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Lesotho’s Battle Against Vaccine Hesitancy: A Tale of Misinformation and Challenges

2 February 2024 by Limpho Sello

 Est Read Time: 5 min(s) 50 sec(s)

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Health Minister Selibe Mochoboroane. Credit: Pascalinah Kabi.

Five colleagues in their early 40s gather around a table adorned with a tray of papa (a staple food in Lesotho), spinach, and grilled pork. Alongside the tray are two bottles of water and ginger drink.

Amidst their conversation, an audio message through a Whatsapp group suddenly interrupts their discussion. It was May 2020.

The voice belonged to a woman who passionately unfolded a conspiracy theory related to the Covid-19 vaccine. According to this unidentified woman, whose voice note gained traction on social media, the vaccine is purportedly part of a sinister scheme orchestrated by satanic worshippers to implant a 666 mark on people’s foreheads.

Intrigued and somewhat disturbed by the revelation, one of the men at the table was swayed by the viral voice note and adamantly refused to undergo vaccination, even as it became a mandatory requirement for every Mosotho to receive the Covid-19 vaccine.

Studies indicate that misinformation, like the one spread in the voice note, became highly evident in the perilous Covid-19 pandemic era, especially with issues related to the vaccine.

A 2021 study titled ‘Investigating Social Media Role in Crisis Communication: Case of Hoatiti News Reporting of the Covid-19 Pandemic in Lesotho,’ states, “Misinformation on the vaccine is proving to be dangerous in the unnecessary prolongation and spread of the virus because of the fragmentation effect misinformation has on societal response.”

Dr. Richard Banda, World Health Organisation (WHO) Country Representative, highlights the challenges, stating that misinformation makes it difficult for stakeholders in the health sector to “build trust and establish the facts on many health topics, particularly when it comes to vaccines.”

Lesotho grapples with vaccine hesitancy.

Persistent hesitancy towards COVID-19 vaccines has cast a long shadow. It influences, not only the adoption of life-saving COVID-19 shots, but also impacts the administration of various other vaccines meant for both children and adults.

Dr. ‘Makhoase Ranyali-Otubanjo, the Director of Primary Health at the country’s Ministry of Health, attributes this challenge to heightened misinformation. She explained, “After the introduction of Covid-19 vaccines, there was a significant amount of misinformation circulating, causing individuals to hesitate in getting vaccinated.”

Dr Ranyali-Otubanjo stresses that a significant portion of Lesotho’s population remains uninformed. She says some are hesitant towards vaccine uptake due to the spread of misinformation and myths surrounding vaccines.

Dr Ranyali-Otubanjo reveals that this poses a serious challenge to her ministry, whose mandate includes administering life-saving vaccines to Basotho.

She noted a decline in vaccine uptake during Measles and Rubella Vaccine campaigns, stating, “The challenges of misinformation are evident in the inadequate response to vaccines noted during a mid-year measles and rubella vaccination campaign in 2023.”

Ministry courts community leaders.

Dr. Ranyali-Otubanjo acknowledges a challenge within her ministry, prompting the development of a new plan. Recognising the importance of health education on vaccinations, she highlighted the need to emphasise the significance of vaccines and address misinformation surrounding them.

“To achieve this, we are going to collaborate with community leaders. Although we have already begun this initiative, the progress has been limited, demanding a greater effort to make a significant impact,” she said.

On January 24, 2024, the Ministry held an Interagency Coordinating Committee Meeting in Maseru, discussing issues around vaccine hesitancy.

“The introspection session came at a time when the Ministry of Health had already embarked on a Human Papillomavirus (HPV) vaccination campaign. The campaign run from December 2023 to January 2024. It will resume on the first week of February,” Dr Ranyali-Otubanjo said.

Health Minister, Selibe Mochoboroane, outlined efforts to intensify the HPV vaccines, including collaboration with the Ministry of Education and Training for school-based and door-to-door HPV vaccination campaigns.

