In January 2022, Poland experienced the highest rate of SARS-CoV-2 transmission since the beginning of the COVID-19 pandemic. Considering the widespread consensus among experts about the efficacy of vaccines in preventing hospitalisation and death resulting from the virus, low vaccination rates and widespread anti-vaccine sentiments in Poland are of great concern. We use data from the DIAGNOZA+ Survey to demonstrate the relationship between various demographic characteristics, opinions around certain gender norms, the propensity for conspiratorial thinking, concern about the pandemic, and vaccine scepticism. While controlling for exogenous demographic characteristics, we measure the strength of the relationship between various beliefs that people hold and how they feel about the COVID-19 vaccine. Our analysis indicates that while respondents who hold more traditional views on gender roles are 6 percentage points less likely to get vaccinated, those who agree with a variety of conspiratorial statements are 43 percentage points less likely to vaccinate against COVID-19.
As of January 2022, Europe finds itself well into the 4th wave of the COVID-19 pandemic, with some countries, including Poland, experiencing the highest rates of transmission since the virus was first detected. There are a few tools available to policymakers and healthcare professionals for combating the spread of the virus, ranging from preventative measures to strict social lockdowns aimed at reducing interpersonal interaction. A comprehensive literature review of 72 academic studies conducted by the BMJ found that the implementation of preventative measures such as hand washing, mask wearing, and social distancing decreased the risk of transmission by 53% (Talic et al., 2021). But even though such measures reduce transmission, the shortcomings in adherence and enforcement make high vaccination rates much more effective in diminishing the risk of hospitalization and death (Moline et al., 2021). With a consensus among experts reaffirming the effectiveness of vaccines in minimising the more severe cases of COVID-19 illness, the widespread availability of the vaccine has become the most effective and cost-efficient tool in limiting morbidity while avoiding future instances of economically unsustainable lockdowns. The drawbacks of the alternative scenario have already been made evident in 2020, before the development and distribution of COVID-19 vaccines. Over the course of the year, hospital capacities were overwhelmed in many countries around the world, leading to significant spikes in excess deaths. Poland saw an increase of over 18% in all-cause mortality in 2020 (OECD, 2021), the fourth-highest in the OECD and second-highest in the European Union (Eurostat, 2021).
Considering the central role that prevalent vaccination plays in combating the impact of COVID-19, it is important to understand the underlying factors and demographic characteristics of individuals who are driving the low vaccination rates in countries such as Poland. With this in mind, we use an online survey: DIAGNOZA+ (DIAGNOZA Plus, 2020-2021), conducted on a representative sample of adults in Poland throughout the pandemic, allowing for the identification of characteristics that are most strongly correlated with vaccine scepticism. This kind of analysis can provide useful indicators for the targeting of certain policies and information campaigns that encourage vaccinations, and thereby suppress future outbreaks of SARS-CoV-2, as well as any other future pandemics. Below, we first outline the key features of the DIAGNOZA+ data, describe the methodology adopted in this study, and present results on the relationship between key demographic characteristics, social norms, views of respondents, and attitudes towards COVID-19 vaccination. We show a strong correlation between traditional family values, conspiratorial views, and reservations relating to the vaccination programme. Having traditional family values (expressed by about 40% of the sample) is associated with an over 10 percentage point (p.p.) lower probability to declare a willingness to get vaccinated. This drops to about 6 p.p. when we extend the model to account for conspiratorial thinking, which strongly dominates the relationship. Individuals who express strong conspiratorial and anti-establishment views (about a quarter of the sample), conditional on other demographic characteristics, were more than 40 p.p. less likely to declare a willingness to get vaccinated.
The following analysis is based on data from DIAGNOZA+, an online survey collected in seven waves over the course of the COVID-19 pandemic (DIAGNOZA Plus, 2020-2021). The panel survey was conducted with the purpose of assessing changes in the labour market situation of adults in Poland between April 2020 and July 2021. The survey consistently included standard questions on individual and household characteristics such as age, gender and education, as well as questions on as well as questions about the respondent’s labor market status, hours worked, and financial situation. Waves 3 and 4 included additional modules where respondents were asked to express their opinions on a variety of statements surrounding gender norms such as “In general, fathers are as well suited to look after their children as mothers”, “A pre-school child is likely to suffer if his or her mother works” and “When jobs are scarce, men should have more right to a job than women”. The questions were answered on a scale of 1 (strongly agree) to 4 (strongly disagree). For the analysis, these categorical variables are dichotomised, with a value of 1 assigned to responses 1 and 2 (strongly agree or agree) and a value of 0 assigned to responses 3 and 4 (disagree or strongly disagree). Thus, for each question, we develop a binary variable that categorises respondents as either having a progressive or traditional reaction to each particular gender norms statement.
In consecutive waves, the same respondents were asked questions surrounding their willingness to vaccinate against the virus (in wave 5) and their trust in experts and the government response to the COVID-19 pandemic (in wave 6). For this analysis, we select questions that may influence an individual’s likelihood to vaccinate, starting with their level of concern about the pandemic or their fear of the virus itself. Furthermore, we identify individuals with a high predisposition for conspiratorial beliefs based on information from wave 6. Each variable included in this module is converted into a binary measure of agreement or disagreement, as outlined above for the social norms questions. We consider seven statements from the survey related to conspiratorial views, including “Secret organisations influence political decisions” or “I trust my intuition more than the so-called experts” (see the full list of statements in Figure 2). For each of them, the variable is converted into a binary measure of agreement or disagreement, similarly to the social norms questions above. Those who agreed or strongly agreed with all seven statements are classified as having conspiratorial views.
