European Journal of Public Health, Vol. 34, No.

1, 156–162
# The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
https://doi.org/10.1093/eurpub/ckad201 Advance Access published on 12 December 2023
...............................................................................................................
An analysis of COVID-19 vaccination campaign
in Ukraine
Tetiana Vasylivna Mamontova

Physiology Department, Poltava State Medical University, Poltava, Ukraine

Correspondence: Tetiana Vasylivna Mamontova, Physiology Department, Poltava State Medical University,
23 Shevchenko Str., 36011 Poltava, Ukraine, Tel: þ38 (0) 50 67 67258, e-mail: mamontova-tv@ukr.net

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

Background: The Coronavirus disease (COVID-19) pandemic is still an important problem of concern in Ukraine.
The rapid deployment of the vaccination program is a key event for the formation of herd immunity and helps to
prevent negative outcomes, overloading the public health system. Methods: The object of the retrospective-
archival study was a depersonalized database of open panels on the management of the COVID-19 situation from
the Ministry of Health of Ukraine. Results: The total number of COVID-19 cases in Ukraine as of 25 December
2022 amounted to 5 314 388 individuals (12.83% of the population), and COVID-19-related deaths reached
110 029 individuals (0.26% of the population). The overall number of COVID-19 vaccinated persons in Ukraine
as of 16 January 2022, with one dose was 36 198 per 100 000 persons (36% of the population), and with two
doses, it was 34 703 per 100 000 persons (35% of the population). It was shown a decrease in the number of
COVID-19 vaccinated persons among men and persons over the age of 70. In the dynamics of COVID-19 vaccin-
ation with one and two doses, an increase in the number of persons vaccinated with Pfizer/BioNTech and
CoronaVac was noted. Conclusions: Despite the significant increase in the morbidity and mortality rates of
COVID-19, the coverage of vaccination among the population remained insufficient in Ukraine. The effective
COVID-19 vaccination strategy should include appropriate management and ensuring the public health system
capacity, implementation of information technologies to address logistics issues, and clear communication strat-
egies to maintain public trust.
...............................................................................................................

Introduction throughout the country. During the period of war, there were se-
curity issues, destruction of the system, and chains of timely delivery

