THE PUBLISHING HOUSE MEDICINE
OF THE ROMANIAN ACADEMY
VACCINE REFUSAL IN ROMANIA.
AN ESTIMATION BASED ON PUBLIC OPINION SURVEYS
Darie CRISTEA, Diana Alexandra PETRESCU and Claudia GHIȘOIU
Faculty of Sociology and Social Work, University of Bucharest, Romania
Corresponding author: Darie Cristea, E-mail: darie.cristea@unibuc.ro
Accepted March 9, 2021
This article has been written in order to take into evidence the quantitative estimations with regard
to vaccine refusal and even hesitation among the public in Romania. This is, of course, in the present
context of the coronavirus pandemic. We believe that this descriptive approach to the current issue
will be extremely useful and helpful. There are a lot of public opinion surveys run in Romania;
however, most of the time, no one is looking back at them for a good period of time in such a manner
as to achieve a longitudinal perspective of the phenomena investigated using these sociological
methods.
Following sociological survey data, this paper aims at a comparative mapping of vaccine
skepticism in Romania before and during the covid-19 pandemic.
Keywords: vaccine, vaccination, coronavirus pandemic, public opinion polls, vaccine refusal
The vaccine and vaccination process have been our questions and even in the indicator lists used to
showing up sporadically as subjects in the public describe the aforementioned phenomena
opinion surveys and even more consistently within statistically.
the last 4–5 years in Romania (this being the Even so, we do believe that a statistical journey
aftermath of the debate surrounding the legislative through the data and its interpretation in order to
proposal regarding mandatory vaccination for form a secondary analysis (at least to observe how
children and the problems caused by the high public opinion on vaccination has evolved within
incidence of flu and measles within the same time the last few years, especially the levels of refusal
period) and, especially during the last year, in the related to vaccination within the Romanian public)
context of the global and national efforts made to will allow us to gain a more pragmatic
combat the coronavirus (SARS-CoV-2) pandemic. understanding of this sector of public opinion. This
Unfortunately, since there is no focused understanding is extremely useful given today’s
institutional effort to gather the relevant context and, of course, any other similar events
sociological data, in order to better describe the that the future might bring.
situations mentioned above, we rely on isolated Considering the fact that we are discussing data
surveys made by various private research gathered by multiple operators on the research
companies or institutions that do not abide by a market, a theoretical discussion regarding the
standard methodology between them or even concepts within the scale spectrum of acceptance,
between each individual project, even when we are trust, hesitation, and refusal of the vaccine is no
looking into data collected by the same marketing longer useful. We believe these concepts rely
research group. This greatly reduces the heavily on how the surveys were designed and how
compatibility of the available data and the the questionnaires were built, individually, for each
possibility of applying a good portion of the survey. Our work has a very pronounced empirical
specialty literature’s well-known concepts, which character, and as such, most of the citations are
could benefit greatly from standardization at the going to be towards the research reports that we
sociological survey’s operational level. What we have analyzed.
do have is a great variation in how we formulate We have selected a few studies to analyze,
which, given our experience in this field, we deem
Proc. Rom. Acad., Series B, 2021, 23(1), p. 25–32 to be serious and bring new elements to pinpoint
26 Darie Cristea, Diana Alexandra Petrescu and Claudia Ghişoiu
the significant moments from the last 4–5 years in grow, as the only method of overcoming an
the public debate about vaccination in Romania. uncomfortable, dangerous and restrictive period
We have split this longitudinal perspective into for, essentially, everyone. We will discuss more in
three moments: before the Covid-19 pandemic; Conclusions whether this hypothesis stands after
during the pandemic, before any public one year since the pandemic started, multiple
announcement about a vaccine was made (which media debates on the anti-covid vaccine, and
has defined the reality of vaccination as a solution during the full vaccination campaign.
