Officials in KwaZulu-Natal are worried about the slow vaccination uptake in the province as the country battles a fourth wave of Covid-19, particularly in townships and rural areas, in contrast with white, Indian and coloured communities, according to KZN health MEC Nomagugu Simelane-Zulu.

Only 25% of South Africa’s population has been fully vaccinated since phase one of the inoculation campaign began on 17 February 2021, during which health workers received the Johnson & Johnson jab. By 22 November 2021, close to 24.75 million vaccine doses had been given countrywide. 

The government and eThekwini municipality have put up billboards in Durban to encourage people to be vaccinated against Covid-19. (Photo: Phumlani Thabethe)

The programme had a rough start as health authorities said the Beta variant (B.1.351 or 501Y.V2) was resistant to the AstraZeneca/Oxford shot. 

Gauteng has the highest number of fully vaccinated citizens (6.69 million), followed by the Western Cape (4.05 million) and KZN (3.8 million).

Gauteng is the most populous province (about 15 million), and KZN the second-most (an estimated 11.3 million, or 19.2% of the country’s total).

The vaccine uptake is highest in southern KZN — areas such as Port Shepstone, Harding and Kokstad — and lowest in the far north region of Umkhanyakude, including the towns of Jozini, Manguzi and Mtubatuba.

KZN health officials have begun engaging councillors, izinduna (headmen), amakhosi (traditional chiefs) and celebrities to help spread the “vaccination message” and counter widespread “myths” about the vaccine and other Covid-19 “propaganda”.

Vaxing the undocumented and the homeless

People were reluctant to be photographed at the Dennis Hurley Centre in the Durban CBD as they lined up to be vaccinated against Covid-19. (Photo: Phumlani Thabethe)

At the Denis Hurley Centre in Durban’s CBD, where undocumented South Africans and foreigners can get their jabs, many of those in line were reluctant to be interviewed, perhaps feeling it was an intrusion or could put them at risk. 

A 34-year-old Democratic Republic of the Congo man said he had come all the way from Eshowe on the north coast where he works as a barber, because he had tried other vaccination centres where he was told he had to produce a South African ID or a passport.

“I felt that I had to vaccinate because I meet a lot of customers who don’t use masks when they come to cut or trim their hair. I have issues with my documents at the moment. But I said I must vaccinate while I wait for these documents to be sorted out,” he said.

Townships and rural areas

Thobile Nambika (52) was in a cheerful mood when she arrived to be vaccinated at the Umlazi D section clinic, south of Durban. (Photo: Phumlani Thabethe)

At the eThekwini Municipality-run clinic in Umlazi’s D section we met Thobile Nombika (52), an unemployed woman waiting in the vaccination queue. She had decided to get the jab “to protect myself, my children, my grandchildren and my community. In my community, some are vaccinated, others are scared of vaccinating. There are lots of stories going around; others say once you vaccinate you become a cannibal, others tell you once you vaccinate you will die, others say once you vaccinate you lose your libido and don’t have sex. There are just too many stories.”

People line up at the Umlazi D section clinic for their Covid-19 vaccinations. (Photo: Phumlani Thabethe)

Sanele Mhlongo, a 23-year-old retail store worker who lives in the informal settlement across the road from the clinic, said he had not been vaccinated and didn’t see the need to.

“I will only vaccinate if they say at work that vaccinating is mandatory. Personally, I don’t see the point of vaccinating because I know of so many people who die despite vaccinating. I went to a funeral of one 72-year-old woman who died just after getting vaccinated. I believe that Covid-19 exists but some of the government messaging around it is unbelievable.”

Albertina Hadebe (58) shows her vaccination card after she had her jab at the Umlazi D section clinic south of Durban. She said her trust was also in Jesus with regard to the coronavirus. (Photo: Phumlani Thabethe)

Albertina Hadebe (58) told us she had her second Pfizer jab after the government’s call for more people to be vaccinated.

“Many people in my neighbourhood don’t want to vaccinate. They say they doubt the efficacy of the vaccines, they say they are scared of dying after vaccinating, others say so many other things for reasons they are not vaccinating,” she said.

People line up at the Umlazi D section clinic for their Covid-19 vaccination. (Photo: Phumlani Thabethe)

In the Nsimbini area of Mbumbulu, a semi-rural area about 30km south of Durban, three community health workers explained the difficulty of getting people to the local Nsimbini Clinic to be vaccinated.

Earlier in 2021, “we were tasked with going out to homes in the community to get the over-60 population — mkhulus and the gogos — to come and vaccinate,” said one of the health workers, who did not want to be named because they were not allowed to speak to the media.

From left: Outside the clinic in Umlazi D Section, Kwazi Ndebele (25) and his friend Sanele Mhlongo (23) say they will not be vaccinated. (Photo: Phumlani Thabethe)

Disinformation also included that the aim of the vaccines was to decrease the world’s poor population, especially in Africa, that they alter DNA in the nucleus or turn you into a zombie.

