The vaccination coverage in Roma communities in Bulgaria is extremely low and certainly too far away from values that would have mattered in epidemiological terms. The main underlying reason is the existence of a strong and widespread mistrust of Covid-19 vaccines, which reveals that the institutions in Bulgaria have lost the informational battle for the attention and trust of these communities regarding the pandemic.
This is shown by the data from field research among five Roma communities in Bulgaria carried out in December 2021. The research covered Roma neighborhoods in the towns of Kyustendil, Montana, Maglizh, Nova Zagora, and Sliven. In each area, surveys and focus group discussions with the residents, and in-depth interviews with local experts were conducted.
Covid-19 vaccination rates are very low in the studied Roma neighbourhoods. As of the time of research fewer than 4% of the respondents have received at least one vaccine dose. About 5% more are the ones who declare their willingness to get vaccinated but it is not sure whether they will do it in reality. The majority of the participants in the study claim that they would not get vaccinated against Covid-19 under any circumstances, even if vaccines became compulsory. A small number of the respondents would get vaccinated if the vaccine was required by an employer or mandatory in order to travel abroad.
General confidence in information about Covid-19 vaccines is extremely low. The majority of the respondents do not trust anyone with regard to information about vaccines.
Belief in conspiracy theories pertaining to Covid-19 vaccines is quite widespread in the Roma neighbourhoods of all monitored towns – 83% of the respondents in total accept as true at least one conspiracy theory.
Approximately two out of three respondents believe that Covid-19 vaccines are more dangerous and involving greater health risks than other vaccines, are not recommended for a number of chronic diseases, have dangerous side effects, have not been sufficiently tested, there is information about them that is intentionally suppressed and ultimately these vaccines are only meant to boost the profits of pharmaceutical companies. Approximately one in two respondents believe that Covid-19 vaccines contain harmful substances, lead to infertility and sterility and do not contribute to reducing the risk of death from infection. One in three (38%) believe that vaccines implant microchips and only 24% of respondents do not believe in such a statement.
These convictions are in direct conflict with the main message of the institutions responsible for the implementation of the vaccination policy in Bulgaria.
The high rate of disagreement with the recommendations of health authorities goes hand in hand with a high rate of trust in almost all known objections against vaccines and vaccination, including: 1) leading conspiracy theories surrounding the process of vaccine development, production and dissemination by secret societies, which, apart from corrupt elites, have been joined by governments, health authorities and international organizations; 2) downplaying the threat and dangerous health implications of diseases preventable with vaccines; 3) spread of false or misleadingly interpreted information about harmful side-effects of vaccination.
Prior to raising these objections to Covid-19 vaccines, they have been used in practice about all vaccines applied on a mass scale that undoubtedly protect from hazardous preventable diseases. The latter fact puts on the line confidence in other vaccines that can be potentially undermined. The findings of our study have not established such a risk in the examined communities. The remaining vaccines, apart from Covid-19 vaccines, continue to enjoy a high level of confidence. However, this confidence is not a given and it could easily erode given the low level of trust in health authorities and institutions in general.
The link between mistrust of institutions and low vaccination coverage against Covid-19 is testimony to the need for significant improvement in communication between public institutions and Roma communities and long-term investment in building mutual trust. The fastest and most effective solution to the challenging task of restoring trust runs through the building or restoration of bridges between local authorities (mayors, councilors, administrators) and neighborhoods with a predominant Roma population. In this process educational, social and health institutions (including health, educational and labor mediators, social workers and doctors) are to play a much more active role than they do now.
About the research:
The study was carried out by a team of experts of Open Society Institute – Sofia with the financial support of the Public Health Program of Open Society Foundations. The sample used in the study is representative of the households in the five surveyed neighbourhoods but it might not necessarily reflect the general situation in the Roma communities in Bulgaria regarding specific data about the share of the already vaccinated and the willingness to get vaccinated against Covid-19 in the future. However, the study covers a wide range of attitudes towards vaccines which match quite well the main motivation mechanisms known in the research literature about vaccines and vaccination. The latter fact makes us quite confident that the attitudes we registered towards Covid-19 vaccination and the main reasons offered for or against vaccination give a credible picture of the situation in the remaining Roma communities in Bulgaria and to a great extent as well among the Bulgarian population in general.
Full text of the report Attitudes to Covid-19 vaccines and vaccination in five Roma communities in Bulgaria.
See also the report „COVID-19 in Roma neighbourhoods in Bulgaria (March – December 2020) ”.