Due to sample attrition and after dropping respondents who did not answer one (or more) of the questions needed for our analysis, the sample reduces to 726 individuals (see table A1 in the Annex). Although each wave of the DIAGNOZA+ survey is carefully weighted to ensure population representativeness of the survey, these cross-sectional weights are only relevant to each independent wave of the survey. Therefore, for our sample, we develop frequency weights by sex and age using population data from Statistics Poland (Statistics Poland, 2021), which are utilised throughout the analysis. Given the low number of participants in the oldest age groups (those above 60 years old), we limit the sample to individuals aged between 21 and 60. Unfortunately, calibrating the weights according to additional characteristics such as education and municipal population is not feasible with a sample of this size. Clearly, the requirement of consistent consecutive participation in at least three waves of the survey has implications for its representativeness. For example, after the sample of respondents that participated in wave 6 is cut to include only those who also participated in waves 3, 4 and 5, we observe a bias in favour of conspiratorial views among the remaining observations, indicating that individuals who hold these views were more likely to continue their participation in the survey. For example, while 18.1% of the total cross-sectional sample of individuals in wave 6 hold conspiratorial views, the proportion is 23.4% in the sample we analyse (falling slightly to 23.2% when weights are applied). From this perspective, while indicative of existing correlations, the results ought to be treated with some caution.
Limiting the sample to respondents who answered all sets of questions across several rounds of the survey allows us to study vaccine scepticism and respondents’ susceptibility to conspiracy theories in relation to a number of personal characteristics. Furthermore, we consider the relationship between a respondent’s attitudes towards certain social norms (asked in waves 3 and 4), their individual response to COVID-19 (asked in wave 5), and their trust in the government’s response to the pandemic (asked in wave 6). We begin the analysis by assessing the relationship between respondents’ demographic characteristics and their opinions on gender roles, their propensity to hold conspiratorial beliefs, and their concern about the pandemic. This is followed by two models measuring respondents’ willingness to vaccinate. In the first of these models, demographic characteristics and traditional family values are used as explanatory variables, while in the second model conspiratorial views are included as well. Finally, we conclude with a summary of results and policy considerations.
Traditional Family Values in Poland
The respondents of the DIAGNOZA+ survey vary, on average, in the ‘traditionality’ of their attitudes towards gender and family depending on the selected indicator. The shares of answers to the three questions about gender norms are presented in Figure 1. The results demonstrate that progressive views on gender norms in Poland were more common in relation to the workplace than the home and family. For example, the statement to which most respondents were opposed was “When jobs are scarce, men have more right to a job than women”, with 37.2% of respondents disagreeing and 50.3% of respondents strongly disagreeing. On the other hand, slightly fewer respondents disagreed (50.5%) or strongly disagreed (34.8%) with “In general, fathers are not as well suited to look after their children as mothers”. Finally, respondents were most ‘traditional’ in their views in reaction to the statement “A pre-school child is likely to suffer if his or her mother works”, with 28% agreeing and 10% strongly agreeing. There is a natural correlation between these different views, and in our analysis, we examine the significance of different combinations of the three indicators. Given the relatively small sample, only the last indicator proved to be significantly related to our main outcome of interest and we use this one to represent the view on the ‘progressive-traditional’ spectrum
Figure 1. Gender norms in the survey sample
In wave 6 of the DIAGNOZA+ survey respondents were asked seven different questions relating to trust in government, politicians, media, and the recommendations of experts. As shown in Figure 2, for five out of the seven statements, a majority of respondents agreed or strongly agreed that the government or media are dishonest, intentionally share misinformation, or have ulterior motives. Nearly three quarters of respondents agreed that “politicians and the media deliberately hide certain information”. This result supports data published by the OECD in 2020 showing that, out of the 38 member countries, Poland had the second-lowest trust in government, with only 27.3% of the population expressing confidence (OECD, 2022). However, the DIAGNOZA+ survey goes further to find that nearly half of respondents in our sample reported that they trust their own intuitions more than the experts during the pandemic, while the least widespread belief out of the seven was that “secret organisations influence political decisions”. Still, even this statement, which suggests deep-seeded nefarious behaviour behind the scenes of government, found 39.8% of respondents to be in agreement. Note that we aim to identify individuals who have a general propensity for conspiratorial thinking, rather than those who simply find some of the statements particularly compelling. To this end, we only categorise those respondents who agreed with all seven statements as having a high propensity for conspiratorial thinking, which was the case for 23.2% of our sample after reweighting.
