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Covid-19 vaccination in Bulgaria and Romania: too easy to blame it on “fake news”

An analysis of the EDMO fact-checking network. Organizations that contributed to this analysis: PagellaPolitica/Facta, Proveri-AFP, Verificat-AFP

This article is the English translation of the original Non solo “fake news”: perché Bulgaria e Romania hanno così pochi vaccinate, published on Pagella Politica the 15th of October 2021.

There are two countries in the European Union which, despite having access to the vaccines purchased by the European Commission for all Member States, have an extremely low vaccination rate: Romania and Bulgaria.

The impact, in terms of deaths, is extremely severe. But what caused this very bad situation in the two countries of Eastern Europe? What is the role of disinformation? We have tried to answer these questions with the help of Bulgarian and Romanian fact-checkers.

Trends in the vaccination campaign and deaths

In Romania, 36.3% of the total population over 18 — according to data from the European Centre for Disease Prevention and Control (ECDC) — received at least one dose of vaccine as of 14 October. In Bulgaria, the share is only 24.7%. The EU average is 80.3%: more than double than the Romanian vaccination rate and more than three times the Bulgarian one.

Unfortunately, a correspondence exists between these negative vaccination records and the number of deaths from COVID-19: as of 12 October, Romania recorded 16 deaths per million inhabitants on a seven-day moving average, while Bulgaria 12.1 deaths per million inhabitants, the two worst figures in the EU.

Graph 1: 7-day moving average COVID-19 deaths in Romania, Bulgaria, the EU and Portugal. Source: Our world in data

On the same day, the EU average stood at 1.67 deaths per million inhabitants: this figure is almost ten times lower than in Romania and seven times lower than in Bulgaria. The comparison with the most vaccinated country in the EU, Portugal (98.2% of adults vaccinated with at least one dose) is even more telling, with 0.73 deaths per million inhabitants (again on 12 October).

Moreover, the situation in the two Eastern European countries — as shown in Graph 1 — is deteriorating. Romania, in particular, has seen the number of deaths increase by eight times over the last month: from just over 2 deaths per million inhabitants on 12 September to 16 deaths per million on 12 October. In Bulgaria, on the other hand, deaths increased from 8.5 to 12.1 per million inhabitants over the same period.

On average, the EU remained fairly stable, albeit slightly increasing: it was 1.11 deaths per million inhabitants on 12 September, reaching 1.67 deaths per million inhabitants one month later. Portugal, cited above, has seen improvement instead: from 0.89 deaths per million inhabitants to 0.73.

This is an undeniable reality, yet…

From the figures above, it is clear that the low rate of vaccinations against COVID-19 has a devastating impact on Romania and Bulgaria in terms of deaths. For example, data on deaths per million inhabitants recorded in recent weeks in the two Eastern countries are similar or even higher than those recorded in Italy at the peak of the first and second waves in 2020, before the vaccination campaign began.

The difference between the effects of the pandemic, after the summer, in a country with a high rate of vaccination compared to one with a low rate is evident. But then why is the vaccination campaign in Romania and Bulgaria going so badly?

Disinformation yes, but not enough

We have contacted our colleagues from Verificat-AFP (Romania), Valentina-Paula Cabescu, and from Proveri-AFP (Bulgaria), Rossen Bossev, who have provided us with various insights and data on the subject.

Romania

In Romania, a problem with fake news and disinformation for sure exists, but this does not seem to be the main factor influencing the vaccination campaign. Fake news circulate across all Europe — as also shown by the recent briefs of the European digital media observatory (Edmo) —, but the main difficulties arise when a large part of the population prefers to believe those over the official or more authoritative sources. And this is where some significant particularities of Romania emerge.

“From the beginning of the pandemic until now, we have changed two prime ministers, three governments and had six different people in charge of the Ministry of Health,” said Cabescu. “This has created a lot of mistrust. And this is not even over yet, as the government has yet again fallen after losing a no-confidence vote”.

The instability of governments, and their internal conflict, also had cascading effects on vaccinations. Ioana Mihăilă, Minister of Health until last September, recently attacked the government of which she was a member for having wasted the summer and for being “too quick to relax our messaging regarding the need to take the vaccine”.

In this regard, according to Cabescu, “people don’t understand why during summertime we can lift the measures and go on holidays but as soon as autumn comes we need to go back to the same restrictions. I have seen lots of people saying they’re being lifted so the politicians could enjoy their summertime holidays”.

The politicisation of the vaccination campaign, with premiers and ministers acting as sponsors for inoculation, had counterproductive effects, given the low popularity of the political class (in December 2020 election, turnout stopped at less than 32%). Political forces skeptical towards or opposed to vaccines — in particular the Alliance for the Unity of Romania, AUR, a populist force that almost reached 10 percent of the popular vote in the last elections — exploited popular skepticism towards political leaders and mistrust of the vaccination campaign.

