Misinformation has been identified as a major threat to public confidence in vaccines, particularly during epidemics. As a response, social listening has become a popular and heuristic public health tool for detecting misinformation and adapting vaccine communication. In this article, we take a critical stance on the normalised approach to social listening which solely relies on the analysis of online discourses. We highlight that the current social listening paradigm inherited a reductionist and utilitarian approach from commercial marketing that struggles to grasp – and even misrepresents – the complexity of health-related perceptions and knowledge. This study draws from online COVID-19 vaccines discourses in Guinea and ethnographic fieldwork among Guinean healthcare workers. While the online social listening showcased a predominance of individual and collective safety concerns, distrust towards African elites and Western actors, fieldwork revealed that healthcare workers’ vaccine perceptions were more nuanced and largely shaped by complex kinship relations spanning across online and offline social landscapes. Furthermore, healthcare workers often displayed frontstage and backstage vaccine discourses, their vaccines related representations and claims could evolve depending on the context of enunciation. We advocate for grounding social listening in global health to avoid disconnection from the public. Failure to accomplish this could result in a detached and hegemonic form of ‘social hearing’, rather than authentic social listening. In light of this, the transdisciplinary methodology exemplified in this paper represents one possible solution.