for the pandemic in a reasonable timeframe);
during the pandemic but after the vaccine has
emerged (this is also the period of time we are now SKEPTICISM AND VACCINATION BEFORE
living in, as we write this material). It should be THE COVID-19 PANDEMIC
noted that, since December 2020, we have already
started the vaccination campaign, and now, in In this section, we will stop to look at two
March 2021, we are practically in the middle of the sociological measurements made shortly before the
campaign, which seems to be successful in SARS CoV-2 pandemic: an IRES survey made in
Romania at this time, compared to other countries, 2017 and an INSCOP survey made at the
including countries in the EU). Time is of the beginning of 2019, exactly one year before the
essence in evaluating the public opinion’s attitude pandemic started.
towards vaccination, especially since we are The IRES1 study’s main subject is about the
discussing a vaccination process that is being legislative project regarding vaccination, and it
developed in the middle of the pandemic, as it is does not contain (or was never shared with the
happening right now. Public opinion is, as public) an explicit question about the general
expected, very sensitive to scientific success, acceptance (or disagreement and refusal) about
media debates about vaccination, visual vectors vaccines and vaccination. The study does,
from the medical field, and also to the media- however, contain two questions from which we can
covered cases (even isolated ones) where the obtain a quantitative evaluation of the skepticism
vaccination has been associated with particular regarding the vaccination: 29% of the respondents
issues. say that they agree with the statement that adverse
It is however critical to mention that our drug reactions of vaccines are higher than the
fundamental hypothesis was, at the beginning of benefits. The second question is evaluating the
the pandemic, that this entire Covid-19 episode, public opinion towards vaccines from the National
with the upheaval that it has brought upon our day- Program of vaccinating children – 15% of them
to-day lives and the long-term restrictions which say that some vaccines are not good for children,
seemed to be echoes from our recent past etc. – 1% of them say children should not be vaccinated,
that it would be perfectly normal to expect the and 83% say that vaccination is good and children
public opinion’s “appetite” for vaccination to should be vaccinated (1% DK/NA).
IRES – 2017 - 29% of the respondents say that they agree
with the statement that adverse drug reactions of vaccines are higher than the benefits
Vaccine refusal in Romania. An estimation based on public opinion surveys 27
INSCOP – 2019 - 10.3% say that the risks of vaccination are much greater than the benefits
Two years later, a larger study dedicated to the nowadays, a direct question about the agreement
general issue of vaccination, the one conducted by with vaccination was arguably not the most
INSCOP2, shows that 28.7% of people said that they relevant. Agreement, hesitation, and refusal of
are neither against or for vaccination and consider vaccination were better measured in this context
that the vaccination process is a complicated issue with a set of specific questions. For now, we are
and it must be evaluated from case to case – 10.3% simply taking note of the questions above for the
said that the risks of vaccination are much pre-pandemic situation.
greater than the benefits of vaccination. In this
very same study, 20.8% of the attendees have said
that the only reason that they have agreed to SKEPTICISM AND VACCINATION DURING
vaccinate their children is that it is mandatory in THE COVID-19 PANDEMIC
order to enroll the children into pre-school.
In 2019, the INSCOP study revealed that 8.1% Starting with March 2020, Romania is clearly
of the people believe that vaccinating the kids is and officially affected by the pandemic.
not necessary, and 4% have said that they have Administrative and medical actions are being
not vaccinated their children (or their taken, restrictions that most people have never seen
grandchildren, depending on the case) as per before are being implemented. March and April are
the National Vaccination Program. national lockdown months for Romania as well as
Another variable that could indicate the in most European countries.