In general, institutional communication may have been ineffective. According to a survey conducted before the start of the vaccination campaign, less than 40% of the total population was opposed to the vaccine in Romania. The rest were generally willing to get vaccinated, at least after receiving more information or seeing the vaccine work on the others. If the percentage of vaccinations has remained low, it is perhaps also because the population has not been provided with sufficiently clear and comprehensible information, for example on how vaccines could be developed quickly. The Romanian population is also the one with the lowest proportion of graduates in the European Union.

Other elements must be added to disinformation — which spreads unsubstantiated news about poisonous graphene oxide in vaccines, or about vaccines changing people’s DNAs, or making the virus worse – and to the poor official information of an unstable and unpopular management class.

In Romania, unvaccinated doctors are a large minority, accounting for 30% of the total in August (only recently the government decided to take action, setting up a draft law making the green pass compulsory for hospital staff). As a result, the population saw a divided medical community, and that increased confusion. “Doctors, experts, researchers who try to share their expertise and publicly encourage people to get vaccinated”, said Cabescu, have been subjected to insults and threats by the most extremist franges of no-vax and cospirationists, who are very aggressive.

Mainstream media also spread false information about the pandemic. Recently, for example, the (erroneous) news that Norway has reclassified COVID-19 as a normal flu was given by several information portals that were considered to be usually reliable.

In short, while Romania has certainly a widespread problem of disinformation, it seems more correct to say that this is a symptom of other problems — political instability, lack of trust in the authorities, lack of public education, polarisation, and mass media permeable to fake news — which in turn have a greater impact on the poor performance of the vaccination campaign.

Bulgaria

The situation in Bulgaria appears to be not very different. There is certainly a serious problem with fake news, but that is not the only – or even the main – one.

As reported by the journalist and fact-checker of Proveri-Afp Rossen Bossev, according to a sociological survey in November 2020, “40% of the population see the virus as a biological weapon created to reduce the population of the planet, 21% are those who believe that Bill Gates is behind the pandemic so that he can chip people. Nearly 12% even believe that the coronavirus spread directly through the 5G network”.

If such manifestly false information has this reach, it is easy, according to Bossev, to imagine the harm that could make more sophisticated false information “such as the statistics on breakthrough infections or deaths among the vaccinated”.

However, as noted above and as Bossev also pointed out, disinformation is endemic all around Europe, while low vaccination levels are not. There are therefore other elements to be considered and, among those highlighted by the Bulgarian fact-checker, many are in common with Romania.

First, the lack of trust in the institutions, perceived as unreliable: Bulgaria is the EU’s country perceived as most corrupt (together with Romania) according to the Transparency International’s Corruption Perceptions Index. “If people don’t trust the institutions, how could they trust their call to get vaccinated?”, Bossev is asked.

Second, the media are also poorly reliable in Bulgaria. In the Reporters Without Borders’ World Press Freedom Index, Bulgaria ranks last, not in the EU but across all Europe (with the exception of Belarus) and, according to Bossev, “the low levels of media freedom are directly linked to the quality of the information flow”.

Third, political instability has an important role: on 14 November, voters will be called to vote for the third time this year. An almost uninterrupted election campaign obviously increases the polarisation of public opinion and the instrumental use of pandemic-related topics.

Other important factors to be considered are age — according to a February 2021 survey, young people are the most skeptical about the vaccine —, income (people living in Sofia, the capital, are more favourable to vaccines) and educational attainment. GDP per capita in Bulgaria is the lowest in the EU as a whole and the proportion of graduates is significantly below the EU average (although countries such as Portugal and Italy, which have much higher rates of vaccination, have lower percentages of graduates: this figure alone is certainly not decisive).

Finally, in Bulgaria, the number of doctors vaccinated at the end of July was just over 60%. The percentage of teachers in September did not even reach 30%.

Therefore, it can be said also for Bulgaria that there is a serious problem of disinformation, but this appears to be — again — more a consequence of other problems (political instability, poverty, misinformation, bad examples, corruption, polarisation and so on), which are the main responsibles for the failure of the vaccination campaign.

In conclusion

The epidemiological situation in Bulgaria and Romania is in serious and worrying deterioration, because of the failure of their vaccination campaigns, which have managed to cover only a minority of the population.

This is due to a variety of factors, including the spread of fake news and disinformation. However, it appears to be wrong to give an excessive role to disinformation: this phenomenon is present throughout all Europe but thrives, and hits harder, in countries that have more serious problems which, reinforcing each other, create the perfect habitat for the proliferation of skepticism and fear of vaccines.

The two Eastern European countries, already the poorest in the EU in terms of GDP per capita, have serious problems with freedom and the general quality of information, corruption, stability and reliability of institutions and of the political class, and education (including of those who should lead by example, such as doctors).

In such a context, it is much easier for people to believe that under the government’s will to vaccinate as many people as possible are hidden unspeakable interests, conspiracies and shady schemes.

Tommaso Canetta, deputy director of Pagella Politica

*Fact-checking organizations that contributed to this analysis: PagellaPolitica/Facta, Proveri-AFP, Verificat-AFP

Photo by Ansa