Rcrease in COVID-19 morbidity and mortality is one of the most

educing the social and medical impact caused by the global in- and distribution of vaccines, along with limited mobility for provid-
ing immunization services.4,5 Since the beginning of the war, the
critical priorities for national healthcare systems worldwide. For this mass displacement of about 15 million citizens has been registered: 6
purpose, on 24 December 2020, Ukraine developed the COVID-19 million persons were forced to leave the country and 9 million be-
vaccination program ‘Roadmap for the Implementation of the came internally displaced persons.6 These population groups are at a
Vaccine against Acute Respiratory Disease COVID-19 Caused by high risk of missing or experiencing delays in receiving the neces-
the severe acute respiratory syndrome coronavirus 2 (SARS-CoV- sary vaccine doses, making them highly susceptible to infectious
2) Coronavirus and Conducting Mass Vaccination in Response to diseases.7 However, the experience of the deployment of the
the COVID-19 Pandemic in Ukraine in 2021–22’.1 One of the key COVID-19 vaccination program in Ukraine from the perspective
directions of this program was to ensure adequate and equal access of assessing its effectiveness in preventing morbidity and mortality
to effective COVID-19 vaccines for the entire population. remains unanalyzed, which strengthened the determination to assess
Ukraine started the COVID-19 vaccination program a few the dynamics of COVID-19 epidemiological characteristics in
months after other European countries, on 24 February 2021. The the country.
campaign was planned to be conducted in five stages based on The aim of this study was to track the total number of COVID-19
prioritizing at-risk groups within the population. Five vaccines are vaccinations with a breakdown into first and second doses, to en-
allowed to be used to implement the immunization program against hance the understanding of the scale and pace of the vaccination
COVID-19: Comirnaty (Pfizer/BioNTech, BNT162b2), CoronaVac campaign’s deployment in Ukraine.
(Sinovac Biotech), AstraZeneca (Covishield, SKBio), Moderna
(mRNA-1273), and Johnson & Johnson (Janssen Ad26.COV2.S).2 Methods
However, from the beginning, the campaign encountered numerous
factors that seriously hindered its success, including widespread The object of the retrospective-archival study was a depersonalized
hesitancy regarding vaccination among both the general population database of open panels on the management of the COVID-19 situ-
and healthcare workers, caused in part by misinformation about ation from the Ministry of Health (MOH) of Ukraine. The epi-
vaccine safety and efficacy, undermining public confidence in the demiological situation of COVID-19 was assessed from 3 March
authorities, logistical problems in the supply of vaccines.3 According 2020 (the patient zero case) to 25 December 2022. The deployment
to the Ukrainian government’s initial forecasts, it was planned to of the COVID-19 vaccination campaign was assessed from
vaccinate 50% of the population in 2021–22, but with the start of 24 February 2021 (the start of the campaign) to 16 January 2022.
armed conflict, widespread COVID-19 vaccination coverage was not Epidemiology of the COVID-19 data is presented as weekly new
achieved in the country. The full-scale invasion of Ukraine by Russia cases of illness, weekly new cases of death, cumulative illness cases
on 24 February 2022, caused not only the destruction of medical and cumulative death cases. The data of the COVID-19 vaccination
infrastructure but also caused an unprecedented humanitarian crisis campaign were determined by weekly new cases of COVID-19
 COVID-19 vaccination campaign in Ukraine 157

vaccination, divided by the number of vaccine doses [one dose and [16% population of Ukraine; Me—85.35; (IQR 24.55–165.2)] and
all doses according to the vaccination protocol (full vaccination)] 18 799 women per 100 000 persons [19% population of Ukraine;
with distribution by gender, age group and type of vaccine. The Me—103.73; (IQR 25.14–195.5)].
age groups of COVID-19 vaccinated persons were divided into The analysis of the age structure revealed inequality in the distri-
intervals as follows: 12–15, 16–19, 20–39, 40–49, 50–59, 60–69, bution of COVID-19 vaccines due to a significant decrease in the
70–79 and 80þ. The state of epidemiology and vaccination against number of vaccinated persons among children and adolescents
COVID-19 was assessed according to indicators calculated per under 19 years and elderly persons over 70 years, regardless of the
100 000 population. number of vaccine doses received (figure 2c and d).
Statistical analysis of data was carried out using the program COVID-19 vaccines were received by the least number of children
‘STATISTICA 10.0’ (StatSoft, Inc., USA). Descriptive analysis, in aged from 12 to 15 years: 54 per 100 000 persons [0.05% population
the form of the sum, median (Me) and interquartile range (IQR), of Ukraine; Me—0.8; (IQR 0.42–3.6)] vaccinated with the first dose,
was used for various epidemiological or vaccination indicators, as 46 per 100 000 persons [0.5% population of Ukraine; Me—0.42;
they have outliers, for some indicators frequency, and percentages (IQR 0.35–4.37)] with the second dose. While elderly persons over
were used. Chi-square statistics (v2) were used to test the difference 80 years were insufficiently immunized with COVID-19 vaccines:
between two independent groups. A P value below 0.05 was consid- 702 per 100 000 persons [0.7% population of Ukraine; Me—3.1;
ered a statistically significant limit. (IQR 1.19—6.2)] vaccinated with the first dose, 641 per 100 000