hesitation towards or refusal of vaccination is the Our hypothesis was that after such an episode
question related to mandatory vaccination of in their lives, the public’s appetency for
children in order to be allowed to enroll in school vaccination (generally speaking, not just against
or pre-school. In 2017, 12% of the respondents covid) was expected to grow, given that the
had said that they have a bad or very bad vaccine is the only solution that could bring the
opinion about the fact that they can only enroll country and the world back to a state of normalcy
their children into a collective body only after at least similar to the one we had before the
they obtain the written legal evidence that the pandemic. After all, vaccination was not a strange
child has been vaccinated, according to the concept to the public compared to the restrictions
National Vaccination Program. In 2019, 24.4% that were unimaginable one or two months before
of them said that they do not agree with the covid virus arrived to Europe.
mandatory vaccination for kids in order for the One year since the debut of the pandemic, we
latter to be allowed into pre-school or school. observe that the anti-vaccine movements have not
We should also mention that, in the context in just persisted; they have created new theories
which vaccination was not tied to a specific exclusively about the anti-covid vaccine. These are
situation, like the pandemic we are confronting not, however, the subject of this paper. Let us
28 Darie Cristea, Diana Alexandra Petrescu and Claudia Ghişoiu
continue to observe how public opinion has evolved through the shock dealt by the restrictive measures
regarding vaccination during the pandemic. taken in April-March, the summer and autumn of
It is obvious that the restrictions imposed in the 2020, the public is more used to the idea of the
efforts of trying to manage and contain the Covid- pandemic, has already seen its effects, and
19 pandemic have affected, like many other witnessed many media debates on this subject. The
industries, the research market industry. Since vaccine was no longer a theory, and the public
many commercial activities have been reduced, opinion practically had time to mature with regard
most of the contracts in the field of collecting to the pandemic.
sociological or marketing data were devoid of We will cite here two studies: a global IPSOS
purpose. Even worse, some interactions required in survey (with a sample that includes Romania) from
sociological research, like questionnaires July–September 2020 and a national LARICS
conducted face-to-face or at the subject’s survey published in November 2020, which was
residence, qualitative interviews, or focus groups actually conducted even before the announcement
with a physical presence, have become impossible, of the first vaccine against Covid-19.
at least during the first part of the pandemic. IPSOS3 conducted an international survey (28
Moreover, we find more studies related to how countries), and in that survey, Romania is among
public opinion perceives the pandemic and all its the last countries in terms of confidence in a future
associated phenomena in the summer and fall of vaccine for Covid-19. In this study, 43% of
2020 when some restrictive measures have been Romanians said that should a vaccine against
lifted. These studies are more methodologically Covid-19 emerge, they would not get it, and 57%
valid to form a long-term perspective. After going said they would get vaccinated.
IPSOS – July-September 2020
Vaccine refusal in Romania. An estimation based on public opinion surveys 29
LARICS – 2020 - 38.6% of respondents said they would not get vaccinated against the coronavirus/
26.6% said that the risks of vaccination outweigh its benefits
One of the key questions (multiple choice) in better explained to them, only 21.8% of
this study is related to the reasons why participants respondents said they would get vaccinated for
in the study do not want to be vaccinated against sure. Also, in the LARICS survey from October
covid-19 (worth bearing in mind that it was 2020, 44.2% of respondents said that vaccination
addressed only to those who said they would not should be evaluated for each individual case for it
get the vaccine). The main reason respondents is a more complicated issue than it seems, and
gave for not wanting to be vaccinated is the fear of 26.6% said that the risks of vaccination outweigh
side effects – 66% of Romanians who answered its benefits. Only 25.5% agreed that the benefits of
this question mentioned this fear. The second vaccination outweigh the risks – of course, the
reason for not getting vaccinated is that people do benchmark for these responses was the covid-19
not trust the effectiveness of the vaccine, 33% of vaccine, which skeptics rejected primarily for
Romanians do not trust the vaccine. Interestingly, being a new vaccine.
in this study, the third reason Romanians give for We note that at this time, in the summer/autumn
refusing to get vaccinated against the coronavirus of 2020, but before the announcement of the first
is that they are against vaccination in general (23% vaccine, about 40% of Romanians refused the idea
of respondents). of getting vaccinated against Covid-19.
