There has been a big improvement in the number of people in Central and Southeast Europe who are willing to be vaccinated against coronavirus (COVID-19), according to a survey this week by the Slovak security think-tank Globsec. However, in most countries the numbers of those vaccinated or willing to be vaccinated are still less than 70%, with Southeast Europe closer to 40%.

Central Europe, the Baltic states and the Balkans have been one of the worst hit regions in the world by COVID-19. Amid great pressure from businesses and the public, many governments are now beginning to relax their lockdown measures, despite daily infection levels still being relatively high. Vaccinations would offer a way both to save lives and avoid further economic damage from lockdowns, but most countries in the region are lagging far behind Western Europe inoculation levels.

The Globsec survey shows that even if the governments of the region secure enough vaccines and make their delivery programmes much more efficient, they may still struggle to convince enough of their people to get vaccinated to reach herd immunity –  a vaccination level estimated at around 70%.

The anti-vaxx scepticism in Southeast Europe and the Baltic states also raises the risk that their continuing high level of COVID-19 infections could spread back across the region and hamper the lifting of travel restrictions.

According to the Globsec survey, which was carried out in March, between 51% and 61% of people in the countries of Central Europe and the Baltic states are willing to be vaccinated, on top of the less than 10% typically vaccinated. But in Bulgaria only 33% are willing, on top of the 5% already vaccinated, while in Romania the figures are 31% on top of the 14% who have already had the jab.

In most countries, the percentage willing to be vaccinated has increased by 20-30% since a Globsec survey in October 2020 as the pandemic worsened, with the Slovak numbers almost doubling by 34pp to 70% willing to be or already vaccinated. However, in Bulgaria and Romania the figures have remained low, rising by just 15pp and 1pp respectively.

Despite the overall improvement, there remains a hard core of around one quarter of the population in most countries who would definitely or rather not get vaccinated, with higher levels of anti-vaxx scepticism in Lithuania (30%), Latvia (35%), Romania (49%) and Bulgaria (55%).

Globsec points out, however, that there is a large ‘grey zone’ of people who don’t know whether they want to be vaccinated or whose opposition is weak, which gives hope that they can be persuaded. In Bulgaria 28% of people would 'rather not' be vaccinated and 10% don’t know.

Flourishing conspiracy theories

This scepticism reflects a low level of trust in governments and mainstream media, which allows anti-vaxx conspiracy theories to flourish. The challenge is made more difficult by disinformation campaigns, often supported by Russia (and also China) that have exaggerated the risks of Western vaccines, while pushing the merits of their own jabs. 

"The so-called “vaccine diplomacy” follows a zero-sum game logic and is combined with disinformation and manipulation efforts to undermine trust in Westernmade vaccines, EU institutions and Western/European vaccination strategies," charged a report by the EU's External Action Service on April 28. 

The failures of the European Commission’s PPE and vaccination procurement programmes, the squabbling over border closures, as well as the infighting over the sharing out of the vaccines, has been a gift to rival powers such as Russia and China. Both Moscow and Beijing have used their success in developing vaccines to burnish their images, and have won new friends by delivering them to countries in the Balkans that have so far received few doses from Brussels. Hungary and Serbia, as leaders in immunisations, have downplayed the help they received from Brussels, and applauded their shipments from Moscow and Beijing.

Nevertheless, a total of 48% of respondents among those who want to get vaccinated say that they would prefer a Western European or US-made jab. Only 5% of respondents, on average, mention the Russian Sputnik V – which has yet to receive approval from the European Medicines Agency (EMA) – as their vaccine of choice. Only Hungary of the surveyed countries is currently using Sputnik V.

Countries with strong support for Sputnik V tend to be those with big Russian minorities – in Latvia 10% chose Sputnik – or ones with traditionally warmer feelings towards Moscow, especially among older generations, such as Bulgaria, where 7% prefer Sputnik.

Chinese vaccines – also not approved by the EMA – barely registered in the survey, except in Hungary, where the government is using Sinopharm. In Hungary – the clear leader in the region in terms of vaccinations – Sinopharm was chosen by 6%, above the figure for Sputnik V (4%).

Globsec said Slovaks were outliers on this matter, with 15% indicating a preference for the Sputnik V vaccine over alternatives. Igor Matovic was forced to step down as premier last month after going behind the backs of his coalition partners to negotiate the procurement of Sputnik V. The government is now preparing to join Hungary and roll out Sputnik V, possibly even before it is approved by the EMA.

The survey found that the age and education of respondents influenced their attitude to vaccination. A total of 60% of university-educated respondents want to get vaccinated, 15 percentage points higher than people with only an elementary-level education.

Interest in vaccination also increases with age, partially reflecting the vaccination strategies of CEE countries, which have initially prioritised inoculations for older people, who are much more at risk of dying from COVID-19. At the same time, anti-vaxx scepticism among older people, who also tend to be more susceptible to conspiracy theories, may encourage some countries to start to open up vaccinations to younger cohorts,  as Poland is currently doing.

Some countries are trying to boost vaccination rates by creative strategies. Romania has been organising “vaccine marathons” in major cities where Romanian citizens and foreigners living in the country can receive the Pfizer vaccine without an appointment. In Bulgaria the government has organised weekends of mass vaccinations, where anyone in priority groups can simply turn up and queue for a vaccine.