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

persons [0.64% population of Ukraine; Me—3.9; (IQR 1.58–6.57)]
with the second dose (Supplementary table S2).
Results Thus, epidemiological monitoring of demographic indicators
Analysis of the dynamics of morbidity and mortality indicates an emerging increased risk of severe COVID-19 outcomes
among unvaccinated men and elderly individuals. These data con-
from COVID-19 firm the necessity of focusing on a personalized approach, consid-
In Ukraine, as of 25 December 2022, the cumulative COVID-19 ering the gender and age specifics of the target population, when
incidence was 5 314 388 persons (12.83% population of Ukraine; optimizing the COVID-19 vaccination strategy.
Me—16 908; [IQR 43 585–49 059]), the cumulative COVID-19 mor-
tality was 110 029 persons (0.26% population of Ukraine; Me - 263; Assessment of the dynamics and structure of the
[IQR 85–1059] (figure 1). At the time of the study, the average
COVID-19 vaccination campaign
COVID-19 incidence in Ukraine was 40.82 per 100 000 persons,
the COVID-19 mortality rate was 0.63 per 100 000 persons. Analysis of the COVID-19 vaccination rates from February 2021 to
Throughout the course of the pandemic from 2020 to 2022, there January 2022 showed a gradual increase in the number of persons
have been five peaks of increased weekly COVID-19 morbidity and who received one or two doses of vaccines. In the trends, the highest
mortality rates (Supplementary figure S1a and b). The maximum peak of COVID-19 vaccination occurred in October–November
rate of morbidity was observed during the fourth wave of the pan- 2021, namely, the most immunized with one dose in the period
demic—in February 2022, with 24 942 weekly new cases, and the from 42 to 45 weeks, and two doses in the period from 45 to
maximum rate of mortality—during the third wave, in November 48 weeks (figure 3a).
2021, with 4622 weekly death cases. During the period from 24 February 2021 to 16 January 2022,
From 2020 to 2021, the number of COVID-19 new cases 36 198 per 100 000 persons [36% population of Ukraine; Me—576.3;
significantly increased by 2.4 times from 1.07 million to 2.55 million (IQR 225.4–1043.5)] received one dose of COVID-19 vaccines;
persons (P < 0.05). In 2022, compared with the previous year, 34 703 per 100 000 persons [35% population of Ukraine;
the number of COVID-19 new cases decreased by 0.6 times to Me—755.8; (IQR 43.3–1111.0)] received two doses.
1.69 million persons (P > 0.05) (Supplementary table S1). The speed of deploying the COVID-19 vaccination campaign and
In the period from 2020 to 2021, the number of COVID-19 deaths the dosing of the COVID-19 vaccines is key in achieving target
significantly increased by 4.1 times, rising from 18 536 persons to indicators. The structure of the COVID-19 vaccination campaign
75 572 persons (P < 0.05). Subsequently, in 2022, compared with revealed a temporal and quantitative gap in the population’s de-
2021, the COVID-19 mortality rate significantly decreased by 0.21 mand for different types of vaccines (figure 3b and c). At the be-
times to 15 912 persons (P < 0.05). ginning of the COVID-19 vaccination campaign in Ukraine, from
Thus, since the beginning of the COVID-19 pandemic in Ukraine, February to March 2021, for a consecutive period of seven weeks,
the epidemiological situation has been marked by a continuous in- the single AstraZeneca vaccine (Covishield, SKBio) was used for
crease in morbidity and mortality among the population, which individuals at critical risk of infection and development of
required the immediate implementation of vaccination measures COVID-19 as well as those performing critical functions in response
capable of preventing further negative outcomes. However, the sig- to the COVID-19 pandemic. The next stages of the vaccination
nificant reduction in COVID-19 morbidity and mortality rates campaign were already implemented with five vaccines available
throughout 2022 in Ukraine suggests an underestimation of the to the population, which were obtained through state procurement
true scale of the pandemic during the wartime period. mechanisms or within the framework of the COVAX international
initiative.8 The further vaccination process was continued since
13 April 2021, with the CoronaVac vaccine (Sinovac Biotech), since
Gender and age indicators of COVID-19 19 April 2021, with the Comirnaty vaccine (Pfizer/BioNTech,
The assessment of gender structure among COVID-19-vaccinated BNT162b2), since 20 July 2021, with the Moderna vaccine
persons revealed heterogeneity between men and women (figure 2a (mRNA-1273) and since 4 August 2021, with the Johnson &
and b). The number of COVID-19-vaccinated women slightly Johnson vaccine (Janssen Ad26.COV2.S).
exceeded the number of men while receiving the first and second A more pronounced increase in demand among the population
doses of vaccines (Supplementary table S2). for Comirnaty (Pfizer/BioNTech, BNT162b2) and CoronaVac
The first dose of COVID-19 vaccine was received by 16 386 men (Sinovac Biotech) vaccines compared with other types of vaccines
per 100 000 persons [16% population of Ukraine; Me—78.1; (IQR was noted (Supplementary table S3). In comparison, the number of
11.83–134.6)] and 19 812 women per 100 000 persons [20% popula- persons vaccinated with Comirnaty (Pfizer/BioNTech, BNT162b2)
tion of Ukraine; Me—91.7; (IQR 12.42–167.2)]. The second dose of with the first dose was 15 724 per 100 000 persons [Me—336.4; (IQR
COVID-19 vaccine was received by 15 905 men per 100 000 persons 206.7–493.5)], with the second dose—15 771 per 100 000 persons
158 European Journal of Public Health

