Vaccine Hesitancy and Immunization Patterns in Central and Eastern Europe: Sociocultural, Economic, Political, and Digital Influences Across Seven Countries

Risk Manag Healthc Policy. 2025 Jun 12:18:1911-1934. doi: 10.2147/RMHP.S519479. eCollection 2025.

Abstract

Background/objectives: Vaccination programs are essential for preventing infectious diseases, yet the effectiveness of these programs varies significantly across Central and Eastern European countries due to diverse socio-economic, cultural, and political influences. This study examines vaccination trends in Hungary, Slovakia, Romania, the Czech Republic, Poland, Ukraine, and Lithuania, focusing on misinformation, regional healthcare disparities, and socio-cultural factors on vaccination rates.

Methods: A comprehensive review of national policies, vaccination rates, and factors influencing vaccine hesitancy was conducted across seven Central and Eastern European countries. Input from local health stakeholders and national data sources was analysed to contextualize vaccination patterns and challenges.

Results: Significant cross-country variation was observed. Hungary and the Czech Republic reported consistently high coverage of mandatory childhood vaccinations, while Romania and Ukraine experienced severe declines in uptake, leading to outbreaks of measles and polio. Slovakia demonstrated low COVID-19 vaccination willingness, and Poland recorded a sharp increase in formal vaccine refusals. Conversely, Lithuania implemented successful campaigns that improved uptake, particularly for influenza and pneumococcal vaccines. Differences were influenced by healthcare system structure, public trust, exposure to misinformation, and digital communication strategies.

Conclusion: Addressing vaccine hesitancy requires targeted, context-sensitive communication and digital literacy programs. Additionally, policy reforms to enhance accessibility, particularly in rural areas, and real-time monitoring systems can strengthen vaccination rates. Cross-border collaboration and tailored public health campaigns addressing cultural and socio-economic challenges are necessary to improve immunization coverage in these regions.

Keywords: Central and Eastern Europe; public health; vaccination trends; vaccine hesitancy.