GLOBSEC Vaccination Trends Perceptions from Central and Eastern

Democracy & Resilience Programme

www.globsec.org 2) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (3 1. 2. Introduction Key highlights

The Central and Eastern Europe region began recording A majority in Central and Only 5% of respondents, on its first cases of COVID-19 in March 2020, initiating a race About the data 1. 5. to stop the spread of the virus and avert casualties. A Eastern Europe want to get average, mention Sputnik V year later governments are now challenged with swiftly The data included in this brief was collected in ten vaccinating their populations to achieve herd immunity Central and Eastern European countries (Austria, vaccinated. Outliers include as their vaccine of choice. before vaccine-resistant mutations emerge. Bulgaria, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Romania and ) in March 2021 based on a Bulgaria and Romania. Slovaks are outliers on this Societal buy-in, however, will be required if the representative sample of the adult population reflecting matter, with 15% indicating a vaccination programmes are to be successful, an age, gender, education and place of residence. Over outcome that is threatened by both anti-vax campaigns 1000 people were interviewed in each country through 2. The willingness to get preference for the Sputnik V backed by disinformation and conspiracy-theory the computer-assisted telephone interviewing (CATI) spreading outlets and public distrust directed towards method. This brief provides a glimpse into findings that vaccinated increased by 20- vaccine over alternatives. pertinent institutions. Though survey data from October will be more comprehensively published in June as part 30% in a five-month period 2020 pointed to concerns on this front, the latest opinion of our Democracy & Resilience Programme’s annual polling from March indicates an improved vaccine flagship report, GLOBSEC Trends 2021. across all V4 countries and 6. The age and education landscape. doubled in Slovakia. levels of respondents is indeed now on path towards eventually DEFINITIONS administering vaccines to around 60-70% of the adult influence their interest in V4: Czechia, Hungary, Poland and Slovakia population. Fewer people, however, have been brought A sizeable contingent - vaccination. A total of 60% on board in Bulgaria and Romania, with interest in Baltic states: Estonia, Latvia and Lithuania 3. vaccination hovering only around 40% in these two of university educated Central and Eastern Europe: V4 + Baltic States + Romania, around 20% of society - still societies. Numerous questions are raised against this Bulgaria and Austria backdrop. Will the lower vaccination rates of some remains either “rather not” respondents want to get countries detrimentally impact the headway made by willing or undecided on vaccinated, 15 percentage their neighbours? And will laggard countries, whose populations may potentially be unable to travel if they vaccination. points greater than people lack COVID passports, become more isolated? Or, on the contrary, will reopenings – and the social and economic with only an elementary benefits that come with them spur higher vaccine uptake? level education. Interest in These questions are to be answered over the upcoming 4. Central and Eastern year. Europeans express a clear vaccination increases with Those interested in getting jabbed, meanwhile, express preference for vaccines age, partially reflecting the trust in scientific bodies in the transatlantic area. A total of vaccination strategies of 48% of respondents eager to get vaccinated indicate that developed in Western they would prefer a Western European or U.S. developed countries (e.g. Moderna and CEE countries, which have shot. Another 34% of this group are keen on any vaccine approved by the European Medicines Agency (EMA). Pfizer) and EMA-approved initially prioritized older This finding should indeed be a wake-up call to CEE people for inoculation. governments that are considering the administration of vaccines. vaccines not yet approved by the EMA. 4) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (5 3.

Countries with fewer people interested in vaccination, nonetheless, include considerable pockets of residents who indicated that they would “rather not” get vaccinated as opposed to “definitely not”. The potential ambivalence among those who Willingness to get vaccinated responded “rather not” or “don’t know” on vaccination, in fact, provides an opportunity to still change attitudes. This “grey zone” represents, on average, around 20% of the adult population of the region. in 10 CEE countries Grey zone: Those who are rather not willing Vaccination intentions vary considerably across Central and Eastern Europe. The greatest level of interest was measured in Austria, with 8 in 10 respondents in the country either already vaccinated or open to it. Residents of Bulgaria and Romania, or do not know whether to get vaccinated meanwhile, were least inclined to get the jab.