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

Figure 1 Dynamic of weekly new cases of COVID-19 and cumulative morbidity from COVID-19 (a), weekly new deaths from COVID-19 and
cumulative mortality from COVID-19 (b) in Ukraine in 2020–22 y.y.

[Me—421.6; (IQR 238.2–539.3)], on the other hand, vaccinated with Biotech) had the highest share. The overall assessment of the situ-
the CoronaVac vaccine (Sinovac Biotech) by 1.3 times less with the ation revealed an insufficient level of COVID-19 vaccination to
first dose—11 709 per 100 000 persons [Me—237.9; (IQR 108.6– achieve ‘herd immunity’ among the population of Ukraine. The
296.9)] and by 1.4 times less with the second dose—11 079 per obtained results can have significant implications for determining
100 000 persons [Me—238.9; (IQR 139.5–328.5)]. further directions for improving the strategy of the vaccin-
In general, the administration of the first and second doses of ation campaign.
COVID-19 vaccines followed the recommended immunization
schedules. It was found that at the beginning of the immunization, Discussion
there was a tendency to shift toward a delay with an average dur-
ation of 4 weeks (from 16 to 19 weeks 2021) between the first and COVID-19 vaccination has significantly altered the course of the
second doses of the Comirnaty vaccine (Pfizer/BioNTech, pandemic, saving tens of millions of lives worldwide; however, it
BNT162b2) (figure 3b and c). has also posed a substantial challenge for governments, public health
The analysis of COVID-19 vaccination trends in Ukraine during systems and the population. Understanding the impact of vaccin-
2021 revealed that despite the steady increase in rates, 36% and 35% ation on the course of the COVID-19 pandemic at a country level is
of the country’s population received the first and second doses of a complex task, given the heterogeneous access of countries to vac-
vaccines, respectively. Among the five types of COVID-19 vaccines, cines combined with measurable outcomes, variability within the
Comirnaty (Pfizer/BioNTech, BNT162b2) and CoronaVac (Sinovac target cohort, vaccine dosing, development of vaccination
 COVID-19 vaccination campaign in Ukraine 159

