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What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe?

In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe. In this article, Dimiter Toshkov investigates the determinants of COVID-19 vaccine hesitancy and refusal, focusing on Eastern, Southern and Western Europe.

Dimiter Toshkov
04 April 2023
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This article addresses the puzzle of significant variation in vaccine attitudes across Eastern, Southern and Western Europe. It tests whether the effects of demographic variables, trust-related attitudes and COVID-19-related beliefs and experiences differ across these regions. The statistical analyses show that the effects of these factors are largely similar across regions, but their levels differ markedly. Hence, it is not different attitude structures that explain vaccine hesitancy across Europe, but different levels of the relevant explanatory factors, such as trust in government, the medical profession, using the internet as a source of medical information, and experience with COVID-19.

The article puts forward three main contributions. First, it provides a comprehensive analysis of the influence of a large number of demographic and trust-related variables, as well as COVID-related experiences and beliefs for a large number of European states. Second, it identifies the difference in levels of vaccine hesitancy predictors in Eastern Europe rather than differential effects of these variables as potential explanations for the much higher levels of vaccine hesitancy and refusal in the region. Third, it shows that the effects of age and education are non-linear and the one of age is direct and indirect (via vaccine-related beliefs). Overall, the article contributes to understanding how social and political attitudes, which significantly affect the fight against pandemics, are formed and sustained.

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