Does education shield against vaccine hesitancy? Evidence from the East-West divide.

Education is among the strongest correlates of health behavior, yet its relationship with vaccine acceptance varies sharply across European contexts. Using the SHARE COVID-19 Survey 2 (summer 2021) linked to rich pre-pandemic data from SHARE and SHARELIFE - a longitudinal survey of adults aged 50 and above across 27 European countries - we document a striking East-West asymmetry: schooling is strongly and positively associated with COVID-19 vaccine take-up in Central and Eastern Europe (CEE) but only weakly related in Western and Central Europe (WCE). We argue that this contrast is consistent with the institutional legacies of communist rule, which generated persistent deficits in institutional trust and social capital that education may help bridge. To investigate which pre-pandemic domains account for the steeper CEE gradient, we add conceptually motivated blocks of covariates capturing cognitive resources, social capital, social networks, health, and early-life circumstances. Cognitive functioning accounts for the largest observable share of the gradient, but a sizable residual remains after extensive adjustment and is robust to sensitivity analysis for unobserved confounding. A within-Germany comparison by birthplace (East vs West) confirms that the education gradient is steeper among those raised in the former GDR, reinforcing the interpretation that institutional context shapes how education translates into vaccine acceptance.