‘I do not trust Edgar Lungu’s government, we will see after the elections’: COVID-19 and vaccine hesitancy in Zambia

The novel corona virus - COVID-19, has had varied yet devastating effects on wellbeing across the globe. In low-income countries where health systems are already under extreme pressure from a double disease burden and livelihoods are threatened by increasing inequality, and vulnerability to social risks amidst weak social protection systems, the effects of the pandemic on wellbeing have been even more deleterious. Within this context, scholars argue that achieving maximum vaccination rates alongside prevention strategies such as quarantines for patients and spatial lockdowns of hotspot areas are the best forms of pandemic response. Despite this recognition ‘vaccine nationalism’ has defined the global pandemic response, exposing structural inequity between low- and high-income countries leading to dismal availability of vaccines in low- income countries. In the Zambian case, a low vaccination rate has been linked to anecdotal evidence of vaccine hesitancy among citizens. This paper examines this phenomenon, to explain why vaccine uptake is low in Zambia through an interpretive comparative case study methodology of five districts across rural and urban Zambia. It argues that comparatively lower infection rates, misinformation about COVID – 19 significantly affect vaccine behaviour but more importantly lack of ‘public trust’ in political elites and by extension the government and national health system as well as overly technical campaign messaging explain the negative public attitudes and behaviours towards vaccination. Broadly, it points to the greater role of generalised trust as a currency for mobilising public support in emergency pandemic response.