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Understanding the roots of vaccine fears in Africa

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One day, while I was sitting on the floor with my young classmates in primary school in rural Malawi, a group of angry parents stormed our class, brandishing panga knives, wooden sticks and an assortment of other makeshift weapons.

It was the early 2000s and my home area in southern Malawi was abuzz with rumours of ‘bloodsuckers’. According to the rumours, the vampires possessed supernatural powers and were targeting their victims to extract blood for witchcraft rituals. Word had spread that bloodsuckers were at the school. We children were sent home, while urgent meetings between the school management and the community took place.

About a decade later, the stories resurfaced, spreading from across the border in Mozambique, this time amplified by social media. Despite assurances from the police that the rumours were false, vigilantes took matters into their own hands with deadly results.

It is against this backdrop of myth and misinformation that Malawi has tried to roll out its Covid-19 vaccination campaign, and some of the same fears have resurfaced.

Last month in my home district of Mulanje, dozens of irate parents descended on a primary school after hearing that there was a stranger at the school administering vaccines. The rumour wasn’t true, but teachers locked themselves in an office as the parents demanded answers.

Vaccine uptake has been a contentious issue, not only in Malawi but across the African continent where myths and misconceptions have thrived. In my country, rumours have been wilder and more widespread in rural areas where access to verified information is limited.

Thoko Chikondi

The ministry of health earlier this year introduced the Pfizer Covid-19 vaccine in a campaign targeting schoolchildren aged 12 to 17. But vaccine hesitancy is also strong among young people, who need to seek their parents’ consent for vaccination.

By the end of January, fewer than 5,000 children had been vaccinated. To Willy Malimba, President of the Teachers Union of Malawi, this is hardly surprising. “There isn’t a school that can say the students will accept the vaccine. Once the health workers come with the vaccine, the learners are likely to run away.”

His own personal experience attests to this. When he was visiting schools on official duties, students started to run away from his vehicle, even in the cities. The teachers told him they thought he was coming with the vaccines.

The solution, according to Malimba, is to talk with community and offer them the facts around the vaccine before approaching schools.

“They should go direct to the community because these students are coming from communities where these negatives are widespread. If the community is sensitized and convinced, they will inform their children to receive the vaccine. But if they (the vaccine teams) go directly to school, it will become a problem.”

People wait for the Covid-19 vaccine at the Zingwangwa Health Centre in Blantyre, Malawi on July 28, 2021

/ Charles Pensulo

Africa is the continent least vaccinated against Covid-19, primarily due to a shortfall in supplies throughout 2021, but in part due to people’s reluctance to take up the jab.

To fully understand fears around the vaccine, we need to look deeper at the misconceptions, and better understand religious and even mystical beliefs, says Dr Chiwoza Bandawe, a clinical psychologist at Malawi’s College of Medicine.

Many people are not critically weighing up the information that has been circulating or questioning how it is sourced.

“One needs to ask, ‘Who am I hearing this from? Is this pertinent authority figure?’ – but that line of critical thinking is not there. As a result, people tend to believe anything that is thrown out there and with the social media these days, everyone is expert.

“And especially if this is captured in religious or spiritual language, mystical justifications are given why the vaccine should not be utilized,” he says.

Raising awareness about the benefits of the vaccine with real-life examples helps to convey the message, he says. “I think it’s important to share stories of people who had the vaccine, got Covid-19 but only developed mild symptoms. Stories of the people who’ve had the vaccine and are still alive and fine.”

John Lwanda, a social and medical historian who published a study on the origin of blood-sucking rumours, believes that attitudes towards vaccines in sub-Saharan Africa have historical and colonial roots.

“One reason is the experiences of some African communities of colonial authorities. Some authorities, like the French in Cameroon, forcibly treated villagers for sleeping sickness. In Nyasaland (now Malawi), some of those caught by colonial authorities practicing local forms of inoculation against smallpox were either arrested or fined.

“So the seeds of doubt against Western medical methods – already sown at the start of colonisation- were fertilised.”

Yet sub-Saharan Africa has a centuries-long history of practicing preventative medicine.

“In some ways, anti-vaccination sentiments are surprising because practices similar to vaccination have been practiced in sub-Saharan Africa for centuries. In Malawi for example, preventive medicine involved, and still involves, inoculation or variolation and scarification. Some aspects of scarification are used in the preventive fortification to ward off disease, enemies and misfortune.”

If variolation – intentionally infecting patients to give them a mild form of a disease – was accepted as a common pre-colonial practice in Africa, and persisted in some areas during the colonial era, then why the change in attitude towards vaccination now?

Getty Images

One explanation is that many fundamentalist Christian groups have adopted a stance against Covid vaccinations, according to Lwanda. Plus the “inadequate state of health services in many African states also contributes to the lack of trust in Western medicine because the majority of people still depend on traditional medicine; the Covid vaccination rates speak for themselves,” he says.

Yet, there is also progress. As the Omicron variant spreads and infections rise, more people are convinced that Covid-19 is real, and they have seen the impact historically of vaccinations against other diseases, including smallpox, measles and polio.

“That’s why (routine) immunisation uptake in Malawi is amazing because people are very practical in their thinking. We need to utilize that with Covid vaccine so that people have the same outlook,” Lwanda says.

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