Are myths about infertility fueling vaccine hesitancy in Malawi?

Though 23-year-old Memory Nkosi knows that COVID-19 is real, she has not yet taken the vaccine against it. Despite the massive civic education campaigns on the benefits of getting vaccinated, the mother of two has been hesitant to get the jab because of the misinformation surrounding the vaccines.

As a member of a Pentecostal church, Nkosi has been made to believe that COVID-19 and its vaccines are from “the devil and his underworld,” she also believes that vaccination could affect her ability to bear children.

“I am still young and I only have two children, I wouldn’t risk losing my fertility,” she told Devex. “After all, these vaccines are from the devil.”

Nkosi is not alone in thinking that COVID-19 vaccination has negative effects on a woman’s fertility. Her friend Lucy Phiri — who has already taken the single-dose Johnson & Johnson vaccine — said many women from her community in Lilongwe, have refused to take the vaccine because of the widespread rumors that suggest getting vaccinated for COVID-19 could lead to infertility.

“When I was going for vaccination, most of my friends discouraged me on the grounds that I would, in the end, become infertile, my argument then was that I would rather become infertile than die and leave behind my three children,” Phiri said. Incidentally, Phiri is now expecting her fourth child. She said her friends were shocked by her pregnancy.

A recent study by CARE International indicates that women from low-income countries have unequal access to COVID-19 vaccines. While the reasons for the inequality vary from country to country, in Malawi the findings suggest the inequality may be influenced by a lack of trust in the vaccines.

The study found that women were less likely to trust the COVID-19 vaccine out of fears about fertility. In one Malawian district, researchers found that women were four times less likely to trust the vaccine compared to men.

Christina Wegs, CARE International’s head of health advocacy, said in a press statement that the findings were a reversal of what is happening in high-income countries where there have been slightly more women getting vaccinated and high hesitancy among men.

Patience Mgoli Mwale, CARE Malawi’s health specialist, said the hesitancy was driven by fears that instead of being vaccinated against COVID-19, the women believe that they will be unknowingly forced to receive contraceptives. This assumption was driven by the fact that the most commonly accessed types of contraception are injectables such as Depo-Provera and Sayana Press.

“This comes on top of misinformation already circulating that COVID-19 vaccines are a way of sterilizing women and that by getting the vaccine they may also be forced to engage in a family planning method that they do not desire and that might cause them to lose their fertility,” said Mgoli Mwale.

She said CARE is currently in the process of establishing a toll-free line where people can call in to ask questions about COVID-19 vaccines in a bid to deal with rumor tracking as it happens.

Gama Petulo Bandawe, the head of the department of biological sciences at the Malawi University of Science and Technology, said though there is no established connection between taking the COVID-19 vaccine and loss of fertility in women, there have always been conspiracy theories surrounding vaccines where the locals allege vaccines are one way to limit population growth.

“All matters relating to information around COVID-19 basically needs intense level of information output from government and other organizations to drown the misinformation that is being circulated as well as to actively seek out and punish those spreading disinformation for their benefit,” he said.

People that have already received COVID-19 vaccination could also be good agents of change to ensure that people have access to the right information so that they can make responsible decisions pertaining to COVID-19 vaccination, said Adamson Muula, a public health professor at Kamuzu University of Health Sciences.

Malawi has administered about 1.4 million COVID-19 vaccine doses; roughly 3.11% of the country’s population is fully vaccinated.

“Recognition that sometimes, myth creators are not really people that are against vaccines is the first step in debugging the myths as oftentimes the people that create the myths don’t have better ways of asking questions and addressing their fears,” he said.

Mary Shawa, a senior public health specialist at Plan International Malawi, said there is a need to equip people with adequate information as vaccine hesitancy was a result of people not having enough information, and as a result, they were developing their own answers to difficult questions.

“Sadly, people in rural Malawi do not have adequate information on comprehensive sexuality and family planning, including how vaccines work,” she said.