Figure 2. Conspiratorial beliefs and trust in authority
Table 1 presents regression results on the relationship between specific beliefs reported in the different waves of the survey and a number of individual characteristics. We show these results for three dependent variables: traditional family values, as defined by the opinion that a pre-school child is likely to suffer if his or her mother works; propensity for conspiratorial views, which identifies the respondents that agreed with all seven statements presented in Figure 2; and concern about the pandemic, a binary variable that identifies individuals who expressed great worry or fear about the pandemic. The results indicate that parents who live with their children are 10.1 p.p. more likely to hold traditional family values. After controlling for age, gender and education, living in a small town or village is associated with a 10.9 p.p higher probability of ascribing to more traditional gender norms, while individuals holding a tertiary degree are 18 p.p. less likely to agree that “a pre-school child is likely to suffer if his or her mother works” compared to those with primary education. Interestingly, neither age nor gender significantly correlates with family values, suggesting that the DIAGNOZA+ survey did not capture an intergenerational or gender-driven divide on these issues. This might relate to the online nature of the survey and the implied sample selection, in particular among older individuals.
Table 1. Regression results on views and attitudes
The results presented in Table 1 also demonstrate a relationship between some demographic characteristics and the likelihood to hold conspiratorial views (as defined by expressing agreement to the seven related statements in wave 6). A number of characteristics strongly correlate with conspiratorial thinking: being a parent living with their children aged 0-17, and living in small cities, towns and villages. Each of these characteristics is associated with a higher probability of believing in secret organisations and mistrusting experts. A number of characteristics strongly correlate with conspiratorial thinking: holding such views are 9.3 p.p. more likely among parents living with their underaged children and 10 p.p. more likely among individuals living in smaller towns or villages compared to those living in cities of over 500 thousand inhabitants. Higher education is strongly negatively correlated with the likelihood of holding conspiratorial views – those with tertiary education are 14.5 p.p. less likely to have these views compared to individuals with primary education.
One simple explanation for the increased vaccination rates among certain demographic groups in Poland could be that some segments of the population are more worried about the virus, and thus choose to take greater precautions. The analysis presented in Table 1 demonstrates that people were increasingly likely to be concerned about the pandemic in higher age groups. When asked “To what extent are you concerned about the COVID-19 pandemic?”, the probability of expressing serious concern increases progressively with age. This is an intuitive result considering the strong relationship between age and the severity of COVID-19 symptoms and the associated risk of mortality (CDC, 2021). Respondents aged between 31 and 40 were 10 p.p. more likely to report being very concerned or frightened than respondents between the age of 21 and 30, while in the age groups 41-50 (12.6 p.p.) and 51-60 (21.4 p.p.) the probability was even higher. There is also a weak but positive correlation (7.7 and 8.6 p.p.) between living in a city with a population of 10,000 to 500,000 inhabitants and expressing fear about the pandemic, as compared to respondents who lived in cities with a population of more than 500,000 people. The relationships between the remaining demographic characteristics and the probability of being seriously concerned about the pandemic are not statistically significant. Below, we use this data to examine the link between people’s beliefs and the likelihood of getting vaccinated.
Vaccine Scepticism, Demographic Characteristics and Conspiratorial Views
In light of the widespread scientific consensus on the safety and effectiveness of COVID-19 vaccines, low vaccination rates in Poland are difficult to explain. In this section, we analyse to which extent they may be driven by the underlying beliefs, on top of the socio-demographic characteristics. Overall, 54% of respondents in the selected sample from the DIAGNOZA+ survey planned to be or had already been vaccinated. Thus, the survey sample closely reflects the actual proportion of the population that was fully vaccinated in Poland as of January 2022. (ECDC, 2022). In Model A of Table 2, we present the relationship between the response to the question “Do you plan to get vaccinated against COVID-19 or are you already vaccinated?” and traditional family values, alongside the usual demographic characteristics. We find that those in the 51-60 age group were 14.5 p.p. more likely to plan to vaccinate than those aged between 21 and 30. This also reflects the higher level of concern about the virus expressed by those over the age of 50, as presented in Table 1, and the risk of serious illness associated with increasing age. However, the relationship between age and the probability of vaccination was much weaker than the relationship between age and the probability of expressing general concern about the pandemic, implying that concern does not translate directly into a willingness to vaccinate. We also find that tertiary education has a particularly strong effect, and respondents who have a university degree were much more likely (17.7 p.p.) to get vaccinated than those with less than secondary education.
Through this analysis we also discover several less intuitive relationships between individual characteristics and the propensity to vaccinate. We find that women are 11.5 p.p. less likely to plan to vaccinate against COVID-19 than men. Moreover, individuals living in a city with less than 500,000 inhabitants were much less likely to vaccinate, with the strongest correlation (-23.5 p.p.) observed for respondents living in medium-sized cities of 100,000 to 500,000 people. However, a strong relationship can also be seen for smaller cities of 10,000 to 100,000 inhabitants (-19.3 p.p.) and small towns and villages (-17.2 p.p.). Respondents’ expressions of traditional family values are also a strong predictor of their propensity to vaccinate. After controlling for gender, age, education and municipality size, those categorised as holding traditional views are 10.6 p.p. less likely to plan to vaccinate against COVID-19. Our findings demonstrate that while population density, education, age and gender, are all strong indicators of vaccine scepticism in Poland, so is the degree of traditionalism in people’s beliefs.