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

Figure 2 Gender (a, b) and age (c, d) indicators of the population during COVID-19 vaccination with one and two doses in Ukraine,
100 000/population

infrastructure, changing landscape of circulating SARS-CoV-2 virus among the population of Ukraine during the fourth wave of the
strains, implemented national quarantine restrictions, and even pandemic (6th week).
more so, especially the impact of armed conflicts. However, an ana- The priority list for COVID-19 vaccine access in Ukraine recom-
lysis of the vaccination strategy may be important for assessing the mends a predominant focus on professionals (healthcare workers;
effectiveness of the COVID-19 immunization program and identi- social workers; persons and workers living in long-term care facili-
fying ways for its optimization. In this study, trends and the deploy- ties; military personnel; employees of critical state security struc-
ment strategy of the vaccination program implemented in Ukraine tures; teachers and employees in the field of education; persons
to protect citizens from the SARS-CoV-2 virus have been who are in places of restriction of freedom and employees of these
investigated. structures) but provided for taking into account age (60 years and
The start of the COVID-19 vaccination campaign in Ukraine was older) and health status (adults aged 18–59 with concomitant dis-
characterized by a slow start (8th week of 2021), as it began shortly eases who are at risk regarding the development of complications
before the increase in the second wave of morbidity and mortality of and the occurrence of death).1,10 An additional measure to strength-
the pandemic (12th week of 2021) among the country’s population. en vaccination efforts was the MOH of Ukraine’s approval on 7
This situation was caused by numerous disputes between govern- October 2021 of a list of professions for which COVID-19 vaccin-
ment officials that arose over the purchase of the first doses of ation is mandatory, encompassing employees in educational institu-
vaccines and the clarification of logistical mechanisms for supply, tions and executive authorities (both central and regional).11
which required storage of the vaccines in ultra-low temperature cold The demographic analysis of COVID-19 vaccinations reveals an
equipment.9 The pace of the vaccination campaign significantly imbalance by age and gender categories, showing a decline in the
accelerated by the 42nd week of 2021, on the eve of the third proportion of men and older individuals receiving both first and
wave of the pandemic, which was marked by a record-high mortality second doses. According to the MOH of Ukraine data, during the
rate (45th week of 2021—4622 people per week) for the entire period 10th week of 2020–21st week of 2021, women prevailed in the num-
of the COVID-19 pandemic in Ukraine. In general, in 2021, the ber of confirmed COVID-19 cases (59.5% of persons), and the
population of Ukraine was vaccinated against COVID-19 with the elderly over 70 years—in the number of deaths (52.5% of persons).1
first dose of 36% persons and with the second dose of 35% persons. The results showed that women were more willing than men to be
The target indicators declared from the beginning of the COVID-19 vaccinated against COVID-19, despite high levels of distrust in the
vaccination program for 2021, which is 50% of the country’s popu- safety and efficacy of vaccines among women at the start of the
lation, were not achieved. The level of morbidity at the beginning of campaign.12 The national vaccination program considered the ele-
2022 reached its record high, amounting to 24 942 new weekly cases vated risks for specific age groups and suggested vaccination for
160 European Journal of Public Health

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

Figure 3 The dynamic of COVID-19 vaccination in Ukraine: common cases with one and two doses (a); different types of vaccines with one
dose (b); different types of vaccines with two doses (c), 100 000/population
 COVID-19 vaccination campaign in Ukraine 161

those over 80 years during the second stage and for those aged 65– It relies on the country making the latest figures on administered
79 years old during the third stage. The vaccination data for the doses available in a timely manner. Also, Ukrainian
elderly reveals a concerning trend: In 2021, one and two vaccine organizations provide daily or weekly updates on the different
doses of vaccine received by only 2.31% and 2.24% of persons aged web platforms that complicate the interpretation of reported data.
between 70 and 79 years, respectively, and a mere 0.7% and 0.64% of In Ukraine, access to COVID-19 vaccination data was closed with
those above 80 years, respectively. These data show that the vaccin- the beginning of the war on 24 February 2022. This affected the
ation coverage target for persons aged 60 years or more (9 978 194 accuracy and comprehensiveness of our analysis in assessing the
persons, 24.1% population of Ukraine)1 was not achieved. The low speed of the vaccination rollout after the onset of the war. It’s im-
level of COVID-19 vaccination among the elderly serves as a clear portant to acknowledge this limitation and interpret the results
signal to strengthen the targeted monitoring and information on the within this context.20
vaccination of this age group. Analyzing the data, it can be concluded that since the beginning
The President and Government of Ukraine made significant
of the deployment of the COVID-19 vaccination campaign, Ukraine
efforts to promote the vaccination program and obtain COVID-19
has been faced with solving several problems related to the procure-
vaccines. Already in March 2021, the campaign was forced to over-
ment, receipt of vaccines and the establishment of communication
come a high level of distrust among the population, which, accord-
within the country. Notwithstanding having signed contracts to sup-
ing to the United Nations Development Program (UNDP) and the

