Europe was one of the first regions in the world to deploy coronavirus vaccines, yet parts of the continent are now seeing a resurgence in cases, with some countries experiencing their highest infection levels of the pandemic.
In the Czech Republic, new daily cases are up 33% over the past week, while recorded infections have jumped by 52% in Croatia and 49% in Austria, according to a Washington Post tracker.
On Thursday, Germany's weekly case rate soared to a record 249 new infections per 100,000 people, according to the country's infectious-disease agency, eclipsing last winter's high of about 197.
The difference now is that safe and effective vaccines have been available for months. But as winter approaches in Central and Eastern Europe, vaccination rates in many countries are lagging behind.
"The pandemic is anything but over," German Health Minister Jens Spahn said at a recent news conference.
"We are currently experiencing a pandemic mainly among the unvaccinated," he said. "And it is massive."
About 66% of Germans are fully vaccinated, according to Our World in Data, which tracks publicly available figures, putting Germany just slightly behind Britain and France. The European Union's overall vaccination rate hovers at about 65%, buoyed in part by sky-high vaccine uptake in countries like Portugal, but bogged down by lagging efforts in Central and Eastern Europe.
In the Czech Republic, about 57% of people are fully vaccinated, a rate nearly identical to that of the United States, where officials have for months blamed the untamed spread of the virus on the unvaccinated. Only a third of the populations in Russia and Romania are fully vaccinated. In Russia, recorded infections are at their highest levels yet, with about 40,000 new cases reported each day.
More than a thousand coronavirus-related deaths are being recorded in Russia each day — a "startling" number, said Elizabeth King, a professor at the University of Michigan's School of Public Health whose research focuses on Russia and Eastern Europe.
Vaccine hesitancy in the region can be attributed to distrust in the government and in the vaccines themselves, King said.
"Misinformation is spreading as fast as the virus," she said.
Conspiracy theories about the coronavirus and vaccines have spread in Bulgaria, fueling resistance to shots there.
"The people in my community don't want to get vaccinated," said Kapka Georgieva, a Bulgarian woman who received the Johnson & Johnson vaccine. "They are afraid and hearing on television and other sources that they might die. There is panic. I can't convince anyone to get the vaccine."
In Russia, the Sputnik V vaccine has been widely available since the spring but has been met with a mix of ambivalence and mistrust.
A doctor in St. Petersburg, Lev Averbakh, recently told The Washington Post that he was "so sick and tired of explaining to people what this virus is about and why they need to be vaccinated."
"This resistance from the population is huge," he said.
King said that "the spread of misinformation around vaccines was a concern" in Central and Eastern Europe "even prior to the COVID-19 pandemic."
She pointed to measles outbreaks in recent years "due to lapses in vaccination" in countries like Ukraine, where less than 1 in 5 people are fully vaccinated against the coronavirus. The surge there is particularly worrisome, she said, because the health-care system is "not adequately prepared" to deal with the deluge of cases.
The low vaccination rate in Ukraine comes despite a wide array of vaccines available, including shots by AstraZeneca, Moderna, Pfizer-BioNTech and Sinovac. Officials there have made a push in recent weeks urging people to get vaccinated.
"I ask everyone to switch off your social networks and turn on your brains," Ukraine's president, Volodymyr Zelensky, said recently in comments to reporters. "We must get vaccinated. It's the only solution."
The increase in cases across the continent come as the United States this week lifted restrictions on incoming travel from 33 countries, including many in Europe. Entry for foreigners is contingent upon proof of vaccination and a negative coronavirus test.
Sputnik V, however, was excluded from the U.S. list of accepted vaccines because it has not yet been approved by the World Health Organization. King said that authorization from the WHO or E.U. could make international travel an incentive for Russians to get vaccinated and also "eventually help change attitudes towards the vaccine within the country."