Table 2. Regression results on vaccination: probability of being vaccinated or planning to get vaccinated
A commonly cited explanatory factor for vaccine scepticism is the susceptibility to conspiratorial beliefs, as well as scepticism towards information disseminated by figures of authority (Hornsey et al., 2018). Thus, in Model B, we seek to identify a relationship between conspiratorial beliefs and scepticism towards the COVID-19 vaccine in Poland. When adding to our model a binary indicator for agreement with all seven of the conspiratorial statements included in the survey, we find that those who agreed across the board were 43.3 p.p. less likely to get vaccinated. Therefore, it seems that the propensity for conspiratorial thinking is a very strong correlate of willingness to vaccinate, and the characteristic most strongly associated with vaccine scepticism. The impact of the demographic factors goes in the same direction for both models, although the scale diminishes in Model B after controlling for conspiratorial views, reflecting the higher propensity of older individuals to hold such views. Furthermore, the effect of traditional family values is much weaker in Model B, suggesting a positive correlation between traditional family values and conspiratorial beliefs (Figure A1 in the Annex shows how values and views in the analysis views overlap with each other). This is in line with past research that ties traditional moral values and conservatism with conspiratorial beliefs, both before and during the COVID-19 pandemic (Pennycook et al., 2020; Romer and Jamieson, 2021).
One explanation for the strong relationship between conspiratorial beliefs and vaccine scepticism could be that respondents who do not trust the media and figures of authority believe that the dangers of the pandemic have been exaggerated and would thus not be concerned about its consequences. We account for this possibility in Model C by including the indicator for fear of the pandemic. We find that those who are very concerned or frightened are 21.1 p.p. more likely to vaccinate than those who are not. However, including this variable in the model has little effect on the estimates of the relationship between traditional gender views or conspiratorial thinking and the likelihood to vaccinate. Further research is needed to understand what is driving these relationships in this particular context. These findings demonstrate that while individuals that believe in conspiracies are the most susceptible to vaccine scepticism, other elements such as fear of the pandemic, education attainment, and where people live play an important role as well.
By January 2022 most European countries have reached a plateau in their vaccination rates, with free vaccines readily available since the summer months of 2021 to all those who are willing to take them. Not only have the high rates of hospital admissions among the non-vaccinated population proven the epidemiological models about the efficacy of vaccines in reducing hospitalisation and death to be true (a study in the United States showed a more than tenfold reduction in the risk of each measure; Scobie et al., 2021), but disparities between countries in the proportion of the population that is vaccinated have created a natural experiment that further substantiates this hypothesis. Poland, a country with a vaccination rate that is 15 p.p. lower than neighbouring Germany, had virtually the same number of cases per 100,000 people in the first two weeks of December, but almost threefold the number of deaths from COVID-19 (ECDC, 2021). Due to the burden COVID-19 related hospitalisations place on healthcare systems, the issues arising from the significant scale of vaccine scepticism are not only related to physical well-being, but also directly impact economic and fiscal stability.
Despite a fairly small sample size available for our analysis from the DIAGNOZA+ survey, a number of important correlations are identified in this study. We find that people living in cities and towns smaller than 500,000 people are less likely to vaccinate than those living in big cities. We show that women, those with less than secondary education, and young people are less likely to be vaccinated. Moreover, those believing that pre-school-aged children suffer when their mothers work are less likely to vaccinate compared to those with more progressive gender views. The most significant predictor of vaccine scepticism, however, is whether a respondent expressed low trust in authority and belief in the conspiracy theories presented in the survey, which was the case for 23.2% of the sample. These individuals are more than 40 p.p. less likely to express willingness to get vaccinated than the rest of the population. This suggests that the low rate of vaccination in Poland can, in part, be attributed to widespread distrust of government, the media, and scientific experts. Poland has already suffered the consequences of the high magnitude of anti-vaccine sentiments in the population, with the severity of the fourth wave of COVID-19 being one of the harshest in Europe (ECDC, 2021). If the government intends to prevent future outbreaks and protect the healthcare system and the economy, it must present a consistent, clear, and transparent message about the safety and efficiency of vaccines to minimise the misinformation that is driving vaccine scepticism among certain demographic groups.
- Centers for Disease Control and Prevention, (2021). Hospitalization and Death by Age.
- DIAGNOZA Plus, (2021). https://diagnoza.plus/
- European Centre for Disease Prevention and Control, (2021). Data on 14-day notification rate of new COVID-19 cases and deaths
- Eurostat, (2021). Excess mortality by month.
- Hornsey, M., Harris, E., &. Fielding, K., (2018). “The psychological roots of anti-vaccination attitudes:
A 24-nation investigation”, American Psychological Association.
- Moline H. et al., (2021). “Effectiveness of COVID-19 Vaccines in Preventing Hospitalization Among Adults Aged ≥65 Years – COVID-NET, 13 States, February-April 2021”, Morbidity and Mortality Weekly Report.
- Organisation for Economic Co-operation and Development, (2021). “The impact of COVID-19 on health and health systems”.
- Organisation for Economic Co-operation and Development, (2022). “Trust in Government, OECD data”.
- Pennycook, G., Cheyne J.A., Koehler, D., & Fugelsang, J.(2020). “On the belief that beliefs should change according to evidence: Implications for conspiratorial, moral, paranormal, political, religious, and science beliefs”, Judgement and Decision Making
- Romer D. & Jamieson K. H., (2021). “Conspiratorial thinking, selective exposure to conservative media, and response to COVID-19 in the US”, Social Science & Medicine
- Scobie H. et al., (2021). “Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021”, Morbidity and Mortality Weekly Report.
