COVID-19 vaccination in Ukraine – The Lancet Infectious Diseases

By Evelyn J. Archuleta Last updated May 5, 2021

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Widespread reluctance to vaccinate in Ukraine threatens the success of the country’s COVID-19 vaccination program. Edward Holt reports.

Ukraine has finally started its COVID-19 vaccination program – months after other European countries – following what critics say are delays due to political struggles and corruption allegations. But even at the start, the government admitted that the country faces a potentially serious obstacle to the success of the program: widespread reluctance to immunize both among the general population and among health workers. Speaking at a public event in Kiev in early February, President Volodymyr Zelensky said: â€œHaving solved the problem of vaccine supply, we are faced with a new problem: the mistrust of the vaccine. ” regarding vaccinations and the refusal of a large part of the population to obtain [COVID-19] vaccine.”

Investigations prior to the SARS-CoV-2 pandemic, in which more than 25,000 people in Ukraine died from COVID-19, have highlighted the depths of vaccine skepticism in the country. A Wellcome Trust survey in 2019 showed that only 29% of Ukrainians believe vaccines are safe, while 50% believe they are effective. â€œThere is a long history of reluctance to vaccinate in Ukraine,â€ said Lotta Sylwander, Ukrainian representative for UNICEF, which helps manage vaccine deliveries to Ukraine. Infectious Diseases The Lancet: â€œSome of them date back to Soviet times when the administration of vaccines was not good, others because of general mistrust of the health system, and others are due to a specific incident which left its mark on society. â€ This incident was a high profile case in 2008, when a boy died from a measles and rubella vaccination. His death was unrelated to the vaccination, but incorrect media reporting on the case and a government response that many considered confused created deep mistrust of vaccinations among the public which continues today. . UNICEF data showed that in the 5 years following death, childhood immunization coverage fell from around 80% to 50%. Reluctance to vaccinate has been identified as the root cause of a huge measles epidemic in the country, which between 2017 and 2019 recorded more than 100,000 infections and more than 40 deaths. Surveys suggest a similar reluctance towards COVID-19 vaccinations.

In February, Prime Minister Denys Shmyhal said only 50% of the population was willing to be vaccinated against COVID-19. A study by the EU-funded research project RECOVER published the same month estimated this statistic to be slightly higher at 61%. The WHO has said coverage needs to be 65-70% to achieve population immunity. Igor Yakusheckin, an economist from Kiev, explained why he believed so many Ukrainians were reluctant to get vaccinated against COVID-19: â€œUkrainian authorities were not transparent about their vaccination policy. They didn’t want to say when the vaccinations would start, then we learned from the media that 80% of the available vaccines would come from AstraZeneca and much less from Pfizer-BioNTech, then we found out the government was negotiating with the producer. Chinese Sinovac. People have no idea what vaccine they will receive. It is all confusing and not very transparent, which has made people suspicious and worried about their own safety. He added, â€œI am not going to get the vaccine. I know vaccination is necessary to end the pandemic, but not at any cost. “

There also appears to be widespread reluctance to immunize among health workers across the country. Sylwander said UNICEF had information that up to 40% of Ukrainian health workers are reluctant to get vaccinated. Svitlana Guk, head of the Respiratory Medicine Center at Feofania Clinical Hospital in Kiev, said Infectious Diseases The Lancet: “There is a fairly serious hesitation with regard to vaccines [among health-care workers]. This is due to the lack of reliable information on how vaccines are developed, work and the quality of their production, as well as guarantees that second doses will be delivered on time. It’s not that doctors consider the vaccine itself to be bad, but that there is a lack of professional information. [about the vaccines]. She added that it was essential that as many people as possible, including health workers, be vaccinated to ensure the population’s immunity and reduce the chances of new strains of the virus emerging. It is not known to what extent this reluctance could affect the roll-out of the immunization program, in which health workers will be among the first to receive doses. The vaccination will be voluntary, but President Zelensky said he believes health workers have no right to refuse vaccination.

The Ukrainian government is working with UNICEF on a public campaign to encourage people to get vaccinated, but even if authorities manage to convince a population reluctant to immunize, it may be a long time before widespread immunization coverage occurs. is carried out in the country. The government plans to vaccinate 50% of the population in 2021-2022. But a report from The Economist Intelligence Unit (London, UK) suggested it would be 2023 before widespread coverage was achieved in the country.

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DOI: https://doi.org/10.1016/S1473-3099(21)00156-0

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