TThe doctor is desperate. For months, she has been trying to convince her neighbors in this city in northwestern Bulgaria to get vaccinated to prevent the rapid spread of Covid-19. But it’s a losing battle and on a recent gray Wednesday afternoon, only a small number of patients show up for the shot.

The supply is plentiful and the choice between the Pfizer, Moderna or Janssen vaccine, but only 12% of people in Vidin, a town of 63,000 people near the Romanian border, have been doubly bitten.

“The cases have increased,” said Pepa Tsvetanova, a doctor and public health official who administers vaccines to residents of this crumbling Danube port city, where dozens of new cases appear in hospitals every day.

The country hit a pandemic record of more than 6,000 Covid-19 infections per day last month, while daily deaths also hit new highs this month.

“We are trying to convince people that the only thing to limit the disease is vaccination, and it is our duty to do everything possible to stop it,” Tsvetanova added.

“We are trying to get the message across. But the most common thing I hear is that they’re reading something somewhere and don’t want to expose themselves to the vaccine.

Bulgaria has the lowest Covid-19 vaccination rate and the highest death rate in the European Union. The pandemic has so far killed more than 27,000 people in a country of seven million people.

Although authorities have tried to encourage the jab with media campaigns and visits to schools, businesses and health facilities by vaccine advocates, less than one in four Bulgarians have been fully immunized.

And this despite the fact that Bulgaria has such large stocks of vaccines that more than 170,000 unused vaccines have been donate in Bhutan in July before they expire.

Bulgaria is not an outlier; vaccine skepticism pervades Eastern Europe. In neighboring Romania, only 37 percent have been vaccinated. Only about one in five Bosnian people have been vaccinated.

And in Ukraine, where only 21% of people have been bitten, hospitals are teeming with Covid-19 patients, forcing medical facilities to set up makeshift tents to treat the sick and dying.

Actual vaccination rates in Eastern European and Balkan countries may even be lower than official statistics. Health workers are issuing so many fake Covid-19 digital certificates that authorities are considering installing cameras in vaccination centers. Poorly paid doctors may also seek to take advantage of vaccine skeptics who are willing to pay up to $ 300 (£ 223) for a fake certificate that will allow them to work and travel.

“To appear in the database, a doctor has to enter it,” said Hristov Ivanov, leader of the opposition Yes party and a strong advocate for vaccines. “You go to the doctor, they go through all the paperwork, then throw the vaccine in the trash instead of pricking you.”

The low vaccination rates have alarmed EU and WHO officials, who have urged Bulgaria and the Balkan region, including Bosnia and Moldova, to speed up vaccinations, for their own sake but also to the rest of the world.

“The first risk is of course for the Bulgarian population but also to generate a new variant, which would be more resistant than the others,” Thierry Breton, EU official in charge of the deployment of the vaccine, told reporters in Sofia. last week. “If we don’t do anything, we might see a Bulgarian variant because there are too many people who are not vaccinated. “

To encourage vaccinations, authorities in Eastern Europe used a mixture of carrots and sticks. The Ukrainian government gave each beneficiary the equivalent of about $ 40 in cash to be vaccinated. Bulgarian authorities sought to force employers to make vaccines mandatory, but also removed the requirement for beneficiaries to sign a liability waiver, which fueled conspiracy theories that vaccination was dangerous.

The measures have yielded small successes, especially among educated professionals in cities like Sofia, the Bulgarian capital, where around a quarter of people have been vaccinated.

At a vaccination center in a metro station in a bustling and affluent part of town, administrators said the number had risen from around 30 a day to 150 since new rules forced companies to surrender compulsory vaccines.

But public health officials warn that the overall numbers are not rising fast enough to counter a possible winter surge. Unlike France, where a harsh speech by President Emmanuel Macron in July caused a dramatic increase in the number of vaccinations, skepticism of the jab in Eastern Europe runs deep.

It is rooted in a long-standing mistrust of authorities dating back to the era of communist rule.