- Statistics Poland, (2021). “Demographic Yearbook of Poland 2021”.
- Talic S. et al., (2021). “Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis”, The BMJ.
Annex is available in the PDF version.
This Policy Paper was prepared under the FROGEE project, with financial support from the Swedish International Development Cooperation Agency (Sida). FROGEE papers contribute to the discussion of inequalities in Central and Eastern Europe. For more information, please visit www.freepolicybriefs.com. The views presented in the Policy Paper reflect the opinions of the authors and do not necessarily overlap with the position of the FREE Network or Sida.
In this brief, we report on the FREE network webinar on the state of vaccinations and the challenges ahead for opening up economies while containing the pandemic, held on June 22, 2021. The current state of the pandemic in each respective country was presented, suggesting that infection rates have gone down quite substantially recently in all countries of the network, except in Russia which is currently facing a surge in infections driven by the delta-version of the virus. Vaccination progress is very uneven, limited by lacking access to vaccines (primarily Ukraine and Georgia) and vaccine scepticism among the population (primarily in Russia and Belarus but for certain groups also in Latvia, Poland and to some extent Sweden). This also creates challenges for governments eager to open their societies to benefit their economies and ease the social consequences of the restrictions on mobility and social gatherings. Finally, the medium to long term consequences for labour markets reveal challenges but also potential opportunities through wider availability of work–from-home policies.
In many countries in Europe, citizens and governments are starting to see an end to the most intense impact of the Covid-19 pandemic on their societies. Infection and death rates are coming down and governments are starting to put in place policies for a gradual opening up of societies, as reflected in the Covid-19 stringency index developed by Oxford University. These developments are partially seasonal, but also largely a function of the progress of vaccination programs reaching an increasing share of the adult population. These developments, though, are taking place to different degrees and at different pace across countries. This is very evident at a global level, but also within Europe and among the countries represented in the FREE network. This has implications for the development within Europe as a whole, but also for the persistent inequalities we see across countries.
Short overview of the current situation
The current epidemiological situation in Latvia, Sweden, Ukraine, and Georgia looks pretty similar in terms of Covid-19 cases and deaths but when it comes to the vaccination status there is substantial variation.
Latvia experienced a somewhat weaker third wave in the spring of 2021 after being hit badly in the second wave during the fall and winter of 2020 (see Figure 1). The Latvian government started vaccinating at the beginning of 2021, and by early June, 26% of the Latvian population had been fully vaccinated.
Sweden, that chose a somewhat controversial strategy to the pandemic built on individual responsibility, had reached almost 15 thousand Covid-19 deaths by the end of June of 2021, the second highest among the FREE network member countries relative to population size. The spread of the pandemic has slowed down substantially, though, during the early summer, and the percentage of fully vaccinated is about to reach 30% of the population.
Figure 1. Cumulative Covid-19 deaths
Following a severe second wave, the number of infected in Ukraine started to go down in the winter of 2020, with the total deaths settling at about 27 thousand in the month of February. Then the third wave hit in the spring, but the number of new daily cases has decreased again and is currently three times lower than at the beginning of the lastwave. However, a large part of the reduction is likely not thanks to successful epidemiological policies but rather due to low detection rates and seasonal variation.
In June 2021, Georgia faces a similar situation as Ukraine and Latvia, with the number of cumulative Covid-19 deaths per million inhabitants reaching around 1300 (in total 2500 people) following a rather detrimental spring 2021 wave. At the moment, both Georgia and Ukraine have very low vaccination coverage relative to other countries in the region(see Figure 5).
In contrast to the above countries, Russia started vaccinating early. Unfortunately, the country is now experiencing an increase in the number of cases (as can be seen in Figure 2), contrary to most other countries in the region. This negative development is likely due to the fact that the new Covid-19 delta variant is spreading in the country, particularly in Moscow and St. Petersburg. Despite the early start to vaccinations, though, the total number of vaccinated people remains low, only reaching 10.5% of the population.
Figure 2. New Covid-19 cases
In some ways similar to Sweden, the government of Belarus did not impose any formal restrictions on individuals’ mobility. According to the official statistics, in the month of June, the rise in the cumulative number of covid-19 deaths and new daily infections has declined rapidly and reached about 400 deceased and 800 infections per one million inhabitants, respectively. Vaccination goes slowly, and by now, around 8% of the population has gotten the first dose and 5% have received the second.
There were two major waves in Poland during the autumn 2020 and spring 2021. In the latter period, the country experienced a vast number of deaths. As can be seen in Figure 3, the excess mortality P-score – the percentage difference between the weekly number of deaths in 2020-2021 and the average number of deaths over the years 2015-2019 – peaked in November 2020, reaching approximately 115%. The excess deaths numbers in Poland were also the highest among the FREE Network countries in the Spring of 2021, culminating at about 70% higher compared to the baseline. By mid-June, the number of deaths and cases have steeply declined and 36% of the country’s population is fully vaccinated.
Figure 3. Excess deaths
Turning to the economy, after a devastating year, almost all countries are expected to bounce back by the end of 2021 according to the IMF (see Figure 4). Much of these predictions build on the expectations that governments across the region will lift Covid-19 restrictions. These forecasts may not be unrealistic for the countries where vaccinations have come relatively far and restrictions have started to ease. However, for countries where vaccination rates remain low and new variations of the virus is spreading, the downside risk is still very present, and forecasts contain much uncertainty.
