The rapid development and deployment of vaccines was an important contributor to pandemic management. The deployment of COVID‑19 vaccines in situations of severe vaccine shortages required countries to prioritise their vulnerable populations. Alongside ensuring sufficient vaccine supply, other challenges included a shortage of equipment and staffing, logistics, managing several different vaccines, and the spread of mis- and disinformation. Adjustments were required, which included changes in eligible age according to the type of vaccination, the time interval between doses, recommendations for those infected previously with SARS‑CoV‑2, and new variants of concern. Countries adopted varying prioritisation strategies, depending on the main objective of their vaccination programmes. The elderly, health care workers and adults with co-morbidities were prioritised most commonly (ECDC, 2020[1]).
The elderly population was prioritised by all countries. Within the first half of 2021, an average of 68% of those aged 60 years and over completed their initial vaccination course across 27 EU countries. This increased to 84% by the end of 2021. The vaccination rate varied greatly across countries. Iceland, Malta and Denmark vaccinated more than 90% of the population aged 60 years or over within the first half of 2021. In contrast, the lowest vaccination rates were observed in Bulgaria (21%), Romania (32%) and Latvia (40%), achieving less than 50% coverage (Figure 8.1). Amongst the countries that reported on the vaccination of these groups in the ECDC data, the average completion of the initial vaccination course in 2021 was 68% for health care workers (15 countries) and 72% for long-term care residents (11 countries).
Vaccinating the whole population was crucial to minimising the risk of death and severe complications from COVID‑19 infection. After prioritising access to vaccination for the most at-risk groups in the first half of 2021, countries vaccinated the rest of their populations. It has been estimated that vaccination campaigns led to a reduction in deaths from COVID‑19 in those aged 60 and older by 250 000 people in the first year of vaccination across 23 EU countries. Countries with a high early vaccination, such as Malta and Ireland, were estimated to have reduced deaths by 70% (Meslé et al., 2021[2]).
By the end of 2021, 27 EU countries had vaccinated an average of 77% of the population aged 18 years and over, but with a wide variation. Portugal, Ireland, Malta and Denmark achieved the highest rates, with above 90% completion of an initial vaccination course. Countries in Central and Eastern Europe, such as Bulgaria, Romania, the Slovak Republic, Croatia and Poland, achieved a completion rate of below 65% among all adults by the end of 2021 (Figure 8.2). Improvements in vaccination coverage, including by reducing barriers (such as dis-information), remains crucial to resilient health systems.
