Mind the gap! The role of health policy capacity and vaccination acceptance in European Covid-19 mortality differences

Two years of the Covid-19 pandemic caused significantly different death tolls in European countries. Nine of the 30 countries with the highest accumulated fatalities belong to Central and Eastern Europe, although the solidarity of the European Union (EU) provided vaccines for all member states. Using correlation and cluster analysis, this paper identifies the demographic, social, and political factors which can explain the differences. As generally accepted in the literature, the death toll is measured by the number of excess deaths. The examination separates the prevaccination and vaccination periods. While the impact of other factors is also present, vaccination coverage has a salient explanatory role in the excess deaths of the second period. The experiences of the Covid-19 pandemic simultaneously highlight the importance and sociopolitical constraints of health policy at the European level. The analysis confirms that complementary competences between the European and national levels are adequate for the EU health policy.