Elene Chkhaidze, a Tbilisi-based artist in her late thirties, has been watching friends in Germany and the United States post enthusiastic photos on Facebook of them and their parents getting vaccinated against COVID-19. Georgians’ own prospects for getting the inoculation are remote, even for the most vulnerable parts of the population, but she doesn’t mind. “I personally would not get the shot even if it was available here, and neither would my mother,” she said.

In the opposite corner of public opinion, NGO professional Tamara Sartania said she can’t wait to get her jab. “I will pay my own money for it,” she said.

For now, it is almost a moot point: With countries around the world snapping up vaccines like it’s Black Friday, Georgia – like many other poor countries – has been left out. Georgia is relying on the international vaccine-sharing platform, COVAX, but that effort has been slowed because wealthy countries have been sourcing vaccines directly from manufacturers. That has left little to go into the COVAX basket, from which poor countries can pick their shares, warned the World Health Organization, which is leading the COVAX effort.

“The world is on the brink of catastrophic moral failure” said the head of the WHO, Tedros Adhanom Ghebreyesus, last month. “It’s not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries.”

But many in Georgia don’t see that as a problem.

According to a new poll, 41 percent of Georgians say they want a vaccine, while equal numbers say they don’t. The numbers are barely changed from a similar poll in spring of 2020, when Georgia had one of the best COVID containment records in the world and the vaccine was a distant prospect. At about the same time in neighboring Armenia, which then was the region’s ground zero for the pandemic, one survey reported that 31 percent would be against and 36 percent in favor of getting a vaccine.

Now Georgia is suffering one of the world’s highest per capita rates of transmission and fatalities. Still, the change in attitudes have been “statistically indistinguishable, suggesting that, even though vaccines now exist, attitudes have not changed,” said Dustin Gilbreath, deputy director of the Caucasus Research Resource Centers, which conducted the two polls.

Globally that puts Georgia in the skeptical camp: A global survey in October of mostly developed countries by the polling company Ipsos found that 73 percent would get vaccinated if they could. At the same time, the Levada polling company found that only 36 percent of people in neighboring Russia were “personally prepared” to get vaccinated. 

While vaccine supporters and opponents in Georgia often openly argue online or at private gatherings, an informal poll by Eurasianet showed that many of the pro- and anti-vaccine Georgians live in virtually different worlds, and are often surprised to learn how big the other group is.

Lack of information 

The majority of the vaccine-hesitant interviewed by Eurasianet worry over the long-term safety of the vaccines. They are uncomfortable with what they feel is a global experiment and insist there is just not enough information yet on the vaccine’s safety. Chkhaidze, the artist, said she is concerned with the unprecedentedly rapid creation and approval. “We know that it works against COVID-19 but is safe in the long-term?” she said.    

Attitudes like that could become a serious problem when the inoculation campaign begins in Georgia, said Deputy Health Minister Tamar Gabunia. “We will need a major information campaign […] to help healthcare professionals and the population at large learn more about the vaccines,” Gabunia said at a January 5 press briefing.

Vaccine skepticism cuts across demographics in Georgia, and level of education makes only a small difference: 38 percent of Georgians with a high school education or less want to get the vaccine, compared to 45 percent of those with a higher education, the CRRC poll found.

Even some doctors are on the fence. One general practice physician in Tbilisi told Eurasianet that even though several vaccines have been proven effective and safe through trials, he wants to see detailed guidelines from both the manufacturer and the national health authorities before he can make up his mind. “When prescribing medication, you need to know what potential complications can be. Is it safe for people with hypertension, people with allergies and so on? At this point, I know nothing about potential complications of the COVID vaccines, except from what we hear on TV,” he said.

He asked that his name and that of his clinic not be identified, fearing that perceived vaccine skepticism could jeopardize his clinic’s contracts with the government. And he said that with more information, Georgians may become more receptive to the vaccines. “I’m sure opinions will change when the vaccines arrive and we can see the manufacturer’s note – hopefully in a language we can understand – and also we have the protocol from the [health] ministry we can follow,” he said.

Other doctors countered that there is already plenty of information on the internationally approved vaccines for a physician to form an opinion.

Sergi Kapanadze, a leader of the opposition party European Georgia, says the government bears responsibility for the lack of information. “Vaccination is already well underway in many other countries but here all we hear are the government’s contradictory statements about when immunization is going to start, about the timeframe and what companies’ vaccines will be used,” he told Eurasianet.       

But it is not just the paucity of information that is driving the skepticism. It is also the wrong information.   

Disinformation

In early January Neli Kobalava, a nurse in a pediatric hospital, clicked on a video shared by a Facebook friend. The video, showing Kamala Harris getting inoculated with the vaccine developed by Moderna, was captioned in Russian: “U.S. Vice President is faking getting the coronavirus shot.”