Defitinely & rather yes Defitinely & rather not Already vaccinated (March 2021) Rather not Do not know

73% 16% 8% Austria Hungary 8% 4%

61% 24% 10% Slovakia Austria 8% 3%

Czechia 57% 29% 9% Poland 11% 7%

57% 27% 9% Poland Slovakia 12% 6%

55% 29% 11% Estonia Czechia 13% 5%

Hungary 55% 23% 17% Lithuania 13% 10%

53% 35% 7% Latvia Estonia 15% 6%

Lithuania 51% 30% 10% Latvia 18% 5%

33% 55% 5% Bulgaria Romania 19% 6% Willingness to get vaccinated in CEE

31% 49% 14% Romania Bulgaria 28% 7% 6) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (7

October 2020 vs. March 2021: A shift in vaccination attitudes over five months

The willingness to get vaccinated climbed steeply over a five-month period in Visegrad Four countries, Bulgaria and Romania. This shift has been most profound in Slovakia where vaccine interest doubled between October and March.

Willing to get vaccinated in March 2021 Willing to get vaccinated in October 2020 + already vaccinated

36% 70% 35% 66% 45% 72% 43% 66% 23% 38% 45% 46%

Slovakia Czechia Hungary Poland Bulgaria Romania

Willingness to get vaccinated rose by 20-30% in V4 countries 8) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (9

Vaccine preference by country

4. Western European or American. such as Pfizer or Moderna Any vaccine approved by the Medicines Agency Preferences for Russian, such as Sputnik particular vaccines Austria 40% Slovakia 23%

26% 19%

2% 15%

The survey findings indicate that people are more willing to get vaccinated in all ten CEE countries if they are Poland 34% Romania 20% administered a Western vaccine (e.g. Moderna or Pfizer) or an EMA-approved vaccine. These figures far surpass 18% 9% the share of respondents most interested in the Sputnik V shot. 1% 1% Disinterest in Sputnik V holds true even in Bulgaria despite the prevalence of pro-Russian sympathies in the country. Similar tepid interest was measured in Lithuania 29% Latvia 20% Hungary even though it is the only EU country currently administering the vaccine and expending considerable 16% 19% muscle to promote it1.

10% Slovakia is an outlier on Sputnik V, with men (18%) 2% drawn more to the vaccine than women (13%). Age (20% of people between 45 and 64 prefer Sputnik V) and education (19% of respondents with lower educational Estonia 26% Hungary 20% attainment prefer Sputnik V) also appear to influence attitudes towards the vaccine. 18% 22%

6% 4%

Czechia 25% Bulgaria 13%

27% 10%

3% 7%

Answers to question “If you had a choice, which vaccine from the following would you prefer?” Options provided: 1) Western European or American (such as Pfizer or Moderna); 2) Russian (such as Sputnik); 3) Chinese (such as Sinovac); or 4) any vaccine approved by the European Union Medicines Agency.

The results are presented as a percentage of the adult population for each country. The question of vaccine preference was, however, 1 https://www.dw.com/en/hungary-government-uses-vaccine-campaign-to-lash-out-at-political-opponents/a-57137738 posed only to those who responded they are “definitely” or “rather” planning to get vaccinated . 10) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (11

The preferences of the public in the CEE region towards Percentage of adult population willing to get vaccinated Western/EMA-approved vaccines vs. Sputnik V by EMA-approved COVID-19 vaccines by country

ESTONIA 18% 43%

LATVIA 19%

LITHUANIA 16%

5%

POLAND Western 18% Sputnik V + EMA approved

CZECHIA The proportion is calculated as an overall average of the adult population’ vaccine preference based on data for each state. 27% SLOVAKIA 19% AUSTRIA 26% HUNGARY 22% Western vaccines, selected by an average 25% of respondents as ROMANIA 9% their jab of choice, are the most trusted across surveyed countries.

An average of 18% of respondents indicate a preference for any EMA-approved vaccine. Only 5% of people, BULGARIA meanwhile, are inclined to choose the Sputnik V vaccine 10% over Western, Chinese and EMA-approved alternatives.

