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Europe's Deadly Cocktail Of Bad Policy And Vaccine Hesitancy

If you compare vaccination rates in European countries, you immediately notice huge differences. And this is despite the fact that the EU has provided all members with sufficient coverage. There are clear reasons of culture, history and attitudes for the gap.

Europe's Deadly Cocktail Of Bad Policy And Vaccine Hesitancy

Germany is not among the rapidly vaccinating countries of the West

Melanie Loos


BERLIN — The next wave of infection is rolling into Europe. Some countries, including Germany, are already in the middle of it. The differences are considerable: While the situation in some Western European countries, such as Spain, Italy or Portugal, is still relaxed with comparatively low numbers of COVID, the situation in Eastern Europe is quite different.

There, infections have been rising rapidly for the past several weeks. Some countries have even recorded significantly more COVID-19 cases than a year ago, when the second and third waves hit the continent. In Latvia, Bulgaria and Romania, hospitals are now completely overloaded.

One reason for the escalating crisis is obvious: Eastern Europe is the region with the lowest vaccination rates in Europe. A map from the European Centre for Disease Prevention and Control (ECDC) shows a real gap between East and West.

And Germany, unfortunately, is not among the rapidly vaccinating countries of the West, such as Ireland, Spain or Denmark, but remains only in the middle with 67% of the population fully vaccinated. With an extra lag on the rate of first-time jabs, there is probably not much left to do on the vaccination front.

Risk of infodemic

The EU vaccination champion is Portugal, with 81%; the lowest vaccination rate is in Bulgaria, where only 22% of people are fully immunized — and Bulgaria has Europe's highest COVID-19 mortality rate.

On the one hand, according to the ECDC, the large differences are due to the pandemic management of individual governments, including the different speeds of vaccine delivery and the type of vaccine supply. The EU had jointly taken the vaccine order for the member states. On the other hand, beliefs and lifestyles have a major influence on whether someone gets vaccinated or not.

Decades of Communist rule have weakened trust in state institutions.

Even before the pandemic, the World Health Organization (WHO) ranked vaccine skepticism or even rejection of vaccines as one of the greatest threats to global health. Since the outbreak of the coronavirus, the problem has intensified; the WHO speaks of an "infodemic" — that is, a worldwide wave of disinformation and false reports about the virus and vaccines.

Many people are confused, citing a lack of clear information about the efficacy and safety of COVID-19 vaccines. And although doubts about vaccines are a worldwide phenomenon, experts consider people in Central and Eastern Europe to be particularly skeptical.

Decades of Communist rule have weakened these citizens' trust in state institutions and left behind ailing, underfunded health systems, the WHO reports.

People are queueing in front of the hospital of the Military Medical Academy in Sofia, Bulgaria, to get the coronavirus vaccine

Denislav Stoychev/NurPhoto/ZUMA

A matter of trust

Recent Eurobarometer surveys show that at least one in three people in eastern EU countries have no confidence in the public health system. It's notable that this disgust is particularly pronounced in Bulgaria, with 40% — the worst ratio in the EU, to match Europe's lowest vaccination rate.

Spain, on the other hand, where trust in the public health system is particularly high, shows that the willingness to be vaccinated may have grown historically. Since the end of the Franco dictatorship in the mid-1970s, healthcare has been seen as a symbol of the country's modernization, which went hand-in-hand with the transition to democracy. Even before COVID-19, trust in vaccination was already high on the Iberian Peninsula. And that is now paying off; Spain could "vaccinate" its way out of the pandemic.

In the latest episode of the NDR Info podcast "Coronavirus Update," German virologist Christian Drosten, referring to Spain's high vaccination rate, explained that by next spring there will be a group of European countries that should be largely through with the pandemic — and a group that won't be.

Political mismanagement can fuel vaccination skepticism among the population

"I don't think Germany will be through by then," he said. That's because the willingness to vaccinate in Germany can hardly be increased any further, as surveys have shown. The low number of additional initial vaccinations also speaks for itself.

Political mismanagement to blame

A global study by Imperial College London has examined attitudes towards vaccination and trust in the state and healthcare system in selected countries. According to the study, trust in COVID-19 vaccination is highest among vaccinated people in Spain and Italy; German and French people have the least amount of trust in vaccines and healthcare among those not vaccinated. Eastern European countries were not included in the study.

"Concerns about side effects and the effectiveness of vaccination have the greatest impact on willingness to vaccinate everywhere," says Sarah Jones of the Institute of Global Health Innovation at Imperial College London, who collaborated on the study. "Particularly striking is the gap between the unvaccinated and the vaccinated in terms of their personal perceptions of whether vaccination protects them from COVID-19."

It's also interesting to note that the better people rate their government's handling of the pandemic, the higher their willingness is to be vaccinated. Three-quarters of immunized Danes think their government handled the COVID-19 situation well. In Germany, only half of the vaccinated see it that way. Among unvaccinated Germans, only 14% are convinced of the German government's pandemic management.

The fact that political mismanagement can fuel vaccination skepticism among the population is particularly drastic in Eastern Europe. In Romania, the pandemic was declared over at the end of summer, even though the vaccination campaign was already stalling at that time. It wasn't until infections surged again in September that the government resorted to measures such as COVID-19 certificates for access to hotels, restaurants, and movie theaters, as well as nighttime curfews. But by then it was too late.

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