Figure 4. GDP-growth
Since immunization plays such a central role in re-opening the economy and society going back to normal, issues related to vaccinations were an important and recurring topic at the event. The variation in progress and speed is substantial across the countries, though.
Ukraine and Georgia are still facing big challenges with vaccine availability and have fully vaccinated only 1.3% and 2.3% of the population by the end of June, respectively. Vaccination rates have in the recent month started to pick up, but both countries face an uphill battle before reaching levels close to the more successful countries.
Figure 5. Percent fully vaccinated
Other countries a bit further ahead in the vaccine race are still facing difficulties in increasing the vaccination coverage, though not so much due to lack of availability but instead because of vaccine skepticism. In Belarus, a country that initially had bottleneck issues similar to Ukraine and Georgia, all citizens have the opportunity to get vaccinated. However, Lev Lvovskiy, Senior Research Fellow at BEROC in Belarus, argued that vaccination rates are still low largely because many Belarusians feel reluctant towards the vaccine at offer (Sputnik V).
This vaccination scepticism turns out to be a common theme in many countries. According to different survey results presented by the participants at the webinar, the percentage of people willing or planning to get vaccinated is 30% in Belarus and 44% in Russia. In Latvia, this number also varies significantly across different groups as vaccination rates are significantly lower among older age cohorts and in regions with a higher share of Russian-speaking residents, according to Sergejs Gubins, Research Fellow at BICEPS in Latvia.
Webinar participants discussed potential solutions to these issues. First, there seemed to be consensus that offering people the opportunity to choose which vaccine they get will likely be effective in increasing the uptake rate. Second, governments need to improve their communication regarding the benefits of vaccinations to the public. Several countries in the region, such as Poland and Belarus, have had statements made by officials that deviate from one another, potentially harming the government’s credibility with regards to vaccine recommendations. In Belarus, there have even been government sponsored disinformation campaigns against particular vaccines. In Latvia, the main problem is rather the need to reach and convince groups who are generally more reluctant to get vaccinated. Iurii Ganychenko, Senior Researcher at KSE in Ukraine, exemplified how Ukraine has attempted to overcome this problem by launching campaigns specifically designed to persuade certain age cohorts to get vaccinated. Natalya Volchkova, Director of CEFIR at NES in Russia, argued that new, more modern channels of information, such as professional influencers, need to be explored and that the current model of information delivery is not working.
Giorgi Papava, Lead Economist at ISET PI in Georgia, suggested that researchers can contribute to solving vaccine uptake issues by studying incentive mechanisms such as monetary rewards for those taking the vaccine, for instance in the form of lottery tickets.
Labour markets looking forward
Participants at the webinar also discussed how the pandemic has affected labour markets and whether its consequences will bring about any long-term changes.
Regarding unemployment statistics, Michal Myck, the Director of CenEA in Poland, made the important point that some of the relatively low unemployment numbers that we have seen in the region during this pandemic are misleading. This is because the traditional definition of being unemployed implies that an individual is actively searching for work, and lockdowns and other mobility restrictions have limited this possibility. Official data on unemployment thus underestimates the drop in employment that has happened, as those losing their jobs in many cases have left the labour market altogether. We thus need to see how labor markets will develop in the next couple of months as economies open up to give a more precise verdict.
Jesper Roine, Professor at SITE in Sweden, stressed that unemployment will be the biggest challenge for Sweden since its economy depends on high labor force participation and high employment rates. He explained that the pandemic and economic crisis has disproportionately affected the labor market status of certain groups. Foreign-born and young people, two groups with relatively high unemployment rates already prior to the pandemic, have become unemployed to an even greater extent. Many are worried that these groups will face issues with re-entering the labour market as in particular long-term unemployment has increased. At the same time, there have been more positive discussions about structural changes to the labour market following the pandemic. Particularly how more employers will allow for distance work, a step already confirmed by several large Swedish firms for instance.
In Russia, a country with a labour market that allowed for very little distance work before the pandemic, similar discussions are now taking place. Natalya Volchkova reported that, in Russia, the number of vacancies which assumed distance-work increased by 10% each month starting from last year, according to one of Russia’s leading job-search platforms HeadHunter. These developments could be particularly beneficial for the regional development in Russia, as firms in more remote regions can hire workers living in other parts of the country.
It has been over a year since the Covid-19 virus was declared a pandemic by the World Health Organization. This webinar highlighted that, though vaccination campaigns in principle have been rolled out across the region, their reach varies greatly, and countries are facing different challenges of re-opening and recovering from the pandemic recession. Ukraine and Georgia have gotten a very slow start to their vaccination effort due to a combination of lack of access to vaccines and vaccine skepticism. Countries like Belarus and Latvia have had better access to vaccines but are suffering from widespread vaccine skepticism, in particular in some segments of the population and to certain vaccines. Russia, which is also dealing with a broad reluctance towards vaccines, is on top of that dealing with a surge in infections caused by the delta-version of the virus.
IMF Economic Outlook suggests that most economies in the region are expected to bounce back in their GDP growth in 2021. While this positive prognosis is encouraging, the webinar reminded us that there is a great deal of uncertainty remaining not only from an epidemiological perspective but also in terms of the medium to long-term economic consequences of the pandemic.