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

United Nations Children’s Fund (UNICEF), was significantly ply COVID-19 vaccines and participating in the COVAX program,
increased by the uncontrolled infodemic about COVID-19 in the majority of the doses were not received until April 2021,8 which
Ukrainian online mass media, blogs, forums, social networks and did not allow the country to fully realize its potential at the desired
messaging platforms.13,14 To overcome these problems, directions pace of the campaign. At the beginning of the campaign, commu-
for responding to the situation have been formed through the in- nication strategies were irregular, with disagreements between
volvement of influencers and leaders to encourage public confidence government officials and the infodemic increasing public concerns
in vaccines, informing through the media, and encouraging at the about the safety and effectiveness of COVID-19 vaccines. However,
local level. On 19 December 2021, the Presidential program changes in the narrative in the political space helped to effectively
‘eSupport’ was launched to financially reward people for getting overcome the problems. Despite these challenges, efforts were made
vaccinated against the coronavirus.15 to address the issues and improve the vaccination strategy, as evi-
In early 2021, the Ukrainian Government signed agreements to dent from various initiatives and programs introduced to enhance
purchase COVID-19 vaccines from several manufacturers, including public trust, accessibility, and coverage of vaccination.
1 913 000 doses of CoronaVac vaccine (Sinovac Biotech), 20 001 150 Thus, the effective rollout of the national COVID-19 vaccination
doses of Comirnaty vaccine (Pfizer/BioNTech, BNT162b2) and program in Ukraine should focus on finding ways to ensure proper
12 000 000 doses of AstraZeneca (Covishield, SKBio). Ukraine’s funding and management, reliable public healthcare system support,
partnership with COVAX, a global vaccine-sharing scheme sup- early investment in vaccine production, implementing information
ported by WHO, the Coalition for Epidemic Preparedness technologies for logistics solutions, and clear and consistent com-
Innovations (CEPI), Gavi and UNICEF, has been a significant con- munication strategies to sustain public confidence. Addressing these
tribution to the distribution of vaccines. Through this program, aspects will contribute to a more successful and efficient vaccination
about 8 million doses of vaccines from various manufacturers campaign, ultimately leading to increased vaccination coverage and
[Comirnaty (Pfizer/BioNTech), Moderna (mRNA-1273),
improved control of the pandemic.
AstraZeneca (Covishield, SKBio), CoronaVac (Sinovac Biotech),
Johnson & Johnson (Janssen Ad26. S)] were delivered to the country
free of charge at different times throughout 2021.8,16,17 However, Supplementary data
due to the supply of vaccines under the COVAX mechanism for 183
countries, including Ukraine, delays in vaccines and the formation Supplementary data are available at EURPUB online.
of a longer interval between the first and second doses could be Conflicts of interest. None declared.
unavoidable in several countries. In Ukraine, immunization of the
Comirnaty (Pfizer/BioNTech, BNT162b2) was delayed by an aver-
age of 4 weeks instead of the recommended 21 days.18 Data availability
Analysis of the structure of different types of vaccines against
The data underlying this article were derived from a source in the
COVID-19 during 2021 showed a significant advantage of
open public domain of the dashboard of COVID-19 of the Ministry
Comirnaty (Pfizer/BioNTech) and CoronaVac (Sinovac Biotech)
among the vaccinated population of Ukraine. Thus, the first dose of Public Health of Ukraine.
of the Comirnaty (Pfizer/BioNTech) vaccine was received by 15.7%
of the population, CoronaVac (Sinovac Biotech) – 11.7% of the
population, AstraZeneca (Covishield, SKBio) – 5.1% of the popula-
tion, Moderna (mRNA-1273) – 3.6% of the population, Johnson & Key points
Johnson (Janssen Ad26.COV2.S) – 0.04% of the population. The
second dose of the Comirnaty (Pfizer/BioNTech) vaccine was • In Ukraine, morbidity and mortality rates related to
received by 15.8% of the population, CoronaVac (Sinovac Biotech) COVID-19 remain high due to insufficient rates of COVID-19
– 11.1% of the population, AstraZeneca (Covishield, SKBio) – 4.5% vaccination with both one and two doses in 2021.
of the population, Moderna (mRNA-1273) – 3.2% of the population. • There has been a decline in the number of COVID-19
The prioritization of these two vaccine types is probably due to the vaccinated persons among men, children and adolescents
high efficacy rates of the Pfizer/BioNTech and CoronaVac vaccines under the age of 19, and elderly persons over 70 years of age
during Phase 3 clinical trials in preventing severe disease and death were noted, regardless of the number of vaccine doses received
(80–100% and 90–99% of cases; 88–100% and 86% of cases, respect- in 2021.
ively) and reducing its impact on public health.19 • The vaccination campaign in Ukraine between February 2021
A potential limitation of our study may arise in the completeness and January 2022 encountered challenges in procuring and
of the vaccination dataset for the year 2022. The dataset on the distributing vaccines, as well as establishing communication to
epidemiological and vaccination of COVID-19 relies on the infor- strengthen public trust in vaccines.
mation provided by the MOH of Ukraine and other official sources.
162 European Journal of Public Health

