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South Africa launched a mass COVID-19 vaccination campaign in May 2021, targeting 40 million adults. Understanding predictors of COVID-19 vaccine intentions was required to achieve this goal. We conducted a population-based survey in June–July 2021 using the WHO Behavioral and Social Drivers (BeSD) of COVID-19 Vaccination tool to determine predictors of vaccine hesitancy, defined as intention to refuse or uncertainty whether to accept COVID-19 vaccination. There were 1193 participants, mean age 39 (standard deviation 15) years, and 53% women, of whom 58% trusted information provided by healthcare workers and 32% were vaccine hesitant. Independent predictors of vaccine hesitancy included concerns about side effects (odds ratio (OR) 11.41; 95% confidence interval (CI) 3.5–50.80), lack of access to the online vaccine registration platform (OR 4.75; CI 2.15–10.37), distrust of government (OR 3.0; CI 1.33–6.77), belief in conspiracy theories (OR 3.01; CI 1.32–6.77), having no monthly income (OR 1.84; CI 1.12–3.07), and depending on someone else to make vaccination decision (OR 2.47; CI 1.06–5.77). We identified modifiable predictors of vaccine hesitancy at the start of South Africa’s COVID-19 vaccination rollout. These factors should be addressed by different stakeholders involved in the national immunization program through tailored communication and other effective strategies that increase vaccine literacy, reach low-income households, and engender confidence in government.

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We argue that research and practice initiatives should consider using a multidimensional perspective of parental coping that recognises the heterogeneity of mothers' coping responses. Impact statement: The current paper offers new insights into the complexities of mothers' coping responses to adolescent substance abuse.

This mini review explores the impact of the COVID-19 pandemic on adolescent sexual and reproductive health. We conducted a rapid review of the literature across three databases, with a particular focus on the African continent. Few studies have specifically focused on adolescents in Africa and this paper contributes to this paucity of research. Findings revealed the unintended consequences of the pandemic. Studies across several countries showed that the respective lockdown measures restricted adolescents' access to sexual and reproductive health services. The literature also showed increases in adolescent pregnancies during the lockdown, along with increases in reports of sexual violence against adolescents. We conclude this paper by offering recommendations to address these unintended consequences and potentially improve adolescent sexual and reproductive health in African communities.

Background South Africa has reported more than half of all COVID-19 cases and deaths in Africa. The South African government has launched a large COVID-19 immunization campaign with the goal of reaching more than 40 million individuals. Nonetheless, certain international, largely internet-based surveys have shown a significant proportion of vaccine hesitancy in South Africa. This study aims to determine and co-create with local stakeholders a comprehensive understanding of vaccine hesitancy and opportunities to support the promotion of other COVID-19 health-promoting behaviours at community level. Methods and design A mixed-methods, multiple case-study design; informed by the socio-ecological model of behaviour change. Four socio-economically diverse communities across South Africa will be selected and data collection will take place concurrently through three iterative phases. Phase 1 will provide insights into community experiences of COVID-19 (response) through desktop mapping exercises, observations, in-depth interviews, and focus group discussions (FGDs) designed as expression sessions with local stakeholders. Phase 2 will explore the extent and drivers of community acceptance of COVID-19 vaccines. This phase will comprise a quantitative survey based on WHO’s Behavioural and Social Drivers of Vaccination tool as well as further FGDs with community members. Phase 3 will involve cross-case study syntheses and presentation of findings to national role-players. Discussion This study will provide ground up, locally responsive, and timeous evidence on the factors influencing COVID-19 health-seeking behaviours to inform ongoing management and mitigation of COVID-19 in South Africa. It will also provide insights into the applicability of a novel vaccine hesitancy model in Africa.

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Decision-making has become an important component of the COVID-19 pandemic. A particular decision that we are currently presented with is whether to take up COVID-19 vaccines or not. Through the lens of autoethnography, I present my personal “vaccine decision-making” process as a social scientist who, despite having mixed emotions toward COVID-19 vaccines, made the decision to get vaccinated. Recognizing the subjective nature of my narrative, autoethnography is valuable to produce knowledge that is meaningful, evocative, and relatable to different audiences. This article thus offers valuable insights into decision-making related to COVID-19 vaccine uptake, shedding light on the importance of vaccine literacy, trust, and social responsibility in this process.