Covid-19 Vaccinations: The Challenges in Eastern Europe

What next for face-to-face contact in the face of minimal vaccination rates?

Since March 2020, when the entire world started its journey towards a ‘new normal’ in combatting and living with Covid-19, we experienced an overnight shut down of all face to face social and Jewish communal activities within the organisations we support for older people in Ukraine, Georgia, Moldova and Belarus. With older people most at risk, and hospitals overwhelmed and under resourced, the impediment to stop the virus spreading was critical.

And so, we gave as much flexibility to our partner organisations as possible, allowing them to redistribute budgets for events that could no longer take place, ramping up their technical capacity to get themselves and older clients online, and investing in PPE for those essential home visits or doorstop deliveries. Yet the impact of 18 months of almost total self-isolation for our older clients has been catastrophic – affecting their physical and mental health, and general wellbeing. And unlike in the UK where many older people have their own garden to at least get fresh air, the majority of older people in Eastern Europe live in high-rise apartment buildings. A balcony might be their only saviour. One of our partner colleagues commented:

Forced isolation has really caused a high number of falls this year as their physical states are getting weaker due to staying at home: Homecare workers cannot take their client for a walk, so people simply do not get enough simple physical activities such as walking up the stairs, getting onto a bus or other transport. Therefore, without daily exercise, clients lose physical skills and are becoming less mobile, leading to problems with balance.

We also heard of several deaths among staff in our partner organisations, many others were hospitalised, and we know of hundreds of deaths among clients, mainly from the Survivor generation who are of an older age.

Once the first vaccines started to receive approval for usage in the UK at the end of December and the vaccination progress started to gather speed, we were aware that the roll-out for our elderly client group in Eastern Europe it was likely to be a longer journey. Vaccines were arriving in insufficient numbers (often donated from other countries/schemes) and the infrastructure for distributing them was lacking. We heard from partners in Moldova that residents who hold an EU passport due to their Romanian ancestry, could make the journey across the border to get vaccinated.

Since the availability of the different vaccines gradually started to increase, unfortunately, this has not been met with significantly increased numbers of people getting vaccinated. Anti-vax movements are strong in Eastern Europe and coupled with low trust in the national healthcare systems, older people have found themselves at the brunt of a confusing mess of information sources. Many family doctors (akin to GPs) advise patients not to get vaccinated at all, especially if they have chronic health conditions such as diabetes or heart conditions.

One of our partners in Southern Ukraine explained as follows:

The vaccine process is cumbersome, for many reasons. Mainly, people do not want to get vaccinated. There are also insufficient vaccines available, of varying quality. And our town is in a ‘green’ zone which means rates of infection are still quite low. As of today about 50% of our office staff are vaccinated, but among clients (people aged 60+) it’s about 5-6%.

Another colleague in Ukraine wrote For elderly, (they believe) the vaccination is risky, which means that it is safest for them to remain isolated for as long as possible. This was an opinion that was expressed by over a dozen of our participants who consulted with their local doctors in late 2020. Since initially there were no vaccines available and limited possibilities of transportation, most elderly were advised to stay at home. Other reason is that there is a lack of trust in the available vaccines and fear of complications. As for now most of our participants are very cautious with the vaccination and - directly speaking - waiting for Pfizer.”

We recognise that vaccination is a sensitive topic for colleagues and clients alike, yet we felt compelled to provide as much fact-based information as we could to enable people to make decisions based on reliable sources.

In May 2021 we embarked on a collaborative project with Project Kesher Ukraine to try and combat misinformation. We organised two webinars with a Ukrainian UNICEF expert, attended by 150 staff members from our partners, which provided up to date information on which vaccines were available, possible side effects, efficacy and answered multiple questions from participants who voiced their concerns (“If I had Covid, do I still need to get vaccinated? How long should I leave between first and second dose?”). The speaker also advised on how to protect yourself against contracting Covid-19 during the vaccination process. “Take several masks, sanitiser, and your own pen to sign in with. You may be waiting several hours so make sure to bring water and snacks, and a book.”

Additionally, with Project Kesher we produced a flyer on how to register for vaccination, designed specifically to be accessible to older people, which was distributed to around 30,000 Jewish older people in Ukraine over the summer months.

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Billboard in Ukraine encouraging older people to get vaccinated.

We helped provide billboards to encourage vaccination - this one reads, “Get vaccinated against Covid-19. Protect your health, and enjoy life with your grandchildren”.

Unfortunately, rates of infection are not abating. Most recently in Georgia a 3-week lockdown was announced, and the Health Minister announced there were no more beds for Covid-19 patients in hospitals.

Vaccination rates are slowly increasing but there remains scepticism about side effects, efficacy and who is eligible for vaccination. As of mid-September,  just 11.2% of the Ukrainian population, and 15% in Georgia, were fully vaccinated (both doses). Numbers are similar in Moldova (14%) and Belarus (15%). In Ukraine, older people are the lowest vaccinated age group, with only around 119,000 people over 80 having received a second dose. 

Given the support provided for Jewish older people who want to get vaccinated (help registering online, transport to the appointment, PPE if necessary) we believe the rates to be slightly higher among in the Jewish community than national averages.  

We will continue working on this issue throughout 2021-22 and look to expand activities into the other countries we work in - Moldova, Belarus and Georgia. In some locations, outdoor activities have been able to take place over the warmer months, with safety measures in place. But as a responsible funder, the question remains – if the vast majority chose to remain unvaccinated, when, if ever, will it be safe to resume the critical social, face to face activities which bring comfort, companionship and offer a safe space to thousands of people?  

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