When Information Is Not Enough: What Africa and Syria Teach Us About VaccineHesitancy
- By Dr. Tatyana El-Kour
- Sep 30
- 3 min read
Updated: 6 days ago
It was the spring of 2021, and the world was holding its breath. Vaccines had arrived, but another obstacle emerged: would people take them?
In a township outside Cape Town, South Africa, a new mural was being painted. Bold colors
stretched across a community wall: young men, strong and smiling, rolling up their sleeves for the COVID-19 vaccine. It was not just art, it was persuasion. Médecins Sans Frontières (MSF) supported these vaccination murals to specifically engage young men and youth, groups with lower vaccine uptake in the community. Within weeks, more youth began showing up at vaccination sites.
This case illustrates a vital point from my research: while syringes and cold chains mattered, it was the mural, the trust and recognition it symbolized, that nudged people into action.
What Worked in Africa: Increasing COVID-19 Vaccine Uptake
In 2022, I documented lessons from Africa and other low- and middle-income countries on what helped turn supply into jabs in arms.
The key findings were clear:
Trusted voices matter. A chief in rural Malawi, speaking directly to his people, did more to dispel myths than any nationwide campaign.
Community-led approaches are essential. Refugee health workers in Lebanon or volunteers in Kenya had far greater influence than distant officials.
Innovation drives uptake. From solar-powered cold storage to WhatsApp hotlines, technology made vaccines accessible and relatable.
Above all, success came down to one thing: trust in public health communication.
You can read the 2022 Africa Evidence Brief here
The Paradox in Syria: Informed Yet Unvaccinated
Fast forward to 2025, I co-authored a study led by my colleague @Afraa Razouk exploring
vaccine hesitancy among Syrian university students, using the 5C framework: confidence,
complacency, constraints, calculation, and collective responsibility.
The results were surprising: 64% of these highly educated students had not been vaccinated.
This was not about access. Vaccines were available, and students knew the facts. Yet:
Confidence weakened under conspiracy theories about profit motives and genetic risks.
Complacency grew among those who felt COVID-19 posed little personal danger.
Calculation backfired: the more they researched online, the less likely they were to vaccinate.
Collective responsibility (the willingness to protect others) was the strongest positive predictor of vaccination.
One Damascus student summed it up: “I know the science, but I do not trust who makes these decisions.”
Here is the paradox: informed, yet unvaccinated.
You can explore the full 2025 Syria study here.
Two Continents, One Lesson
At first glance, Africa’s murals and Syria’s lecture halls may seem worlds apart. Yet, both point to the same truth: information alone does not change behavior.
What truly matters is whether people:
Trust the messenger.
See themselves reflected in the message.
Feel part of something larger than themselves.
Community health workers and innovative campaigns fostered trust in Africa. In Syria, fractured institutions and competing narratives widened the gap between knowledge and action.
Rethinking Vaccine Hesitancy: A Human Challenge
As a media psychologist, I see vaccine hesitancy not as ignorance but as identity. People are asking themselves:
Do I trust you?
Do you respect my fears?
Does this choice honor who I am and protect those I love?
That is why effective vaccine communication must go beyond facts:
Empower trusted community leaders with evidence-based tools.
Frame vaccination as collective care, not just individual protection.
Employ innovation for storytelling, not only for logistics.
Closing the Circle
From African murals to Syrian lecture halls, the pandemic showed us that vaccines save lives only when people choose to take them. That choice is rarely about science alone. It is about trust, belonging, and the stories people tell themselves about risk, responsibility, and resilience.
As communicators and health advocates, our challenge is clear: not just to inform, but to
connect. Not just to deliver facts, but to earn trust. Because in the end, vaccines do not work until sleeves are rolled up. And that only happens when hearts and minds are reached first.
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