Vaccination against COVID-19

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.


[1] ECDC (2020), COVID-19 vaccination and prioritisation strategies in the EU/EEA,

[2] Meslé, M. et al. (2021), “Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021”, Eurosurveillance, Vol. 26/47,

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