- Iurii Ganychenko, Senior Researcher at Kyiv School of Economics (KSE/Ukraine)
- Sergejs Gubins, Research Fellow at the Baltic International Centre for Economic Policy Studies (BICEPS/ Latvia)
- Natalya Volchkova, Director of the Centre for Economic and Financial Research at New Economic School (CEFIR at NES/ Russia)
- Giorgi Papava, Lead Economist at the ISET Policy Institute (ISET PI/ Georgia)
- Lev Lvovskiy, Senior Research Fellow at the Belarusian Economic Research and Outreach Center (BEROC/ Belarus)
- Jesper Roine, Professor at the Stockholm Institute of Transition Economics (SITE / Sweden)
- Michal Myck, Director of the Centre for Economic Analysis (CenEA / Poland)
- Anders Olofsgård, Deputy Director of SITE and Associate Professor at the Stockholm School of Economics (SITE / Sweden)
Disclaimer: Opinions expressed in policy briefs and other publications are those of the authors; they do not necessarily reflect those of the FREE Network and its research institutes.
There are great expectations that vaccinations will enable a return to normality from Covid-19. However, there is massive variation in vaccination efforts, vaccine access, and attitudes to vaccination in the population across countries. This policy brief compares the situation in a number of countries in Eastern Europe, the Baltics, the Caucasus region, and Sweden. The brief is based on the insights shared at a recent webinar “Addressing the COVID-19 pandemic: Vaccination efforts in FREE Network countries” organized by the Stockholm Institute of Transition Economics.
As of February 16, 2021, the total number of confirmed COVID-19 deaths across the globe has reached 2.45 million according to Our World in Data (2021). Rapid implementation of vaccination programs that extend to major parts of the population is of paramount importance, not only from a global health perspective, but also in terms of economic, political, and social implications.
Eastern Europe is no exception. Although many countries in the region had a relatively low level of infections during the first wave of the COVID-19 pandemic in the spring of 2020, all have by now been severely affected. Vaccination plays a key role for these economies to bounce back, especially as many of them depend on tourism, trade, and other sectors that have been particularly hurt by social distancing restrictions.
Figure 1. Cumulative confirmed COVID-19 cases (top panel) and deaths per million (bottom panel) in the FREE Network region
Against this background, the Stockholm Institute of Transition Economics invited representatives of the FREE Network countries to discuss the current vaccination efforts happening in Eastern Europe, the Baltics, and the Caucasus (the represented countries were Belarus, Georgia, Latvia, Poland, Russia, Sweden, and Ukraine). This brief summarizes the main points raised in this event.
In Latvia, Poland, and Sweden, the second wave of infections started to pick up in November 2020 and peaked according to most COVID-19 impact measures in early 2021. As all three countries are members of the EU and take part in its coordinated efforts, they have all received vaccines from the same suppliers (i.e. Astra/Zeneca, Moderna, and Pfizer/BioNTech).
Latvia had problems early on with getting the vaccination process off the ground. The health minister was blamed for the slow start since he declined orders from Pfizer/BioNTech in the early stages, and was forced to resign. As of February 16, two doses per 100 people have been distributed primarily to medical staff, social care workers, and key-state officials.
Figure 2. Cumulative COVID-19 vaccination doses per 100 people
With the first phase starting in late December, Sweden has by February 16th, 2021, fully vaccinated 1,05% of the population while experiencing serious problems with delivery and implementation. As planning and delivery of vaccines are centralized while the implementation is decided regionally, there have been some unclarities regarding who stands accountable for issues that emerge. Guidelines, issued by the Public Health Agency of Sweden, for how to prioritize different groups have been changed a couple of times. Currently, the (non-binding) recommendation is to prioritize vaccinating people living in elderly care homes, as well as personnel working with this group, followed by those above 65 years of age, health care workers, and other risk groups.
Looking at regional statistics there are significant differences in vaccinating people across regions with an average of 70% usage rate of delivered vaccines, and with lows at 40-60%, see figure 3. Reasons for this remain unclear.
Figure 3. Distributed relative to delivered vaccines across counties (län) in Sweden.
Poland has so far been somewhat more efficient than Sweden in its vaccination efforts. Despite turbulent political events over the last couple of months, it has managed to distribute 5.7 doses per 100 people. The country has just finished the first phase of the national vaccination plan, which focused on vaccinating healthcare personnel, and has now entered the second phase with a shifted focus towards elderly care homes, people above 60 years of age, military, and teachers.
Among the countries that are not members of the EU, and thus, not taking part in its coordinated vaccination efforts, the vaccination statuses are more diverse.
Russia was fast in developing and approving the Sputnik V vaccine. The country started vaccinating in early December, although only people in the age of 18-60 in prioritized occupations such as health care workers, people living and working in nursing homes, teachers, and military. At the start of 2021, the program extended to people above 60 and, on January 16, all adults were given the possibility to register themselves and get vaccinated within one week. There are no precise data at the moment, but the fraction of the population vaccinated is likely to be higher than 1%.