References 11 Website: Verkhovna Rada of Ukraine. Ministry of Public Health of Ukraine. Order No.
2153 from 04.10.2021. On the approval of the List of professions, industries, and
1 Website: Verkhovna Rada of Ukraine. Ministry of Public Health of Ukraine. Order
organizations whose employees are subject to mandatory preventive vaccinations.
No. 3018 from 24.12.2020. On the approval of the roadmap for the introduction of a
Available at: https://www.kmu.gov.ua/news/moz-zatverdilo-perelik-profesij-dlya-yakih-
vaccine against the acute respiratory disease COVID-19 caused by the SARS-CoV-2
shcheplennya-proti-covid-19-ye-obovyazkovim. (12 August 2023, date last accessed).
coronavirus and mass vaccination in response to the COVID-19 pandemic in
Ukraine in 2021—2022. Available at: https://zakon.rada.gov.ua/rada/show/ 12 Toshkov D. Explaining the gender gap in COVID-19 vaccination attitudes.
v3018282-20#Text (13 August 2023, date last accessed). Eur J Public Health 2023;33:490–5.

2 Website: Resolution of the Cabinet of Ministers of Ukraine. No. 95 from 02.08.2021. 13 Website: UNICEF. ‘03.03.2021. Infodemic’ of COVID-19 disinformation bad for
Some issues of state registration of vaccines or other medical immunobiological Ukrainians health, study for UN finds. Available at: https://www.unicef.org/
drugs for the specific prevention of acute respiratory disease COVID-19, caused by ukraine/press-releases/infodemic-covid-19-disinformation-bad-ukrainians-health-
the SARS-CoV-2 coronavirus, under obligations for emergency medical use. study-un-finds (13 August 2023, date last accessed).
Available at: https://www.kmu.gov.ua/npas/deyaki-pitannya-derzhavnoyi-reyestra 14 Zoaib Habib T, Ennab F, Matiashova L, et al. Double trouble: COVID-19 vaccine
ciyi-vakcin-abo-inshih-medichnih-immunobiologichnih-preparativ-dlya-t80221 misinformation amidst conflict in Ukraine. Ann Med Surg (Lond) 2022;
(13 August 2023, date last accessed). 80:104127.
3 Holt E. COVID-19 vaccination in Ukraine. Lancet Infect Dis 2021;21:462. 15 Website: Verkhovna Rada of Ukraine. Cabinet of Ministers of Ukraine
4 Haque U, Naeem A, Wang S, et al. The human toll and humanitarian crisis of the Resolution No. 1272 from 9.122021. Some issues of assistance within the