Interest in the Chinese vaccines is negligible apart from Hungary, where a small proportion of the adult population The results are presented as a percentage of the adult population in each country. The question of vaccine preference was, however, (6%) would opt for them. posed only to those who responded they are “definitely” or “rather” planning to get vaccinated. 12) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (13 5. Willingness to get vaccinated according to age and education

An analysis of socio-demographical variables underscores the fact that vaccination interest is Potential to get vaccinated by age group. influenced, in addition to between-country variation, by age and educational attainment within each country. Austria Bulgaria Romania Vaccination 100 potential by age 89%

The graphs below display vaccination potential among 81% different age groups, encompassing people professing 79% 79% 80 that they are “definitely” or “rather” planning to get 79% vaccinated and those who were already vaccinated at the 74% time of the survey. A positive correlation was observed between respondent age and vaccination potential, with older people more willing to get vaccinated than young. 60 56% Austria, where vaccine potential is robust among all age 51% groups, is a regional outlier. Conversely, a 45-percentage 46% point gap was measured in Latvia between the youngest 44% 42% and oldest respondents. 44% 40 36% 43% Among the oldest age demographic (age 65+), Bulgarians 40% expressed the least interest in vaccination in the CEE Vaccination 34% region, with only 44% either already vaccinated or open 31% to getting the jab. This figure stands in stark contrast to potential their Hungarian peers where vaccination potential was 20 24% recorded at 90% for this age group. It is important to rises with note that, at the time of the survey, Hungary, in contrast to all other surveyed countries, had already begun age in V4 and administering vaccines both approved and not approved Baltic states by the EMA2. 0

18 - 24 y.o. 25 - 34 y.o. 35 - 44 y.o. 45 - 54 y.o. 55 - 64 y.o. 65+ y.o.

The calculated percentages include people who responded with affirmative answers (“definitely yes” and “rather yes”) on vaccination 2 This information is valid to April 16, 2021. interest or indicated that they are already vaccinated 14) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (15

Potential to get vaccinated according to Potential to get vaccinated according to different different age groups of V4 respondents age groups of respondents from Baltic states

Czechia Hungary Poland Slovakia Estonia Latvia Lithuania

100 100

90% 86% 84% 79% 80 80 82% 74% 78% 71% 74% 68% 76% 73% 68% 67% 74% 65% 70% 72% 60% 66% 60% 62% 60% 58% 60% 59% 60 60 54% 58% 61% 60% 58% 56% 58% 55% 55% 52% 46% 50% 49% 46% 40 40 33%

20 20

0 0

18 - 24 y.o. 25 - 34 y.o. 35 - 44 y.o. 45 - 54 y.o. 55 - 64 y.o. 65+ y.o. 18 - 24 y.o. 25 - 34 y.o. 35 - 44 y.o. 45 - 54 y.o. 55 - 64 y.o. 65+ y.o.

The calculated percentages include people who responded with affirmative answers (“definitely yes” and “rather yes”) on vaccination The calculated percentages based on age include people who responded with affirmative answers (“definitely yes” and “rather yes”) on interest or indicated that they are already vaccinated. vaccination interest or indicated that they are already vaccinated. 16) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (17

Willingness to get vaccinated and educational attainment

The willingness of individuals to get vaccinated is also linked to educational attainment; people with higher levels of formal education are generally more likely to get the vaccine.

This pattern is illustrated, for example, in Latvia’s 36 percentage point gap, the largest in the region, in vaccine interest between people living in Lithuania. A total of 64% of Lithuanians with elementary education, nevertheless, are interested in getting vaccinated, comparing favourably to those with higher education levels in the country. Educational attainment appeared to elicit no effect in Poland.

Average willingness to get vaccinated in CEE region based on educational attainment of respondents

45%

% of resp. with elementary education

60%

% of resp. with university education

The average of affirmative answers (“definitely yes” and “rather yes”) in response to the question: “Are you planning to get vaccinated against COVID-19?” among respondents with elementary and university education. 18) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (19 6. Annex

The numbers in the tables represent percentages of the respondents. The abbreviations represent the following countries: AT – Austria; BG – Bulgaria; CZ – Czechia; EE – Estonia; HU – Hungary; LV – Latvia; LT – Lithuania; PL – Poland; RO – Romania; SK – Slovakia.

