Why the vaccination rates dividing Europe are a symptom of a bigger problem

Article by Lea Schiller

In the beginning of November, the World Health Organisation (WHO) warned that Europe had once again become the epicentre of the pandemic – Case numbers and deaths had soared to record highs in Germany, the Netherlands, Greece and all over Eastern Europe (BBC, 2021). The continent as a whole hit its highest weekly increase in Covid cases since the start of the pandemic that same week (UN, 2021). This development comes at a time when all residents of the EU are eligible to get vaccinated, and many also have access to booster shots. While some member states such as Spain and Malta have vaccinated over 80% of their population (Reuters, n.d.), vaccine hesitancy is widespread in Eastern Europe, where vaccination rates are as low as 40% of the population, as well as some parts of Western Europe. These sharp differences point to structural differences in public trust in healthcare systems which urgently need to be addressed.

Across Eastern Europe, vaccine hesitancy has a common denominator: distrust in the government. For countries who transitioned to democracy from communist rule only a few decades ago, trust in public institutions is still eroded (Laizans & Tsolova, 2021). As it is, the sharp divide in vaccination rates lies exactly where the iron curtain used to split Europe (Kottasová, 2021). And those who do turn to the state for guidance receive contradicting information – some politicians caution against the vaccine (Higgins, 2021). Instead of the state or the healthcare system, many citizens instead place their trust in religious leaders, particularly in rural areas. In Romania, where the Orthodox Church is the second most trusted institution, its leaders have sent mixed signals to the public (Higgins, 2021). Some have called on Romanians to listen to doctors, while others urged people not to be scared of Covid and even denounced the vaccine as the devil’s work (Higgins, 2021). Additionally, political instability is impacting the governments’ ability to respond to the situation, and exacerbating the lack of trust among the population. Bulgaria, for example, held three elections in 2021, after the first two ended in a stalemate (Kottasová, 2021). All these deep-seated issues do not divide the people along partisan lines but make them distrustful of politicians as a whole, which makes the vaccination campaign in Eastern Europe complex and difficult to speed up.

But Eastern Europe is not the only region in the bloc struggling with vaccine hesitancy. In Western European countries such as Germany and the Netherlands, the vaccination campaign stagnated for several weeks, and incentives like entry restrictions for the unvaccinated yielded little uptake in the number of first doses administered. This development should not be a surprise – after all, even before the pandemic began, Europe had been one of the most vaccine-hesitant regions in the world (Skapinker, 2019). Several causes of this have been proposed by researchers: some point to the rise of social media and misinformation, others to the vaccination campaign during the 2009 influenza pandemic, which many believed was an overreaction supported by pharmaceutical companies (Skapinker, 2019). Experts from Spain, which has one of the highest COVID-19 vaccination rates in Europe, have also pointed out that the structure of healthcare systems may also be to blame (Amiel, 2021). Many European countries have a mix of public and private healthcare. This means a division of access to healthcare into two different groups, which is likely to alienate people who are already sceptical about putting trust in vaccines. These structural problems have been present for much longer than COVID-19 has, and are thus not easily negated by material incentives or vaccination-dependent restrictions.

For a long time, vaccine hesitancy in Europe has been an underlying problem, too controversial to be properly addressed and not urgent enough for the population to realise the danger stemming from this phenomenon. The pandemic has shown Europe’s high vaccine hesitancy rates for what they are: an emergency. And while it is important to increase the COVID-19 vaccination rates in Europe as quickly as possible, the next pandemic will push the continent into a similar situation if the structural causes of vaccination hesitancy are not addressed.

blue and white plastic bottle
Picture by Daniel Schludi published on Unsplash


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BBC (2021, November 5). Covid: WHO warns Europe once again at epicentre of pandemic. Retrieved from: https://www.bbc.com/news/world-europe-59160525

Higgins, A. (2021, November 8). In Romania, hard-hit by Covid, doctors fight vaccine refusal. The New York Times. Retrieved from: https://www.nytimes.com/2021/11/08/world/europe/romania-covid-vaccine-refusal.html

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