In Hungary, politicization of vaccine hangs over immunization efforts

Hungarian Prime Minister Viktor Orbán has spent months boasting that Hungary was working harder than other EU countries to secure vaccines against the coronavirus, even jumping the gun to start vaccinating a day earlier than other member states.

That move — disregarding the European Commission’s plan for a coordinated bloc-wide rollout of the jab on December 27 — will likely be seen as an attempt to undermine the EU’s vaccination strategy. It comes after Orbán complained that European regulators were taking too long to approve the vaccine and claimed that Hungary would be the first country in Europe to use Russian and Chinese shots.

But months later, Hungary has no Russian or Chinese vaccine and Orbán’s critics say he might have undermined confidence in getting vaccinated at all.

Even though the EU-approved BioNTech/Pfizer vaccine is the first to go into Hungarian arms, critics say his politicization of vaccines has fueled skepticism: In a recent survey by the country’s Central Bureau of Statistics, only 15 percent of Hungarians said they would get the jab.

“Hungary is a member of the European Union, and they should follow the rules and do the same things the other countries are doing,” Ferenc Falus, a former chief medical officer in Hungary, said. 

Critics say the Hungarian government has been too focused on the politics of vaccination to properly prepare the public for them. In the Central Bureau of Statistics poll, 21 percent said they didn’t know if they would or didn’t answer, another 28 percent said maybe, while 35 percent said they would not get vaccinated.

While the most recent poll doesn’t distinguish between the different vaccines, at least one poll conducted by Pulzus for Napi.hu in November found that Hungarians were more confident in the Western vaccines, with 53 percent saying they would use an EU-approved vaccine, while only 11 percent would use a Russian or Chinese vaccine.

Health professionals worry that vaccine skepticism might affect all vaccination efforts.

“My patients are concerned about getting vaccinated against SARS-CoV-2 in general,” said Awid Adnan Ádám, a general practitioner in Budapest. They aren’t paying as much attention to differences between Russian or German-American vaccines, he added.

Dániel Eörsi, another Budapest-based GP, also said many Hungarians are skeptical of coronavirus vaccines “in general.”

Politically motivated push

Public health experts say Orbán has wasted precious time trying to score points with Russian President Vladimir Putin by pushing the use of the Sputnik vaccine.

Instead, Falus said the government should have pushed a large-scale public health campaign to reassure the public about the safety and efficacy of coronavirus vaccines.

Politicizing vaccines or general mistrust of governments can increase vaccine skepticism, experts found in numerous studies, including a September study from the Vaccine Confidence Project. In the December poll, two-thirds of participants say that government and media communications affected their opinion.

“There are many contradictory statements about the vaccination against COVID 19 in Hungary, public information is insufficient and, as a result, the measured vaccine rejection rate is higher than the European average,” said Mihály Kökény, a former Hungarian health minister and now a consultant for the World Health Organization.

Although the Sputnik vaccine is promising, scientists criticized the Russian government for authorizing the vaccine before completing large scale human trials and stating it was more effective than western vaccines based on a scant sample size, all to claim a victory in the global vaccine race. 

All this talk has worked as “a political firework for Orbán” that proved loyalty to the Russian president and fought against Brussels, said Kökény. “[Orbán is] just using this whole vaccine story … in accordance with his political games with the European Union.”

The Hungarian government, however, said they’re just trying to examine “all possible vaccine solutions.”

“The safety of a vaccine is not a political or ideological issue, but a professional one,” the government’s communications office wrote to POLITICO.

Growing mistrust

Historically, Hungary is not a very vaccine-skeptic country. In 2018, more than 91 percent of Hungarians said vaccines were “generally safe” in a Commission-backed report, and the country has one of the highest MMR vaccination coverage rates in the EU, according to the European Centre for Disease Prevention and Control.

As recently as August, 55 percent said that they were ready to vaccinate themselves. The apparent drop in coronavirus vaccine confidence is the “No. 1 issue” affecting Hungary, said Péter Krekó, the executive director of Political Capital Institute.

“The Hungarian government’s promise to apply and license Sputnik V quickly is … not only unfounded, but could also undermine the general confidence in vaccination,” Krekó’s think tank Political Capital wrote.

He acknowledged in an interview that there are other reasons people could be hesitant to use coronavirus vaccines, including the fact that Hungarians are nervous about how quickly the vaccines were developed, a fear found across the EU. 

This is why public health campaigns explaining the safety and efficacy measures are so important. The Hungarian government said “such a campaign is still underway to get as many people as possible vaccinated and trust the vaccine.”

Assuming the EU’s six vaccines are approved by regulators, Hungary has purchased 17.5 million doses of coronavirus vaccines via the Commission’s deals — enough to vaccinate everyone in the country. 

Plans relying on the Russian vaccine are less advanced, with the government planning to have between 3,000 and 5,000 people participate in a phase 3 trial of Russia’s Sputnik vaccine. The government is also in the process of fast-tracking the “Chinese vaccine,” although they did not specify which one.

But Brussels always appears “as the obstacle in governmental communication,” Krekó said, “always a problem and never the solution.” Rather, it’s “crucially important for Orbán to show that he is the one who is bringing the vaccines to Hungary; he is the one saving the country.” 

Political gamble

His critics say this is also why, rather than go through GP offices, the government wants all Hungarians to volunteer to get vaccinated by registering on a government website or sending in physical cards to the government. Falus was aghast that the government was asking for personal details including his social security number — none of which he argued is necessary for a mass vaccination campaign. 

The Hungarian government said this is “completely incomprehensibly challenged many times and for political reasons.”

“The Cabinet Office of the Prime Minister is in charge of the general tasks of information dissemination in connection with the epidemic, it stands to reason that this ministry should manage the details of those who register for vaccination,” the government wrote. This “is the most effective campaign for vaccination, so the government … will continue to do so.”

But if people don’t get vaccinated, critics say the strategy could blow up in Orbán’s face, as the government already faces one of the highest coronavirus death rates in the EU and the possibility of a united political opposition ahead of parliamentary elections in 2022. 

“The stakes are pretty high,” said Krekó. “If you undermine the willingness of people to vaccinate themselves, [Orbán] can suffer the political consequences.”

Lili Bayer contributed reporting.

This article has been updated.

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.