Countries around the world are in a race against time to vaccinate their populations against Covid-19. But there is one particular region which appears to have a growing problem with vaccine scepticism: Central and Eastern Europe.
As a British expat living in the Czech Republic, I have noticed the lack of eagerness with which many Czechs discuss the vaccine rollout. This may in part be due to the country’s floundering and much-criticised vaccination programme. But it is noticeable that anti-vaccine sentiment is more common – and gets much more attention – here than in the UK. Ex-President Václav Klaus recently told a large anti-lockdown rally in Prague that vaccines are not the solution to the virus.
It’s worth remembering that Central and Eastern Europe is a highly diverse place: Poland is one of Europe’s most religious countries, while neighbouring Czech Republic is often described as the most atheist place in the world. Yet a high level of scepticism about Covid vaccination seems to be shared throughout the region.
In October 2020, only a third of Czechs said they would accept a Covid-19 vaccine. And in an international survey of attitudes towards Covid vaccination, Polish respondents exhibited the highest proportion of negative responses. Another survey in December found that less than half of Poles want to get vaccinated, with 44 per cent planning to refuse the jab. The picture is similar elsewhere: in Bulgaria only 30 per cent of people would definitely get the jab, while a Eurobarometer poll found that only 49 per cent of Hungarians are willing to be vaccinated.
What explains this trend? It doesn’t appear to be down to low vaccine uptake in general. Central Europe has extremely high coverage levels for regular, mandatory vaccines. When it comes to the tetanus vaccine, Poland and the Czech Republic have higher levels of uptake then Britain. And while the UK’s average vaccination coverage for infant measles stood at around 90 per cent between 2010 and 2015; in the Czech Republic, the average was approximately 98 per cent, and in Poland above 95 per cent. The story is the same for diphtheria, polio, and rubella.
But the effectiveness of Eastern and Central European vaccination programmes may be having undesired repercussions now. According to a study by Unicef, one of the consequences of the region's high rates has been a reduction in the perceived necessity of vaccinations. Once preventable diseases have been eradicated, people forget why the vaccines were so important in the first place. In some ways, inoculation programmes have been the victims of their own success.
And so while the number of people being vaccinated has remained high in many Eastern European countries, confidence in the safety of vaccines has plummeted in recent years. In a survey conducted in 2018, only 50 per cent of Eastern Europeans agreed that vaccines are safe.
Eastern Europeans also have the world’s second-lowest level of trust in hospitals and health clinics in their countries. This dubious attitude towards the health profession, coupled with scepticism about vaccine safety, is perhaps why there has been a markedly low uptake recently for voluntary vaccines such as the seasonal influenza jab. Unlike mandatory vaccines for measles and tetanus, the flu jab is optional in Poland, the Czech Republic, and other countries in Central and Eastern Europe, and is only recommended for vulnerable groups. From 2015 to 2018, the six EU countries with the lowest levels of influenza vaccination among older age groups were Lithuania, Slovakia, Slovenia, Poland, Latvia and Estonia.
Long-held unease about vaccines may be linked to a distrust of authority. Speaking on Spectator TV last week, Trevor Phillips suggested one reason ethnic groups in Britain may choose not to be vaccinated is that they have little trust in the government. This theme is common in analyses of Eastern European vaccine scepticism. People in ex-Soviet-bloc countries tend to be more suspicious of the intentions of those in power; and more wary about what gets stuck into their arm on a doctor’s (or politician’s) orders.
But though history’s influence on present day attitudes is undoubtedly significant, it is notable that the highest levels of vaccine scepticism in Poland and the Czech Republic are among people under the age of 40 – those who have no memory of any kind of authoritarian rule.
It seems instead that in many ex-Soviet-bloc countries people may have inherited their scepticism of authority from older generations. This certainly applies to a suspicion of foreign superpowers. 40 per cent of Czechs say they would trust a Czech-made vaccine and 36 per cent would definitely trust a German-made one, but only 15 per cent would take a US-made jab without hesitation.
Central European Covid vaccine scepticism seems to be the result of a number of interlinked concerns that have grown over many years. Unfortunately for the region, these factors have combined to create a perfect storm of suspicion. For the sake of those living in these countries, their governments will have to work hard to overcome these concerns.