A vaccine success in Europe that sinks in the East

More than 70% of the European Union’s adult population has been fully vaccinated, making it one of the world’s vaccination leaders. But some Eastern European countries are lagging far behind, exposing the bloc to new waves of infections and creating a divide that EU officials and experts say could hamper recovery efforts.

While 80% of the adult populations in countries such as Belgium, Denmark and Portugal have been fully vaccinated, in Bulgaria that figure plunges to only about 20%, while in Romania it lags at around 32%, according to European authorities.

The high numbers in Western European countries are an achievement that few would have believed possible earlier this year, when EU member countries, embroiled in sluggish rollouts, quarreled with bloc officials and vaccine-makers over delivery issues.

But vaccination rates in Eastern and Central Europe are all below the bloc’s average, with Bulgaria and Romania among the starkest examples. Those countries, along with the Czech Republic, Hungary and Poland, also have some of the highest excess mortality rates across the European Union during the pandemic — one measure of how many deaths the coronavirus has caused.

In many cases, vaccination programs in the European Union have been successful, despite a sluggish start that probably caused thousands of additional deaths.

Twenty-two of the bloc’s 27 member states have now fully vaccinated more than half of their population. And EU officials have argued that smaller, poorer countries would have struggled to acquire doses on their own had the European Commission, the bloc’s executive arm, not secured vaccines on behalf of national governments.

But inoculation rates have fallen in recent weeks, particularly in countries such as Poland and Slovakia, and deaths have surged in countries including Bulgaria and Romania, leading to concern from the bloc’s authorities.

“We cannot afford to have parts of Europe less protected. This makes us all more vulnerable,” said Stella Kyriakides, the EU’s health commissioner.

Countries such as France and Germany are about to vaccinate millions with booster shots. Spain is aiming to inoculate 90% of its total population soon. And Italy is considering making vaccinations mandatory. But large swaths of the populations of Eastern European nations have yet to receive a single dose.

“The story we hear about the pandemic in France, Germany or the Netherlands is very different than the one we hear in Bulgaria or Poland,” said Ivan Krastev, a Bulgarian political scientist and co-author of a report on the perceptions of the pandemic in 12 EU countries.

The scarcity of doses that dogged early vaccination campaigns across the bloc is no longer an issue. Instead, misinformation, distrust of authorities and ignorance about the benefits of inoculation seem to be behind the low uptake in Central and Eastern Europe.

The World Health Organization warned last month that 230,000 people in Europe could die of the coronavirus by December, citing slowing vaccination rates and the lack of restrictive measures to combat the spread.

The situation is even more dire in some of the European Union’s neighbors, which the bloc has promised to supply with vaccine doses. Just 23% of Albania’s total population has been fully vaccinated, and that number falls to 11% in Georgia and 3% in Armenia.

A wave of coronavirus deaths in the fall and winter could cast a shadow on the success story that EU officials have touted in recent weeks.

“Europe’s Covid-19 experience has been a tale of two pandemics — and the differences in each story could haunt the continent for many years to come,” noted the report co-authored by Krastev, which was published by the European Council on Foreign Relations, a research institute.

Bulgaria, which has the lowest vaccination rate in the European Union, also has the bloc’s highest death rate, adjusted per population. “The last place in vaccinations ranks us first in mortality,” the country’s health minister, Stoycho Katsarov, acknowledged this month. “That’s the logical connection.” Authorities implemented fresh restrictions this week on the hospitality sector and cultural venues to try to curb a surge of cases and deaths.

In Romania, the vaccine uptake was once one of the highest in the European Union, but it has slowed so much that EU officials wonder if it has already reached a glass ceiling.

Many in villages and small towns have shunned the shots, with some wrongly believing myths including that vaccines are more dangerous than the virus.

Access is not the problem, according to Valeriu Gheorghita, head of Romania’s efforts. “We have fixed vaccination centers, mobile vaccination centers, drive-in vaccination centers,” he said, and still, he noted, more than half of those living in rural areas had yet to be inoculated.

Romania has had to sell or donate millions of unused doses, including to other EU countries; Bulgaria, likewise, has passed on hundreds of thousands.

Roma people, who constitute around 10% of the populations of Romania and Bulgaria, are even less willing to get vaccinated, according to the medical journal The Lancet. Activists in both countries have criticized their governments for failing to adequately include the group in their inoculation efforts.

In Bulgaria, as coronavirus wards in hospitals fill up, resorts on the Black Sea teem with tourists. In Sofia, the capital, inoculations have reduced to a trickle, and vaccination centers are mostly empty.

At a center this month, Mariela Metodieva, 34, said she had decided to get inoculated after a vaccinated friend had become infected with COVID-19 and developed only mild symptoms, while several unvaccinated relatives had been admitted to the intensive care unit.

Metodieva, a shop assistant, said she still doubted the efficacy and safety of the shots. “We are either going to die from Covid-19 or from the vaccine,” she said.

Studies have shown that side effects caused by the vaccines are rare, but Bulgarian news outlets have given an outsize platform to skeptics.

Political instability has also compounded vaccination efforts in Bulgaria as the country is about to face its third national election in a year. “The political elite hasn’t taken responsibility to push for a nationwide inoculation campaign,” said Vessela Tcherneva, deputy director of the European Council on Foreign Relations and head of its Sofia office.

There are other, structural issues, Tcherneva added, noting that anti-vaccine sentiment in Eastern and Central Europe was rooted in a deep mistrust of state institutions. That could explain why governments have been reluctant to implement vaccine mandates like those enforced in France and Italy, she said.

The European Commission said it has been helping governments fight misinformation, but EU officials have limited leverage because member countries are in charge of their own vaccination campaigns.

“The European Commission has done all it could do,” Tcherneva said. “It can help countries buy vaccines, which it has done, it can make sure that all EU citizens have access to them, but it cannot enforce or push governments on how to administer them.”

[This article originally appeared in The New York Times.]