A thematic analysis of South African opinions about COVID-19 vaccination on Twitter

Vaccine hesitancy is a public health concern in South Africa and internationally. Literature on vaccine hesitancy associates this with mistrust of the government. We present a qualitative analysis of opinions about COVID-19 vaccination expressed by South African Twitter (now X) users during the first year of the vaccine rollout in South Africa. We conducted a thematic analysis of 800 randomly selected tweets containing vaccine-related keywords, sampled from four time periods in 2021. We categorised comprehensible South African non-news tweets as pro-vaccination (24.75% of sample), anti-vaccination (20.25%) or ambivalent (4.5%), and then identified themes. Among pro-vaccination tweets, the most common themes were criticism of the government’s handling of vaccine procurement and the rollout; concerns that the vaccine was urgently needed and/or not being made available fast enough; and statements that vaccines were safe and/or effective against COVID-19. Among anti-vaccination tweets, the most common themes were claims that the vaccine was harmful or too risky; suspicion of the government’s intentions with respect to the vaccine it was offering the public; and opposition to mandatory or ‘forced’ vaccination. Criticism and mistrust of the government were present among both pro- and anti-vaccination tweets, though for different reasons. We discuss this in light of literature recommending trust-building as a response to vaccine hesitancy.