Downloaded from https://academic.oup.com/eurpub/article/34/1/156/7471542 by guest on 02 June 2024

Russia-Ukraine war: the first 162 days. BMJ Glob Health 2022;7:e009550. framework of the "eSupport". Available at: https://zakon.rada.gov.ua/laws/show/
5 Dzhus M, Golovach I. Impact of Ukrainian- Russian war on health care and 1272-2021-%D0%BF#Text. (12 August 2023, date last accessed).
humanitarian crisis. Disaster Med Public Health Prep 2023;17:E340. 16 Website: Ministry of Public Health of Ukraine. 100 000 doses of the Janssen vaccine
6 Website: Operational data portal Ukraine refugee situation refugees fleeing Ukraine (Jcovden) were delivered to Ukraine as part of COVAX. Available at: https://moz.
(since 25 July 2023). Available at: https://data2.unhcr.org/en/situations/ukraine (13 gov.ua/article/news/v-ukrainu-dostavleno-100-tis-doz-vakcini-janssen-jcovden-u-
August 2023, date last accessed). ramkah-covax. (12 August 2023, date last accessed).

7 Hill M, Vanderslott S, Volokha A, Pollard AJ. Addressing vaccine inequities among 17 Website: UNICEF. 18.05.2021. This week, Ukraine is receiving almost half a million
Ukrainian refugees. Lancet Infect Dis 2022;22:935–6. more doses of the COVID-19 vaccine as part of COVAX. Available at: https://www.
unicef.org/ukraine/press-releases/ukraine-receive-close-half-million-doses-covid-
8 Website: UNICEF. 16.04.2021. Ukraine received the first vaccines against COVID-
19 as part of the COVAX mechanism. Available at: https://www.unicef.org/ukraine/ 19-vaccine-under-covax-week. (13 August 2023, date last accessed).
press-releases/covax-arrival-ukraine (13 August 2023, date last accessed). 18 Website: State Expert Center of the Ministry of Health of Ukraine. COVID-19
9 Website: Freedom Radio. The battle for the vaccine against COVID-19: Ukrainian vaccination. ‘OMIRNATYTM from Pfizer, Belgium. Available at: https://www.dec.
departments are arguing about the purchase, and the EU and the US are already gov.ua/materials/somirnaty%ef%b8%8f-vid-pfajzer-belgiya/?role=ua. (12 August
vaccinating. Available at: https://www.radiosvoboda.org/a/vaccine-covid-19- 2023, date last accessed).
ukraine-scandal-moz-vaccination/31035602.html.(12 August 2023, date 19 Xu K, Wang Z, Qin M, et al. A systematic review and meta-analysis of the effect-
last accessed). iveness and safety of COVID-19 vaccination in older adults. Front Immunol 2023;
10 Matiashova L, Isayeva G, Shanker A, et al. COVID-19 vaccination in Ukraine: an 14:1113156.
update on the status of vaccination and the challenges at hand. J Med Virol 2021; 20 Korolchuk O, Vasiuk N, Klymkova I, et al. COVID-19 vaccination under conditions
93:5252–3. of war in Ukraine. Asian Bioeth Rev 2023;15:259–81.