Regional and Temporal Patterns of COVID-19 Vaccine Misinformation in Sub-Saharan Africa
Journal:
medRxiv
Published Date:
Aug 7, 2026
Abstract
BackgroundDespite a global rollout of COVID-19 vaccines, Sub-Saharan Africa lagged behind other regions in vaccination coverage, driven primarily by inequitable vaccine distribution and affordability barriers. Compounding this gap, COVID-19 vaccine hesitancy, fueled by concerns about side effects, distrust in institutions, and misinformation circulating on social media platforms like Twitter, further suppressed uptake even where vaccines were available.
MethodsWe collected, preprocessed, and geolocated 6,305,628 tweets related to COVID-19 vaccination from Sub-Saharan Africa, and used a validated LLM-based classification framework to identify 1,312,969 tweets containing misinformation. We characterized the relationship between vaccine topics and misinformation prevalence, its variation over time, and its distribution across income-based and sub-regional country clusters.
ResultsMisinformation-associated discourse centered on vaccine safety concerns, institutional distrust, and opposition to mandates. Sub-regional clustering revealed far more discourse variation (87 of 100 topics) than income-based clustering (7 of 100 topics), a pattern robust to excluding each regions or clusters highest-volume country, with misinformation prevalence highest in Southern Africa and higher-income countries. Eastern and Western Africas discourse was largely implementation-focused, while Southern and Central Africas was more skepticism- and conspiracy-driven. Misinformation prevalence rose sharply around the introduction of vaccine mandates in late 2021 and remained elevated despite declining discourse volume.
ConclusionsThese findings suggest that counter-misinformation strategies in Sub-Saharan Africa should be regionally tailored rather than uniform, and that public health communication should extend well beyond the rollout period, particularly after contentious policy decisions such as mandates, when misinformation appears to become more entrenched.
