What Lies Behind Substantial Differences in COVID-19 Vaccination Rates Between EU Member States?

Abstract

Background: Despite the billions of doses at disposal, less than three-quarters of EU citizens received a COVID-19 vaccine by the end of 2021. The situation is particularly worrying in transition societies, which experience much stronger opposition to vaccination compared to their Western counterparts. To understand whether and to what extent this has to do with the socialist legacy, in this paper we explore wider economic, political, and cultural determinants of the COVID-19 vaccine uptake in the EU. Methods: Data from Flash Eurobarometer 494 conducted in May 2021 were used to model the attitudes of EU citizens toward COVID-19 vaccination. Based on their views and intentions, each of 26,106 survey participants was allocated into one of the following categories: (1) already vaccinated/plan to get vaccinated; (2) indecisive; (3) refuse vaccination. Multilevel multinomial logit was employed to understand what underlies the reasoning of each group. Results: The survey revealed that 13.4% of Europeans planned to delay vaccination against COVID-19, while 11.2% did not intend to get vaccinated. Although numerous demographic and socio-economic factors jointly shape their viewpoints, it is trust (in the authorities, science, peers, and online social networks above all) that strongly dominates citizens' reasoning. Given that most transition societies are witnessing the pandemic of distrust at various levels, this seemingly unrelated feature appears to be vital in explaining why newer member states record lower vaccination rates. Education was also found to play a pivotal role, which is reflected in an individual's ability to critically assess information from various sources. Conclusion: The study results clearly illustrate how long-lasting structural problems (specific for, but not confined to, transition countries) can manifest themselves in unforeseen circumstances if left unaddressed. It is hence of vital importance to learn the lesson and prevent similar issues in the future. Above all, this would require wide-ranging reforms aiming to repair the imperceptible psychological contract between citizens and the state authorities.