At the very mention of the word “vaccine”, 82-year-old Josefine Hlomuka vehemently shook her head, her face clouding with worry as she gazed at the storm bearing down on her home in the Johannesburg township of Soweto.
“We don’t trust,” whispered the former peanut seller, haunted by the four decades she spent under apartheid.
White-minority rule was swept away a generation ago but faith in South Africa’s government today, its reputation undermined by corruption and incompetence, is poor.
Such deep-rooted distrust, say experts, lies behind vaccine scepticism that has flared since coronavirus hit the country last March.
Vaccine hesitancy is growing, even as leaders prepare a mammoth inoculation campaign set to begin this month.
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The country hit hardest in Africa by the coronavirus aims to vaccinate around two-thirds of its 60 million-strong population by the end of 2021.
But fears span generations in Soweto’s White City neighbourhood, where iron-domed roofs recall a time when the area hosted military barracks.
“I saw (online that) people are getting injected but they die,” said Soweto-raised Tshegofatso Mdluli, 22, flashing two gold front teeth.
“What if most people get a third-grade kind of vaccine?” fretted Mbali Tshabalala, 35, sitting outside the terracotta walls of her home. “It gives me sleepless nights.”
Scepticism and suspicion have fed into a flurry of unsubstantiated conspiracy theories about the coronavirus pandemic.
“So-called rumours and myths have a basis in real anxieties,” said Helen Schneider, a professor of public health at the University of the Western Cape.
And those anxieties in turn stem from “very concrete experiences,” she said.
She pointed to the evidence of a secret apartheid-era chemical warfare programme in the 1980s to develop injections to curb the fertility of black citizens.
The head of that programme, cardiologist Wouter Basson — dubbed “Dr Death” — came back to haunt the public psyche last month.
It emerged he was still practising at private clinics, sparking outrage on social media.
Similar suspicions played out during the rollout of HIV treatment in the early 2000s.
“The end of apartheid was not far away, so you can easily imagine the parallels,” said Doctors Without Borders veteran Eric Goemaere, recalling efforts to curb AIDS in Cape Town’s Khayelitsha township.
“(Many thought) white people… invented something new to dominate (and) control.”
‘Don’t believe WhatsApp’
Public officials were trying to cut through misinformation long before South Africa’s first batch of vaccines arrived on Monday.
“False information and fake news can and does put lives at risk,” President Cyril Ramaphosa wrote in a weekly letter to the nation last month.
“We all need to work together to build confidence in the vaccine.”
In a public webinar on vaccines hosted by the health ministry last week, microbiologist Koleka Mlisana urged listeners not to believe “everything you read in WhatsApp messages.”
Tackling widely-disseminated stories one by one, she said “there are no microchips or tracking devices in vaccine bottles” and that “no vaccine will alter the DNA,” before using global death figures to debunk a relatively common belief that the jabs are a ploy to “destroy Africans.”
One January poll by Ipsos found that only 51 percent of South Africans would agree to get a coronavirus vaccine — a 17 percent drop since October.
But another survey by the University of Johannesburg (UJ) suggested 67 percent of respondents were willing.
“Most South Africans generally do have positive attitudes to vaccinations,” noted Sara Cooper, a senior scientist at the South African Medical Research Council.
Nevertheless, “the problem with vaccine hesitancy is that even small amounts can have big effects.”
‘They lie to us’
Not all of South Africa’s uncertainty hinges on conspiracy theories.
In fact, the UJ survey found that around half the 18 percent of respondents refusing to take the vaccine cited plots as the reason.
“They do play a role,” Cooper said. “But there are more complex issues that receive less attention in the media that also play a big part.”
Just as when AIDS was first spreading, civil society has pitched in alongside government to try to disseminate accurate information about coronavirus and upcoming vaccines.
Public figures such as anti-apartheid icon Desmond Tutu and opposition leader Julius Malema have also said they will get vaccinated.
But “there is a problem with top-down information,” said Mocke Jansen Van Veuren, running a coronavirus workshop one rainy morning at a community hall in Soweto’s impoverished Kliptown suburb, where anger towards the government repeatedly surfaced.
“Government is a suspicious source, unfortunately — they lie to us about a lot of things.”
Local distrust has also been compounded by global wariness over the speed at which pharmaceutical companies have developed and marketed their vaccines.
In the meantime, apartheid continues to cast a long, dark shadow.
“Black people and coloured people suffer from PTSD (trauma),” said one workshop participant, standing up to interrupt a presentation on coronavirus prevention.
“That is something the government is not even considering.”