Overview of answers to the question: “Are you planning to get vaccinated against COVID-19?” in percentages. Affirmative answers (“definitely agree” and “rather agree”) of respondents on the statement “I would get vaccinated against COVID-19” in October 2020. Already Do not know Definitely yes Rather yes Rather not Definitely not vaccinated (do not read) SK CZ HU PL BG RO AT 56.9 15.7 7.5 8.9 8.3 2.7 Definitely agree 16.7 13.7 30.4 22.0 5.4 19.2 BG 11.4 21.4 28.1 27.3 5.0 6.8 Rather agree 19.4 21.7 14.7 21.4 17.9 25.7 CZ 40.1 16.9 12.6 16.7 9.1 4.6 EE 33.7 20.8 14.9 13.7 10.5 6.3 People affirming vaccine willingness (“definitely yes” and “rather yes”) or indicating that they have been “already HU 45.0 10.2 8.4 15.0 17.2 4.2 vaccinated”, reported in percentages, in response to the question: “Are you planning to get vaccinated against COVID-19?”. LV 29.1 23.7 18.0 17.0 7.3 5.0 LT 27.4 23.9 12.9 16.6 9.6 9.6 AT BG CZ EE HU LV LT PL RO SK PL 39.2 17.8 11.4 16.0 8.5 7.1 18 - 24 y.o. 79.2 23.8 64.9 58.2 52.1 32.5 45.7 51.6 44.4 54.4 RO 19.5 11.9 19.2 29.3 14.3 5.9 25 - 34 y.o. 78.6 30.7 46.0 59.9 58.0 49.9 56.4 59.6 35.9 68.2 SK 44.2 16.7 12.0 11.7 9.5 5.9 35 - 44 y.o. 80.7 40.4 58.3 48.7 59.5 60.0 57.5 54.5 41.9 71.0 45 - 54 y.o. 73.8 34.2 65.5 68.2 73.7 55.4 59.2 60.6 51.1 70.3 Breakdown of adult populations’ attitudes towards vaccination against COVID-19 55 - 64 y.o. 78.7 43.4 72.7 67.2 85.5 62.0 59.8 71.9 55.7 74.1 AT BG CZ EST HU LV LT PL RO SK 65 + y.o. 89.2 44.3 84.3 78.5 90.0 77.5 73.7 82.1 46.4 75.9 Not planning to get Not 16.4 55.4 29.3 28.6 23.4 35.0 29.5 27.4 48.4 23.7 planning/ Do vaccinated Vaccine willingness (“definitely yes” and “rather yes”), reported in percentages, based on the level of educational not know if Do not know if planning attainment of respondents on the question: “Are you planning to get vaccinated against COVID-19?”. 2.7 6.8 4.6 6.3 4.2 5.0 9.6 7.1 5.9 5.9 planning to get vaccinated Western European or AT BG CZ EE HU LV LT PL RO SK American (such as Pfizer 40.4 13.4 24.7 25.8 19.6 20.3 29.5 33.9 20.4 23.1 Elementary/ without 69.0 30.8 49.1 33.3 50.4 25.9 63.5 59.2 20.0 53.6 or Moderna) formal education Russian (such as Secondary or 2.2 6.9 3.1 6.4 3.7 10.3 2.5 0.5 0.8 15.4 Sputnik) apprenticeship Planning 69.9 24.1 53.7 52.6 53.0 24.0 37.6 54.5 26.9 56.3 Chinese (such as without school leaving to get 0.2 0.0 0.0 0.2 5.7 0.4 0.2 0.2 0.0 1.0 Sinovac) exam vaccinated Secondary with school Any vaccine approved 76.8 33.1 58.8 51.7 53.5 50.8 50.7 59.9 29.1 63.6 by the European Union 26.0 9.7 26.9 18.0 22.4 18.6 16.1 18.2 8.5 18.7 leaving exam Medicines Agency University 79.4 41.7 64.6 67.1 65.2 61.9 54.8 56.7 45.1 65.8 Do not know which 3.8 2.8 2.3 4.2 3.8 3.1 3.1 4.2 1.7 2.7 vaccine Vaccinated Already vaccinated 8.3 5.0 9.1 11 17.2 7.3 9.6 8.5 14.3 9.5 20) GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe GLOBSEC Vaccination Trends | Perceptions from Central and Eastern Europe (21 7. Credits

AUTHORS:

Dominika Hajdu, research fellow Katarína Klingová, senior research fellow Miroslava Sawiris, research fellow

Democracy & Resilience Programme

This publication and research were supported by the National Endowment for Democracy.

GLOBSEC and the National Endowment for Democracy assume no responsibility for facts or opinions expressed in this publication or their subsequent use. Sole responsibility lies with the authors of this publication.

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