“Because we have lived under totalitarian regimes, we believe that the truth does not belong to power,” said Ilian Vassilev, analyst and former diplomat in Sofia.

But the reluctance is also the result of a new wave of effective disinformation campaigns by passionate anti-vaccination campaigners promulgated via social media, which have occurred across much of the world.

“The problem with these first-generation vaccinations is that they are not mature enough,” Tihomir Bezlov, a researcher at the Center for the Study of Democracy, a think tank, said of the relative novelty of Covid vaccines by compared to other vaccinations. which are tested for years before mass use.

“And that gives anti-vaccines an opening and an opportunity. “

Analysts also cited the lingering influence of religion as a factor.

During a recent visit to rural Romania, an Orthodox Christian priest said he opposed any public discussion about the vaccine or vaccine statuses, calling it a private decision. In Romania, two priests are also under investigation after allegedly turning back vaccinated members of their congregations.

The Russian Orthodox Church publicly urged worshipers to get stung last summer, but critics have accused the Bulgarian Orthodox Church of subtly promoting an anti-vaccination message by refusing to endorse mass vaccinations and speaking instead of the sacredness of the body of Christ.

In all of these countries, health systems have been exhausted by immigration and decimated by lack of investment, fueling mistrust of authorities. In recent weeks, deadly fires have broken out in Covid departments in Romania and Bulgaria, killing a total of 12 people.

Like much of Eastern Europe and the Balkans, large swathes of rural Bulgaria and Romania have been affected by depopulation.

The rural northwest of Bulgaria looks like a wasteland. Hundreds of houses appear abandoned, with broken windows, barricaded doors and overgrown with weeds. Massive warehouses and excavated factory complexes are covered in rust and graffiti. Few businesses operate.

Residents roaming towns and villages have little faith in the future of their country, let alone the vaccine.

“I doubt that the vaccine they give the rich is the same as the one the poor get,” said a teenager in the main square in Vidin.

Polarized and fractured politics have also damaged public confidence. Romania has been without a government for months. Ukraine remains locked in a state of perpetual crisis, with pro-Russian forces occupying the eastern part of the country. Bosnia is said to be on the verge of implosion as Serbian nationalists question the country’s 25-year peace agreement.

Bulgaria has held three inconclusive elections this year and has yet to form a governing coalition.

Critics blame the machinations of the country’s political elite, including both longtime former prime minister Boyko Borisov and his opponents. He acted quickly on the pandemic first, imposing reasonable lockdown measures. However, he then sought to guard against any political fallout by creating two care oversight bodies, each delivering contradictory messages.

“He would wake up in the morning and say: ‘Today I will meet this group and support its message… another day, the other group,” said opposition leader Ivanov.

When Borisov’s popularity appeared to increase last year as the nation rallied to his Covid-19 measures, the opposition rushed in, questioning the lockdown, mask warrants and ultimately, vaccinations as a means to cause its demise.

A far-right political party with barely more than a strident anti-vaccination message entered parliament for the first time in a vote this month. Polls suggest that up to 70 percent of Bulgarians oppose the vaccine. In interviews, their reasons vary. Some question the effectiveness of the vaccine. Others have cited unfounded concerns about side effects and there are those who worry about conspiracy programs.

“I am a healthy person and I do not need any vaccination,” said Karamfil Kamenov, a 52-year-old truck driver.

“Generally speaking, I trust the doctors, but the vaccine, I don’t trust. “

The prevalence of anti-vaccination sentiment makes those who choose to be bitten a discreet minority.

Valentin Tsenov, a 47-year-old Bulgarian who works in agriculture in the UK, received his first stroke on a trip home to visit his family in Vidin. He said watching life slowly return to normal near Canterbury where he lived had convinced him the vaccine was safe and effective.

However, he refuses to advocate vaccines to his friends and family in Bulgaria.

He said: “I prefer not to quarrel with them because I am afraid that they will try to convince me not to get the vaccine. “

Milena Hristova contributed to this report.