Something in the video did seem strange to her. After administering the shot in Harris’ arm, the nurse pressed the syringe against the arm of the chair, snapping a pink plastic top into place. A note under the video, which included zoomed-in footage of that gesture, claimed that the nurse had merely pressed a syringe with a bent and capped needle against Harris’ arm, only pretending to be delivering the injection.

“I administer injections every day and it’s a simple process: You insert the needle, you pump the medication in and you dispose of the syringe. I honestly could not figure out what that nurse was doing,” Kobalava told Eurasianet.

She shared the video on her Facebook feed, following it up with a question: “does anyone know what kind of syringe was used here?” 

Her post sparked a lively discussion in the comments section, with many proposing elaborate conspiracies by way of explanation, until finally Kobalava’s boss joined in with a link to a video that describes the syringe used by the American nurse. The syringe, which comes with a safety cap attached to the side of the needle to cover it after usage, is not commonly used in Georgia. The boss followed up with a testy comment: “Neli, as a healthcare worker you should know better than be sharing such nonsense.”

“I then realized that I have seen those kinds of syringes before. It was at a presentation by this medical supplies distributor. We did not end up buying them since they were more expensive than the regular ones,” Kobalava said.

Embarrassed, she removed the post, but the damage was done. The video had already been shared from her Facebook page 46 times.

Similar videos and claims are often bandied about on Facebook, by far Georgians’ preferred social network. Media Development Fund, a Georgian NGO monitoring and combating disinformation, has been studying online vaccine disinformation and has identified three main strains, said Tamar Kintsurashvili, the organization’s director. 

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The first consists of “anti-vaxx groups and influencers, who are opposed to immunization in general,” she told Eurasianet. This group does not appear to have any other political agenda and often borrows its anti-vaccine content from similar pages in the U.S.

Next, there are Russia-oriented groups that place vaccine skepticism in a geopolitical context, seeking to discredit the American and European vaccines, and promoting the alleged superiority of the Russia-developed Sputnik V. One story in Russia’s state-run Sputnik news agency was headlined “Once again, the Russians are saving everyone.”

This narrative faces some headwind in Georgia, where many categorically oppose the Russian-made inoculation, doubting its quality and/or hostile to the idea of collaborating with what they see as an enemy state. Nevertheless, the anti-vaccine sentiment has gotten traction with some priests in the influential Georgian Orthodox Church.

“We see all these claims of Satan marking his followers by inserting chips and injecting vaccines,” said Kintsurashvili, who argues that there is some overlap between pro-Russia narratives and anti-vaxxers. “The role of the clerics is actually quite worrisome as we live in a very religious country and priests carry a lot of influence over their parishes,” she said.

Finally, there are opportunistic websites and groups that use vaccine scare-mongering as clickbait. Groups with names like “Pears of Georgia,” “The Christian,” and “The Truth,” have spread a photo of Mary and the baby Jesus claiming that it is “coronavirus-repelling” and an alternative to vaccination. “Share this icon and write amen, and you will be spared the coronavirus.”

“The impact of all types of online disinformation campaigns is hard to gauge, but such content often gets hundreds and thousands of shares,” Kintsurashvili said.

The rise of COVID vaccine conspiracy theories has exposed deep crises faced by the increasingly divided modern world, said prominent historian Lasha Bakradze. “All this is symptomatic of the bigger issues the world has,” he told Eurasianet. “I keep saying that we now live in changing times. COVID lifted the curtain on the deep issues we face as world. This is my own conspiracy theory.”

Too much information

The problem has been exacerbated by quickly changing and at times contradictory information coming out from the sources who are supposed to be authoritative.

When Naniko Gabadadze, a public relations manager in Tbilisi, first started reading about the new virus a year ago, she got alarmed. She instituted her own personal lockdown, working from home, and on her own started wearing gloves and a mask. At the time, the getup was as conspicuous as a “hazmat suit,” she said with a laugh. “At that point, it was just me and China who were doing that.”

But then she watched the global health authorities repeatedly change their message about COVID. The WHO initially said that travel restrictions were overkill, praised China for its response, said masks were unnecessary in public, and that it was rare for asymptomatic carriers to pass on the virus – only to later walk back all those points. Drugs like hydroxychloroquine were endorsed as a potential cures only to be jettisoned as useless later. The WHO and the U.S. Food and Drug Administration (FDA) disagreed in their assessment of efficacy of another drug, Remdesivir, in treatment of COVID patients.

This scramble to figure out how to manage the pandemic eroded Gabadadze’s trust in the global healthcare establishment. “Everyone was running around screaming: ‘don’t wear masks, you fools, no-no wear them; oh, we found this new remedy, oh, no we did not; oh, we found this new complication that COVID causes, wait no, we were wrong,’” she said. “I was thinking to myself: ‘can’t you just shut up and wait until you have conclusive evidence on any of those things? And err on the side of caution in the meantime?”

