Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone
The WHO identified vaccine hesitancy as a threat to global health in 2019, but it was the COVID-19 pandemic that brought it to the fore of public discussions. Despite efforts to account for context in public health frameworks, these fail to translate into analyses that meaningfully capture the local...
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Elsevier
2025-12-01
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| Series: | SSM: Qualitative Research in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321525000691 |
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| author | Yara Alonso Abu Bakarr Jalloh Kwabena Owusu-Kyei Augustin E. Fombah Clara Menéndez Mohamed Samai Cristina Enguita-Fernàndez |
| author_facet | Yara Alonso Abu Bakarr Jalloh Kwabena Owusu-Kyei Augustin E. Fombah Clara Menéndez Mohamed Samai Cristina Enguita-Fernàndez |
| author_sort | Yara Alonso |
| collection | DOAJ |
| description | The WHO identified vaccine hesitancy as a threat to global health in 2019, but it was the COVID-19 pandemic that brought it to the fore of public discussions. Despite efforts to account for context in public health frameworks, these fail to translate into analyses that meaningfully capture the local dynamics forging vaccine hesitancy, while dominant public narratives continue to offer decontextualized and monolithic portrayals of this multifaceted phenomenon. Drawing on ethnographic insights from fieldwork conducted in northern Sierra Leone, we propose the notion of ‘social imaginaries of epidemics’ as a socio-historical lens through which to understand how people made sense of the COVID-19 pandemic and the ensuing response, thereby disentangling the shared meanings that enabled vaccine hesitancy in this setting. We do this by reconstructing three key narratives that shaped how COVID-19 was being socially imagined: epidemic memories, mistrust in the governance of epidemics, and diverging health priorities. The social imaginary of COVID-19 as a disease that was ‘deadly’, ‘harmless’, ‘invisible’ or ‘fake’ continuously shifted, yet always in dialogue with shared memories of the last Ebola epidemic. The social imaginary of the COVID-19 response was shaped by existing mistrust in the state's governance of epidemics, whereby the response was underfunded or weak as the result of the government ‘eating COVID money’ or pursuing electoral advantages. The immunisation response was socially imagined as responding to foreign instead of local priorities by disregarding food insecurity in favour of vaccines. Together, this social imaginary rendered COVID-19 vaccines useless, harmful or unimportant to many. |
| format | Article |
| id | doaj-art-48a09d76e4f34fa4b94f1b28c6f80c7f |
| institution | Matheson Library |
| issn | 2667-3215 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-48a09d76e4f34fa4b94f1b28c6f80c7f2025-06-26T09:53:43ZengElsevierSSM: Qualitative Research in Health2667-32152025-12-018100591Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra LeoneYara Alonso0Abu Bakarr Jalloh1Kwabena Owusu-Kyei2Augustin E. Fombah3Clara Menéndez4Mohamed Samai5Cristina Enguita-Fernàndez6ISGlobal, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), SpainCollege of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Sierra LeoneISGlobal, Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, SpainISGlobal, Barcelona, Spain; College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Sierra Leone; Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, SpainISGlobal, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; International Health Service, Hospital Clínic de Barcelona, Barcelona, Spain; Manhiça Health Research Center, Manhiça, MozambiqueCollege of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Sierra Leone; Ministry of Health and Sanitation, Freetown, Sierra LeoneISGlobal, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Corresponding author. Barcelona Institute for Global Health, C/ Rosselló, 132, E-08036, Barcelona, Spain.The WHO identified vaccine hesitancy as a threat to global health in 2019, but it was the COVID-19 pandemic that brought it to the fore of public discussions. Despite efforts to account for context in public health frameworks, these fail to translate into analyses that meaningfully capture the local dynamics forging vaccine hesitancy, while dominant public narratives continue to offer decontextualized and monolithic portrayals of this multifaceted phenomenon. Drawing on ethnographic insights from fieldwork conducted in northern Sierra Leone, we propose the notion of ‘social imaginaries of epidemics’ as a socio-historical lens through which to understand how people made sense of the COVID-19 pandemic and the ensuing response, thereby disentangling the shared meanings that enabled vaccine hesitancy in this setting. We do this by reconstructing three key narratives that shaped how COVID-19 was being socially imagined: epidemic memories, mistrust in the governance of epidemics, and diverging health priorities. The social imaginary of COVID-19 as a disease that was ‘deadly’, ‘harmless’, ‘invisible’ or ‘fake’ continuously shifted, yet always in dialogue with shared memories of the last Ebola epidemic. The social imaginary of the COVID-19 response was shaped by existing mistrust in the state's governance of epidemics, whereby the response was underfunded or weak as the result of the government ‘eating COVID money’ or pursuing electoral advantages. The immunisation response was socially imagined as responding to foreign instead of local priorities by disregarding food insecurity in favour of vaccines. Together, this social imaginary rendered COVID-19 vaccines useless, harmful or unimportant to many.http://www.sciencedirect.com/science/article/pii/S2667321525000691Sierra LeoneVaccine hesitancyCOVID-19EbolaSocial imaginaries |
| spellingShingle | Yara Alonso Abu Bakarr Jalloh Kwabena Owusu-Kyei Augustin E. Fombah Clara Menéndez Mohamed Samai Cristina Enguita-Fernàndez Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone SSM: Qualitative Research in Health Sierra Leone Vaccine hesitancy COVID-19 Ebola Social imaginaries |
| title | Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone |
| title_full | Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone |
| title_fullStr | Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone |
| title_full_unstemmed | Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone |
| title_short | Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone |
| title_sort | disentangling covid 19 vaccine hesitancy the role of social imaginaries of epidemics in northern sierra leone |
| topic | Sierra Leone Vaccine hesitancy COVID-19 Ebola Social imaginaries |
| url | http://www.sciencedirect.com/science/article/pii/S2667321525000691 |
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