Northern Greece, vaccination coverage and the autumn 2021 COVID-19 wave

Submitted by Kostas Maistrelis on · last edited
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The purpose of this note is to check whether there is enough support for the claim that:

  • the national vaccination coverage concealed lower rates in parts of Northern Greece,
  • and that the heavier autumn wave of 2021 appeared there first, or more intensely, or both.

Summary conclusion

The basic idea holds, but the safest wording is not that “Northern Greece” as a whole had low coverage. It is more accurate to say that:

  • several critical regional units of Macedonia and Thrace had noticeably lower vaccination coverage than the national average,
  • that the autumn / fifth wave of 2021 was described by sources of the period as a wave evolving first in Northern Greece and then in the remaining regions,
  • while the pressure on hospitals and the deaths in Macedonia and Thrace were already very high in late October and early November 2021.

So the substance of the observation stands, but it is better to speak of:

  • large regional variations,
  • lower rates in several regional units of Macedonia and Thrace,
  • and a wave that appeared first and more heavily in Northern Greece,

rather than of a uniform picture across all of Northern Greece.

What was found

1. Lower coverage in parts of Macedonia

On 12 October 2021, eKathimerini wrote that the authorities were stepping up vaccination efforts in parts of Macedonia where the rates were low. Named as examples:

  • Kilkis: 41.7% fully vaccinated
  • Florina: 47.7% fully vaccinated

The article speaks explicitly of low-performing areas of northern Greece and of mobile vaccination units in Pieria, Kilkis, Xanthi, Drama, Pella, Florina and Serres.

Source:

2. Regional units below 50% in Macedonia-Thrace

On 25 October 2021, eKathimerini published figures from the epidemiological map of covid19.gov.gr. Of the country’s 74 regional units (total), those with vaccination coverage below 50% were nine, and five of them were in Central and Eastern Macedonia-Thrace:

  • Drama
  • Kilkis
  • Pella
  • Pieria
  • Serres

The other four: Evrytania and Fokida (Central Greece), Ilia (Peloponnese), West Attica.

This reading is confirmed by the article’s own distribution: below 50% nine, 50-55% twenty-four, 55-63% twenty-four, above the average seventeen; total 74.

Other figures from the same publication: national coverage 62.4% with at least one dose; a range from 38% (Evrytania) to 78.5% (Mykonos); within Attica, the northern sector at 72% against the western sector’s 45.4%; and in the ten units with the most new cases per 100,000 residents, coverage ranged from 44% (Kilkis) to 54% (Larissa).

Mind the unit of measurement: the 62.4% is stated as “at least one dose”, so the rates on the map must not be presented as full vaccination. The 41.7% (Kilkis) and 47.7% (Florina) of the previous section refer explicitly to fully vaccinated people and come from a different publication.

The same article also noted that the areas with low coverage were, in relative terms, responsible for high transmission as well, while the low vaccination coverage and high transmission in Northern and Central Greece appeared to affect the pressure on COVID intensive care units too.

Source:

3. The wave was described as one starting in Northern Greece

On 30 October 2021, in a Reuters piece republished by eKathimerini, Athanasios Tsakris said of the fifth wave in Greece:

“we see it evolving first in northern Greece and then in the other regions”

What matters here is that this documents not merely high pressure in Northern Greece, but also the public description at that moment: that the surge was evolving there first and in the rest of the country afterwards.

Source:

4. A very heavy burden in Macedonia and Thrace in early November

On 8 November 2021, in yet another Reuters piece via eKathimerini, it was reported that:

  • more than 300 people had died of COVID in the previous two weeks in Macedonia and Thrace,
  • 85%-87% of them were unvaccinated,
  • and the hospitals of the 3rd and 4th health regions were under very heavy load in both ordinary beds and ICUs.

This gives strong support to the statement that the wave hit Northern Greece hard.

Source:

5. A high share of unvaccinated patients in the ICUs of Macedonia and Thrace

On 22 October 2021, a Reuters piece in eKathimerini reported that more than 94% of the patients hospitalised in ICUs for COVID in 28 hospitals of Macedonia and Thrace were unvaccinated.

This finding does not by itself prove lower regional coverage in the general population, but it reinforces the picture of a low level of protection in the areas that were under strong pressure at the time.

Source:

How it can safely be used in the text

The safest wording for article.html or another text would be something like:

Two further possible causes are not examined here, but deserve a mention: the national coverage of 88% conceals large regional variations, with several regional units of Macedonia and Thrace at noticeably lower rates, and the autumn wave of 2021 appearing first and more heavily in Northern Greece. In addition, the booster dose began after the wave had already started.

What these sources alone do not fully establish

From the material found, it is not established with the same certainty that:

  • all of Northern Greece had uniformly low coverage,
  • that the lower regional coverage on its own explains the overall Greek outcome,
  • or that there is an exact quantitative decomposition of the national result into a “northern” and a “non-northern” part.

The sources support well the existence of regional variations and the heavy burden on Northern Greece during the wave of that period. On their own, however, they are not enough for a full causal conclusion.

Sources

Further useful source

The official epidemiological map of covid19.gov.gr includes regional figures and was used as a basis in publications of the period:

Topics: COVID-19epidemiology

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