On the one hand, in the study conducted by
LARICS4 in October, there is a very interesting
question related to vaccination against covid-19, AFTER THE EMERGENCE
whereby 38.6% of respondents said they would not OF THE VACCINE
get vaccinated against the coronavirus, and 30%
said that they would get vaccinated, but not as soon The next study that we shall analyze is the one
as the vaccine appears. They said that they conducted by Avangarde5 in November 2020. It is
preferred to wait for other people to get vaccinated a phone survey, run over a short period of time,
before them so that they could monitor the side which slightly overlaps the moment of the public
effects that should occur. Also, 8% of people said announcement of the first anti-covid vaccine being
they would get vaccinated if the vaccine were approved, whose delivery to the European
30 Darie Cristea, Diana Alexandra Petrescu and Claudia Ghişoiu
countries would begin in December 2020/ January In January 2021, therefore after the vaccination
2021. Let us not forget that this moment is also the campaign was de facto in Phase 1 in our country, we
one when the image vectors of the medical field have an abundance of national surveys on the topic of
communicate frequently with the mass media on the anti-covid vaccine and vaccination process:
the topic of the upcoming vaccine, with the express Avangarde, IRES and INSCOP make such data sets
purpose of reducing the anxieties of the populace, available to the media and the larger public.
which had been revealed in the previous surveys, In the survey conducted by Avangarde,6 we
regarding this new type of vaccination. observe that 35% said that would definitely get
In this study, 25% of Romanians said they vaccinated and 30% said they would definitely not
would never accept to be vaccinated against get vaccinated against covid-19, taking into
Covid-19 when such a vaccine should become consideration that a part of the population has already
available, and 36% said that they would want to be been vaccinated. On the question regarding the trust
vaccinated, but only after a period of time needed they have in the efficacy of the anti-covid vaccines,
to monitor the possible strong side effects among 39% said that they are more likely to not trust it,
the already vaccinated segment of the population. whereas 37% said they are more likely to trust it. In
Moreover, among those who said that they would addition, we can readily make note of the fact that
definitely not get the vaccine, 72% said that they 24% of respondents declare themselves against
do not believe in the efficiency of this vaccine, vaccination and 37% are for vaccination, while
whereas 24% said that they do not believe in 27% say that do not have a well-formed opinion nor
vaccines in general. are they interested in the subject.
Avangarde – 2020 - 25% of Romanians said they would never accept to be vaccinated against covid-19 when such a vaccine should
become available/ 72% said that they do not believe in the efficiency of this vaccine, whereas 24% said that they do not believe in
vaccines in general
Avangarde - 2021
Vaccine refusal in Romania. An estimation based on public opinion surveys 31
INSCOP – 2021 - 39.4% said they do not want to be vaccinated against covid-19 during this year
In the survey conducted by IRES7, still in they do not want to get the vaccine because they
January, we observe that 9% of the respondents fear the side effects, 26.8% said they are not
said they have a very bad opinion on vaccines, in convinced of the efficacy of the vaccine and only
general, and 9% said they have a bad opinion. 5.8% declared themselves to be against vaccines in
Only 22% said they have a very good opinion on general.