Others in the region have faced greater challenges in signing contracts with vaccine suppliers. Georgia and Ukraine are still waiting to secure deliveries and have not yet started to vaccinate. Being outside the EU agreements and with public and political mistrust towards Sputnik V and Russia alternatives are being explored. Georgia has ordered vaccines through the COVAX platform (co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO) but there are concerns about potential delays in deliveries. In terms of prioritizing groups once vaccinations can start, both Ukraine and Georgia have set similar priorities as other countries, with extra focus on health-care and essential workers, age-related risk groups, and people with chronic illnesses.
While Belarus’ official figures on the death toll have been widely perceived as unrealistic from the beginning, the most accurate and recent data shows an excess deaths rate of about 20% in July. The country has no precise data on vaccinations, but some reports have emerged based on interviews with government officials in the Belarusian media. These suggest that around 20,000 imported doses of Sputnik V have been distributed mainly to medical professionals and an additional 120,000-140,000 doses have been promised by Russia.
The discussion during the Q&A session at the webinar concerned the economic and political implications of vaccinations in the region.
Pavlo Kovtoniuk, the Head of Health Economics Center at KSE in Ukraine, stressed the importance of a coordinated vaccination effort in Europe with regards to geopolitics. There is a clear EU vs Non-EU divide in the vaccination status across European countries. The limited vaccine availability in Non-EU countries such as Ukraine, Georgia, and Belarus offers opportunities for more influential nations like Russia and China to pressure and affect domestic policy in these countries.
Also highlighting the fact that no one is safe until everybody is safe, Lev Lvovskiy, Senior Research Fellow at BEROC in Minsk, noted that vaccination efforts in Europe are important for recovery in small open economies like Belarus as many of its trade partners currently have imposed temporary import restrictions.
Similar to the political crisis happening alongside the pandemic in Belarus, the challenges we see in Poland – protests against the recent developments regarding abortion rights and attempts by the government to limit free media – have deflated the urgency to vaccinate in terms of its future economic and political implications, according to Michal Myck, director of CenEA in Szczecin.
Looking forward, another major challenge for the region is vaccine skepticism. Not only do many countries have to build proper infrastructure that can administer vaccines at the required scale and pace, but also make sure that people actually show up. In Latvia, Poland, Georgia, Russia, and Ukraine, polls show that less than 50% of the population are ready to vaccinate. Sergejs Gubin, Research Fellow at BICEPS in Riga, highlighted that there can be systematic variation in the willingness to vaccinate within countries as e.g. Russian-speaking natives in Latvia have been found to be less prone to vaccinate on average. Also, most of the skepticism in Georgia has been more directed towards the Chinese and Russian vaccine than towards those approved by the EU, according to Yaroslava Babych who is lead economist at ISET in Tbilisi.
Even though vaccine skepticism is an issue in Russia too, Natalya Volchkova, Director of CEFIR at New Economic School in Moscow, pointed to the positive impact of “bandwagon effects” in vaccination efforts. When one person gets vaccinated, that person can spread more accurate information about the vaccine to their social circle, resulting in fewer and fewer people being skeptical as the share of vaccinated grows. In such a scenario vaccine skepticism can fade away over time, even if initial estimates suggest it is high in the population.
Almost exactly a year has passed since Covid-19 was declared a pandemic. The economic and social consequences have been enormous. Now vaccines – developed faster than expected – promise a way out of the crisis. But major challenges, of different types and magnitudes across the globe, still remain. As the seminar highlighted, there are important differences across transition countries. Some countries (such as Russia) have secured vaccines by developing them, but still face challenges in producing and distributing vaccines. Others have secured deliveries through the joint effort by the EU, but this has also had its costs in terms of a somewhat slower process (compared to some of the countries acting on their own) and sharing within the EU. For some other countries, like Belarus, Ukraine, and Georgia, the vaccination is yet to be started. All in all, the choice and availability of vaccines across the region illustrates how economic and geopolitical questions remain important. Finally, for many of the region countries vaccine skepticism and information as well as disinformation are important determinants in distributing vaccines. Summing up, the combination of these factors once again reminds us that how to best get back from the pandemic is truly a multidisciplinary question.
List of Participants
- Iurii Ganychenko, Senior researcher at Kyiv School of Economics (KSE/Ukraine)
- Jesper Roine, Professor at Stockholm School of Economics (SSE) and Deputy Director at the Stockholm Institute of Transition Economics (SITE/ Sweden)
- Lev Lvovskiy, Senior Research Fellow at the Belarusian Economic Research and Outreach Center (BEROC/ Belarus)
- Michal Myck, Director of the Centre for Economic Analysis (CenEA/ Poland)
- Natalya Volchkova, Director of the Centre for Economic and Financial Research New Economic School (CEFIR NES/ Russia)
- Pavlo Kovtoniuk, Head of Health Economics Center at Kyiv School of Economics (KSE/Ukraine)
- Sergej Gubin, Research Fellow at the Baltic International Centre for Economic Policy Studies (BICEPS/ Latvia)
- Yaroslava V. Babych, Lead Economist at ISET Policy Institute (ISET PI/ Georgia)
Disclaimer: Opinions expressed in policy briefs and other publications are those of the authors; they do not necessarily reflect those of the FREE Network and its research institutes.
Video of the FREE Network webinar “Addressing the Covid-19 Pandemic: Vaccination Efforts in Free Network Countries“