Targeted beneficiaries are girls aged 9 to 18 years, with a special extension for girls between 19 and 24 years with immunocompromised or weakened immune systems. This exercise is scheduled for the first week of February 2024.

“The campaign will start in schools across Lesotho, providing a convenient and accessible venue for eligible girls to receive the HPV vaccine. We urge parents and caregivers to embrace this opportunity and ensure that the health and well-being of their daughters are protected,” Mochoboroane said.

He added, “We acknowledge the vulnerabilities faced by immunocompromised girls. Hence, extending the vaccination age up to 24 years for this group is a testament to our commitment to leaving no one behind.”

Dr. Banda believes the outcomes of the January 24 interagency meeting will lead to a situation where no woman or girl dies of cervical cancer.

Fact-checking as a catalyst for vaccine uptake

The authors of the study titled ‘Investigating Social Media Role in Crisis Communication: Case of Hoatiti News Reporting of the Covid-19 Pandemic in Lesotho’ argue that news authenticity can be established even with social media news to mitigate the spread of misinformation.

The study highlights, “Fact-checking can reduce the spread of fake news (Chung and Kim, 2020), especially when, after fact-checking, one exposes the article as fake news.”

It encourages individuals to exercise caution. “When reading a story and you sense that something is not right about the story, search around different news websites for the story, or simply visit the readers’ comments section of the story, and you will get indicators that the story is authentic or disinformation.”

Furthermore, the study suggests that, “More Google searches around the story will lead you to unravel the true details of a story that will authenticate or prove an article to be fake.”

In another study titled ‘Exploring Health Communication: Case of Lesotho in the Face of the COVID-19 Pandemic,’ a recommendation is made for the Lesotho government to implement an aggressive communication campaign on all media platforms.

These platforms, according to the study, should encompass mainstream channels such as television, radio, and newspapers, as well as social media platforms like WhatsApp, Facebook, Twitter, etc.

The government is also advised to distribute flyers, stickers, billboards, on t-shirts, hats all over the country as part of an aggressive communication strategy to counter misinformation around the COVID-19 vaccine.

The study further advocates for the use of door-to-door campaigns by health workers to educate citizens about the virus.

“Rural communities to be targeted by health personnel through distribution of flyers from the air, door to door campaigns by health personnel on horseback or with cars with public address systems blasting the messages to the citizens day and night for a sustained period,” reads the study.

Learning from China’s approach

According to Nour Mheidly and Jawad Fares, authors of ‘Leveraging Media and Health Communication Strategies to Overcome the Covid-19 Infodemic,’ media serves as a potent avenue for the dissemination of wellness education.

The duo emphasises that media plays a fundamental role in the public response to a pandemic, acting as a crucial communication portal between governments, health institutions, and the public.

“The ‘invisible’ nature of pandemics dictates an important role for media as the ‘eye’ of the public. Media channels become windows through which the public looks for accurate information, scientific sound facts, government decisions, and reactions of the general public,” states the study.

It further adds, “Media’s effectiveness in health communication lies in strong written, verbal, and visual communication strategies that can impact public views and perceptions.”

Interestingly, in China, the origin of COVID-19, the infodemic around the disease and vaccination was successfully contained. The study notes, “An analysis of Chinese newspapers, social media content, and other digital platform data found that a unique combination of strong governance, strict regulation, strong community vigilance and citizen participation, and wise use of big data and digital technologies were key factors in China’s efforts to combat this virus.”

The study recommends that health communication specialists adopt a 12-item Infodemic Response Checklist (IRC) as a comprehensive tool to overcome the challenges posed by infodemics. This includes providing more exposure and airtime for medical professionals, scientists, and public health personnel to offer authentic, useful, and transparent information for the public.

By implementing such measures, individuals like the man at the beginning of this story, who believed a viral voice note perpetuating myths around the COVID-19 vaccine, could potentially still be alive.

Reflecting on this, Relebohile Sehapi remarks, “Our friend would not have died if authentic messages were easily accessible, same as that woman’s voice note was easily accessible on our fingertips.”

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