this subject and 57% said they have a good Therefore, after the emergence of the first
opinion. Of the 18% who said that they have a bad vaccine and after the vaccination campaign has
and very bad opinion on vaccines, 30% of them already started in Romania, we can observe that
said that the main reason for their bad opinion is 30% (Avangarde) and 31% (IRES) said they would
that vaccines have side effects and 18% said that not get vaccinated. These percentages are slightly
they do not believe in vaccines and do not agree more favorable to vaccination when compared to
with them. With regard to anti-covid vaccines and the ones before the vaccination campaign even
their safety and efficacy – 26% said that they are begun. As to the reasons for not accepting the
safe to a small degree and 20% said that they are vaccine, we can see that before the beginning of
safe to a very small degree or not at all. Of all the the campaign, the most frequently given ones
respondents to the survey, 22% said they would against anti-covid vaccination are the side effects
definitely not get vaccinated and 9% said that they (66% Ipsos) and the second reason was the lack of
would most probably not get vaccinated. Of the trust people have in the efficacy and safety of the
31% who said that that would probably or vaccine (33% Ipsos). After the campaign started
definitely not get vaccinated, the majority said rolling, of the ones who declared that they would
that they do not plan to be vaccinated because they not be getting the vaccine in the INSCOP study:
are afraid of the side effects of the vaccine (27%), 30.9% said they do not want to be vaccinated
because they do not trust these anti-covid vaccines because they fear the side effects, 26.8% said they
(23%), while 12% said they do not believe in are not convinced of the efficacy of the vaccine
vaccines in general. (INSCOP) and in the IRES study: they said they do
The study conducted by INSCOP8 shows that not want to be vaccinated because they fear the
21.4% of the respondents believe that the risks of side effects of the vaccine (27%) and because they
vaccination outweigh the benefits and 41.4% do do not trust these anti-covid vaccines (23%).
not trust the process of approval given to the anti- Before the vaccination campaign even began,
covid vaccines at the level of the medical 23% of those who said that they would not get the
institutions of the European Union. Of all the vaccine against Covid-19 said that they chose not
respondents, 39.4% said they do not want to be to do it because they are against vaccination in
vaccinated against Covid-19 during this year, general (Ipsos), whereas, once the campaign
and of these latter ones, 49% said it is a started in earnest, only 5.8% (INSCOP) and 12%
definitive decision and 49% said they might (IRES) of the ones who said they would not get
change their mind in the future. Of the ones who vaccinated against Covid-19 also declared to be
said they choose not to be vaccinated, 30.9% said against vaccination in general.
32 Darie Cristea, Diana Alexandra Petrescu and Claudia Ghişoiu
CONCLUSIONS program becomes a certainty. We expect the
hesitation and refusal regarding the anti-covid
The pandemic was rapidly installed, including vaccination to continue decreasing as the
in our country, and it was perceived as a total vaccination program goes forward, notwith-
social fact, if we take into account the issue that, standing the issues that might arise (see the episode
ever since the beginning, it entailed unprecedented with the problematic Astra-Zeneca batches of
restrictions, at least in our lifetimes. Our March 2021).
hypothesis, when we began monitoring the Last but not least, a paradox that, this time,
ongoing social phenomena and public opinion, helps with the acceptance of the vaccine by the
was that such a program of restrictive measures larger public: the fact that the vaccination schedule
would lead to an increase in the acceptance level was made according to rather strict criteria and
of the vaccine and the vaccination of the categories, as well as the fact that vaccine stocks
population, as an only solution to overcome this go through some unexpected shortages, have
milestone of medical crisis. transformed the vaccine into a scarce resource and
Of course, we also took into account that, in the asset, which in turn made it sought after by the
last few years, as the access to health-related “hesitant” public. The perception that medics,
information was democratized (together with the military, police and secret service people, and even
proliferation of conspiracy theories and messages high-ranking administrators “jostle” for the first
pertaining to the anti-vaxx movement on social available spots in the vaccination schedule, has
media), the acceptance of the existence of the created a type of valorization of the vaccine among
pandemic, as well as the necessity for vaccination the social segments that were previously skeptical
could not have been exempt from denial, hesitation or uninterested in this issue. In a nutshell, a parallel
and other such social reactions. However, we were conspiracy-laden narrative that actually aids in the
entirely convinced that, as the need to return to a popularization of the vaccine.
world resembling the pre-pandemic one grew
stronger, the motivation for vaccination would be
very high and the anti-vaxx campaigns would be REFERENCES
regarded as rather bizarre episodes of the fight
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sondaj de opinie, April 2017, available at
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2021, when the implementation of the vaccination