Putting little stock in her own country’s ability to handle the virus, Gabadadze hoped that Western countries would lead the way, but the West’s response was anything but unified. If Italy and other European nations boarded themselves up, Sweden famously stayed open to let the coronavirus run its course. “UK went back and forth on lockdowns; in the U.S. all you read in the news was Trump, Trump, Trump,” Gabadadze said. 

In her opinion, the Georgian government did the only sensible thing in the early stages of the pandemic: shut everything down and wait. But that sensibility, which at first did result in one the world’s best pandemic containment efforts, didn’t last long. As the public began to grumble amid layoffs and business closures, Georgia opened up again.

By the end of summer, a massive outbreak began. “It was a mistake to cave in to public demands and open up last summer and we saw what happened in November and December,” Tengiz Tsertsvadze, Georgia’s top infectious disease doctor, said recently. By mid-fall, Georgia was leading global charts of per capita transmission and death rates, but the government held off on instituting new restrictions until the ruling party secured victory in parliamentary elections in November.

Many surveyed by Eurasianet said they now believe that politics come before the pandemic, both globally and locally. “The end result is that I don’t believe anything anyone says these days, and the same goes for the vaccine,” Gabadadze said. Still, she said, she is leaning toward getting the jab – whenever it’s available.

To other Georgians, the question isn’t whether or not to get the vaccine. It’s which vaccine they’ll be offered.

Which vaccine?

The Georgian government recently announced its COVID-19 immunization strategy, setting a target of inoculating 60 percent of its above-18 population by the end of the year. The plan, estimated to cost up to $19.5 million, is ambitious given the vaccine skepticism at home and the fierce global competition over access.

With the plan providing only a broad outline, some want the government to provide a more detailed timeline for the immunization campaign. “I want to see a concrete plan, a timeline of when I – a non-risk category, an ordinary mortal – will have the access to the vaccine. I don’t care if it’s 2022. I just need to know when,” said Maka Meshveliani, senior fellow at the National Democratic Institute, a Washington-backed non-profit.

Officials have variously mentioned the end of March or beginning of April as potential time for rolling out immunization, but European Georgia’s Kapanadze expects delays. “The handling of the pandemic wave in fall is not a very promising preview of how vaccine importing and mass immunization may go,” he said.

Health authorities said that prior to a larger rollout – Georgia has doses for 700,000 people preordered through COVAX – Georgia will begin a smaller immunization effort as early as this month. “We have been given a final confirmation that we will receive 29,250 doses of the Pfizer-BioNTech vaccine in mid-February,” Deputy Health Minister Gabunia said on January 30.

As that vaccine requires two injections, this shipment will take care of fewer than 15,000 people, primarily front-line healthcare workers. In spring, Georgia will begin receiving the larger batch of vaccines manufactured by AstraZeneca, Gabunia said.     

People in the pro-vaccine camp are hoping that Georgia will rely on the two innovative vaccines produced by Pfizer-BioNTech and Moderna, which have reported the highest levels of efficacy. Both deploy new technology to deliver synthetic genetic material, which mimics a coronavirus invasion and prompts the immune system to create antibodies. The AstraZeneca vaccine developed in collaboration with Oxford University is a cheaper alternative that uses an attenuated common cold virus, modified to look like the coronavirus, to provoke an immune response.

“Moderna is like the Chanel of the vaccines,” quipped Sopo Chaava, a public relations officer in Tbilisi. Despite having a favorite, Chaava, like many others, ultimately places her trust in vaccines approved by the Western health institutions, which would include AstraZeneca, and remains skeptical of Chinese and, especially, Russian produced vaccines. 

“It needs to be Pfizer, Moderna and also AstraZeneca. In other words, the vaccines that have been approved by the FDA and WHO, and are used in the European Union,” said television host Eka Kvesitadze, who has heavily covered the pandemic and Georgia’s response.

Some Georgian health officials said that the nation should be open to all options, which touched off a small controversy over the prospect that Russia’s Sputnik V could be used. The newly published immunization plan says merely that Georgia will import a vaccine licensed by organizations like the WHO and American and European regulators. This does not necessarily exclude the Russian jab, which is being currently reviewed by European regulators and was found to be safe and highly effective in a study published by the prestigious Lancet medical journal on February 2. Gabunia, the deputy health minister, later specified that Pfizer, Moderna and AstraZeneca vaccines would be the priority.

But not everyone is picky about provenance. One video widely shared on social media captured a social gathering where, as is often the case these days in Georgia, the vaccine was being debated. “Near the town of Chiatura there is a beautiful little village called Rkvia. […] If Rkvia makes the vaccine tomorrow, I will take it,” a young woman raved, half-jokingly. “People, you don’t know how important vaccines are to me. So let me be the first one to take it, let me be the guinea pig,” the woman tells skeptics at the dinner table, and then raises a glass of wine. “Here’s to the vaccines!”