Evidence map›Paper›PMID 41041361›Full record

ReviewFrontiers in public health2025

The deadly triple M (mistrust, misinformation, and missed opportunities): understanding Romania's COVID-19 vaccination campaign and its lasting impact on public health.

Stefan Dascalu, Catalin Valentin Raiu, Emilian Olteanu, Adrian Vasile Comanici, Mihaela Maria Comanici, Tudor P Toma, Bogdan Ionut Robu, Raul Mihailov, Laura Mina-Raiu, Gindrovel Gheorghe Dumitra and 3 more

Abstract readReview
In one paragraph

Review in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stefan DascaluDepartment of Biology, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom.
Catalin Valentin RaiuDepartment of Public Administration, Faculty of Business and Administration, University of Bucharest, Bucharest, Romania.
Emilian OlteanuDepartment of Pathology, British Columbia Cancer Agency, Vancouver, BC, Canada.
Adrian Vasile ComaniciDepartment of Endocrinology, "Titu Maiorescu" University of Medicine and Pharmacy, Bucharest, Romania.
Mihaela Maria ComaniciDepartment of Immunology, "Titu Maiorescu" University of Medicine and Pharmacy, Bucharest, Romania.
Tudor P TomaLewisham and Greenwich NHS Trust, London, United Kingdom.
Bogdan Ionut RobuGreat Western Hospitals NHS Foundation Trust, Swindon, United Kingdom.
Raul MihailovFaculty of Medicine and Pharmacy, Dunarea de Jos University, Galați, Romania.
Laura Mina-RaiuBucharest University of Economic Studies, Bucharest, Romania.
Gindrovel Gheorghe DumitraFamily Medicine Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Doina AzoicaiDepartment of Epidemiology, School of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania.
Emilian Damian PopoviciDepartment of Epidemiology, School of Medicine, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania.
Cristian ApetreiDivision of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

Funding

Assessing the Role of GI Tract Dysfunction to HIV/SIV Disease ProgressionR01DK113919 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CRISTIAN APETREI, Ivona Vasile-Pandrea · 2017 to 2026
$5.7M
New Strategy to Improve Gastrointestinal Health in SIV/HIVR01DK119936 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI APETREI, CRISTIAN · 2018 to 2022
$5.1M
Impact of metabolic programing of T cells from the GI tract and related tissues on HIV reservoir seeding, maintenance and reactivationR01DK131476 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CRISTIAN APETREI · 2021 to 2026
$3.9M
Animal Model for Testing SIV Latency Reversal StrategiesR01AI119346 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI APETREI, CRISTIAN · 2015 to 2019
$3.4M
Probing the role of adenosine pathway in SIV pathogenesisR01AI179317 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Ivona Vasile-Pandrea · 2023 to 2026
$3.3M
Mechanistic Studies of Gut Dysfunction Exacerbation due to SARS-CoV-2 in HIV/SIV infected IndividualsR01DK130481 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI VASILE PANDREA, IVONA · 2021 to 2023
$1.2M
NIAID NIH HHS R01 AI119346NIAID NIH HHS R01 AI179317NIDDK NIH HHS R01 DK113919NIDDK NIH HHS R01 DK119936NIDDK NIH HHS R01 DK130481NIDDK NIH HHS R01 DK131476
6 · The paper itself

Abstract

Romania's COVID-19 vaccination campaign presents a compelling case study on the intersection of public health policy, societal dynamics, and political influences in pandemic response. Despite an initially promising rollout, Romania ultimately achieved one of the lowest vaccination rates in the European Union, with severe consequences during the subsequent pandemic waves. This review examines the key factors contributing to the campaign's shortcomings, including pre-existing vaccine hesitancy, widespread misinformation, inadequate governmental communication strategies, and the politicisation of public health efforts. We explore the deep-seated mistrust in governmental institutions, exacerbated by restrictive measures implemented without adequate public engagement, as well as the influential role of religious communities and the rise of populist political forces that actively opposed vaccination efforts. Additionally, we discuss the impact of media sensationalism, conspiracy theories, and the failure to regulate anti-vaccine rhetoric within the medical profession. While logistical and infrastructural challenges were largely addressed, the inability to effectively engage key societal stakeholders led to lagging of vaccine uptake. The consequences of this failure extended beyond COVID-19, contributing to a severe measles outbreak in 2023, which underscored the long-term deleterious effects of vaccine hesitancy. Drawing from Romania's experience, we highlight critical lessons for future public health campaigns, emphasising the need for trust-building initiatives, targeted misinformation countermeasures, stronger community engagement, and enhanced collaboration with religious and cultural institutions. By addressing these challenges, countries worldwide can strengthen their public health frameworks and improve the resilience of their immunisation programmes in the face of future crises.

Indexed as

CommunicationCOVID-19COVID-19 VaccinesImmunization ProgramsPublic HealthTrustVaccinationVaccination HesitancyHealth PolicyHumansPoliticsRomaniaSARS-CoV-2COVID-19 VaccinesCOVID-19 vaccinationmisinformationpublic healthRomaniavaccine hesitancy

Identifiers

PMID41041361
PMCPMC12484034

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.