake. In contrast, vaccine hesitancy is an established driver of suboptimal COVID-19 vaccine uptake in South Africa, suggesting that the COVID-19 pande...

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Main Authors: Michelle M. Matsangaise, Rosemary J. Burnett, Zeenat Ismail, Johanna C. Meyer
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1578992/full
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author Michelle M. Matsangaise
Rosemary J. Burnett
Rosemary J. Burnett
Rosemary J. Burnett
Zeenat Ismail
Zeenat Ismail
Johanna C. Meyer
Johanna C. Meyer
author_facet Michelle M. Matsangaise
Rosemary J. Burnett
Rosemary J. Burnett
Rosemary J. Burnett
Zeenat Ismail
Zeenat Ismail
Johanna C. Meyer
Johanna C. Meyer
author_sort Michelle M. Matsangaise
collection DOAJ
description IntroductionDuring the pre-pandemic era, negative vaccine sentiments did not feature in South African publications reporting on infant vaccination uptake. In contrast, vaccine hesitancy is an established driver of suboptimal COVID-19 vaccine uptake in South Africa, suggesting that the COVID-19 pandemic increased vaccine hesitancy in South Africa. This study used data from a social media tracking project to investigate vaccine sentiment expressed on South African social media platforms in the pre-pandemic era.MethodsThis mixed-methods study analysed South African social media [Twitter (now X); online news forums; microblogs] posts mentioning vaccine-related words from 1 December 2016–31 May 2017. Content analysis was used to assign vaccine sentiment, and thereafter a step-wise thematic content analysis of negative sentiment posts was conducted using NVivo12®.ResultsOf 10,997 posts about human vaccines, 16.2% expressed negative vaccine sentiments. Specific vaccines were discussed in 35.9% of posts, with human papillomavirus (HPV) vaccines attracting the most negative sentiments (31.9% of all negative posts). The majority of negative posts included links to articles emanating from other countries, predominantly the USA. Five themes were identified: Vaccine safety; autism; vaccine effectiveness; conspiracy theories; and philosophical/religious objections.DiscussionRelatively high levels of pre-existing negative sentiments toward vaccines were expressed in the pre-pandemic era, with HPV vaccines attracting the most negative comments. These results provide a baseline for comparison to post-pandemic social media studies and may prove useful for measuring the impact in South Africa of global policies introduced to limit the spread of vaccine mis- and disinformation.
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spelling doaj-art-cb340392cd0149d3a2af9de36a0f52aa2025-08-20T02:00:55ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-05-01510.3389/frhs.2025.15789921578992Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods studyMichelle M. Matsangaise0Rosemary J. Burnett1Rosemary J. Burnett2Rosemary J. Burnett3Zeenat Ismail4Zeenat Ismail5Johanna C. Meyer6Johanna C. Meyer7Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South AfricaDepartment of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South AfricaSouth African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South AfricaDepartment of Virology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa,Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South AfricaSouth African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South AfricaDepartment of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South AfricaSouth African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South AfricaIntroductionDuring the pre-pandemic era, negative vaccine sentiments did not feature in South African publications reporting on infant vaccination uptake. In contrast, vaccine hesitancy is an established driver of suboptimal COVID-19 vaccine uptake in South Africa, suggesting that the COVID-19 pandemic increased vaccine hesitancy in South Africa. This study used data from a social media tracking project to investigate vaccine sentiment expressed on South African social media platforms in the pre-pandemic era.MethodsThis mixed-methods study analysed South African social media [Twitter (now X); online news forums; microblogs] posts mentioning vaccine-related words from 1 December 2016–31 May 2017. Content analysis was used to assign vaccine sentiment, and thereafter a step-wise thematic content analysis of negative sentiment posts was conducted using NVivo12®.ResultsOf 10,997 posts about human vaccines, 16.2% expressed negative vaccine sentiments. Specific vaccines were discussed in 35.9% of posts, with human papillomavirus (HPV) vaccines attracting the most negative sentiments (31.9% of all negative posts). The majority of negative posts included links to articles emanating from other countries, predominantly the USA. Five themes were identified: Vaccine safety; autism; vaccine effectiveness; conspiracy theories; and philosophical/religious objections.DiscussionRelatively high levels of pre-existing negative sentiments toward vaccines were expressed in the pre-pandemic era, with HPV vaccines attracting the most negative comments. These results provide a baseline for comparison to post-pandemic social media studies and may prove useful for measuring the impact in South Africa of global policies introduced to limit the spread of vaccine mis- and disinformation.https://www.frontiersin.org/articles/10.3389/frhs.2025.1578992/fullSouth Africavaccine hesitancyvaccine sentimentssocial mediapre-pandemichuman papillomavirus
spellingShingle Michelle M. Matsangaise
Rosemary J. Burnett
Rosemary J. Burnett
Rosemary J. Burnett
Zeenat Ismail
Zeenat Ismail
Johanna C. Meyer
Johanna C. Meyer
Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
Frontiers in Health Services
South Africa
vaccine hesitancy
vaccine sentiments
social media
pre-pandemic
human papillomavirus
title Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
title_full Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
title_fullStr Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
title_full_unstemmed Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
title_short Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study
title_sort negative vaccine sentiments on south african social media platforms before the covid 19 pandemic a mixed methods study
topic South Africa
vaccine hesitancy
vaccine sentiments
social media
pre-pandemic
human papillomavirus
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1578992/full
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