“Some people slammed doors on our faces, accusing us of wanting to kill them, accusing us of working with Ramaphosa and his friends overseas to inject and kill them,” she said.

Her colleague agreed: “Some people in the community have been vaccinated and nothing has happened to them. But still, attitudes have not changed much. You still get people spreading false information about the vaccine. Some of the young people who had been hesitant to take vaccines are starting to come to the clinic to vaccinate. They say they are compelled to do so in their workplaces or they will lose their jobs.”

Mbusi Ngwane (left) and his friend Sboniso Maphumulo from Folweni, south of Durban, say they are not convinced about being vaccinated. (Photo: Phumlani Thabethe)

Mbusi Ngwane (23) and Sboniso Maphumulo (22) said they are proudly unvaccinated.

“I believe that the current vaccination effort is a trial and they (the scientists) want to find out how vaccination affects people. I will not participate in a human vaccination trial. I will not vaccinate until I am sure that once you are vaccinated you don’t get Covid-19. At the moment, vaccinating doesn’t make sense to me. It is like saying use a condom but you could still get HIV and STI even if you are using condom,” said Ngwane

There are few people in the vaccination area at the Clermont clinic, west of Durban. (Photo: Phumlani Thabethe)

In Clermont, a bustling township about 24km west of Durban, several people were queueing for the jab at a clinic. A senior nurse said that, on average, they vaccinated about 48 people daily. She was pleading with people who were in the clinic for other reasons, to consider vaccinating.

Street vendors Manaka Mnguni (left) and Noluthando Pheteto say they have been vaccinated to protect themselves against Covid-19. They trade outside the clinic in Clermont, west of Durban. (Photo: Phumlani Thabethe)

Outside, Noluthando Phathela (36) and Manaka Mnguni (40) were hawking fruit, sweets, cakes, biscuits, chips and other items. Phathela said she had her first Pfizer jab in August and the second in October. “I decided to do it because I meet a lot of people here. I saw many people were getting vaccinated and nothing was happening to them, going about their life normally, so I said, ‘heck, let me do it, too’.”

‘I cannot afford to travel to vaccinate’

Thami Bhengu, a 36-year-old unemployed man from KwaNyuswa, a peri-urban area about 41km west of Durban, said he had not been vaccinated because the closest vaccination site was about 6km away, at the Valley Trust clinic.

“I have to pay R20 to and come back from the clinic. Where will I get this money? As you can see I am unemployed. They (the government) should bring vaccination closer to us, close to the communities,” he said.

Zodwa Dlamini (28) from Umlazi, south of Durban, says she is waiting to have her second jab in January 2022. (Photo: Phumlani Thabethe)

Mbusi Ngwane, (23), from the Gulube area in Mid Illovo, a rural area about 83km southwest of Durban, said he would only vaccinate if he was looking for work or was not allowed into places without a vaccination certificate.

“I am very sceptical about vaccination at the moment because, in my opinion, vaccination at the moment is at a trial level. I have known some people who had been vaccinated but they still died,” he said.

David Harrison, CEO of the DG Murray Trust who leads a cross-sectoral demand acceleration strategy mandated by the National Department of Health in support of the national vaccination effort, said more than 23 million adult people are yet to be vaccinated in South Africa.

The slow uptake was evident in townships and rural areas countrywide, but was magnified in KZN: “When the vaccination programme started, KZN began at the same time like other provinces, but in KZN it stagnated. This could be linked to people using the programme, especially refusing to vaccinate, as some form of protest against authority.

“Some people, especially in poor areas, see Covid-19 as one of the threats to life like crime, HIV, poverty, compared with people who live in suburban areas who see Covid-19 as the main threat to their lives and therefore they are vaccinating in numbers. So there are many more people who are angry and hungry, who are saying they want jobs before jabs.”

Harrison said the government should consider incentivising vaccination.

“They should consider buying airtime or other things for people coming forward to vaccinate.” The R200 Vooma vaccination voucher aimed at over-50s was becoming increasingly popular.

Ntokozo Maphisa, spokesperson for KZN health MEC Nomagugu Simelane-Zulu, said they worried about KZN’s vaccination numbers, especially in townships and rural areas where most black Africans live. The MEC had launched the #SpreadFactsNotFear# programme to counter misinformation.

“The MEC and KZN department of health officials are working with councillors, with traditional leaders like amakhosi and izinduna, with celebrities and other stakeholders, to take the vaccination campaign to township and rural areas. The message is that ‘we must all speak with one voice and counter the myths spread in our communities about vaccination’. The MEC has been saying we have to turn this tide and pick up vaccination figures in KZN.” DM

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