The Politics of Vaccination in Belgium, Germany and the Netherlands

• In Event: Pandemic Preparedness, Past and Future

Abstract

This paper examines the politics of vaccinations: how do governments go about ensuring that their populations are vaccinated, and what determines their success? Our focus is on the COVID-19 vaccination campaigns in Belgium, the Netherlands and Germany. Academic literature identifies trust (general, scientific, medical) and administrative capacity as the most common political and policy factors influencing successful vaccination campaigns: countries with high levels of trust and high administrative capacity have high vaccination rates. In this paper, we question the conventional wisdom. We argue that neither administrative capacity nor trust explains variations in the first round of COVID-19 vaccinations in Belgium, the Netherlands and Germany. Belgium has one of the lowest levels of political trust in the OECD and has struggled with capacity due to the complexity of its federal system and governing crises; the Netherlands exhibits high levels of trust and capacity; and Germany has relatively high levels of trust but has a federal system, albeit less complex than Belgium’s. We should expect that the Netherlands would have the highest vaccination rate, followed by Germany, and with Belgium trailing. However, the country with the highest vaccination rate (for two primary shots) is Belgium, while the Netherlands has a vaccination rate below the EU average, and Germany’s rate is above the EU average, yet below that of Belgium.

We argue that Belgium’s traumatic experience in the early phase of the pandemic convinced its subnational authorities to delegate authority to the federal government while the public, lacking trust in institutions, opted for a shot instead of risking illness. In the Netherlands, a “good” pandemic fostered complacency among the public while vaccine hesitancy was widespread among the younger population, suppressing vaccination rates. In Germany, conflicting messages from the federal government and local authorities fueled hesitancy among the public and resulted in an ‘average’ vaccination rate, below that of what would be expected.

We conclude that COVID-19 is unusual crisis, not comparable to other vaccination campaigns. Low trust in our cases led to a greater likelihood of accepting Covid-19 vaccination, while high trust created more space to be deliberative and reluctant. Furthermore, we argue that administrative capacity is elastic: low capacity can be transcended, but high capacity can be wasted. Ultimately, however, some puzzles remain about the determinants of vaccination rates.

Authors

• Paulette Kurzer, University of Arizona

• Janet M. Laible, Lehigh University