For many countries in Eastern Europe and the Western Balkans, the dilemmas thrown up by the dash to acquire COVID vaccines have been compared to those that existed during the Cold War.
Governments in the area have been presented with the questions: Which vaccine is best? Which can be available quickly? Do they risk damaging relations with the West if they look to Russia for their missing doses?
"What I like about the Cold War are the deeper ideological implications, because I do think vaccine diplomacy is about values more than vaccines," Allison Carragher, a visiting scholar at Carnegie Europe, told Euronews.
The specialist in the Western Balkans and countries of the former Yugoslavia sees the choice of where Eastern European countries can get their doses from as a "clash of two value systems", with the Chinese and Russian vaccines on one side and the Western vaccines on the other.
"It's not just about soft power or geopolitical goodwill, it's about what are the values underlying those vaccine programmes," she added.
Some of the broader issues thrown up by this divide that Eastern countries are having to consider are if they need transparency, to share data, to involve the private sector and to trust a regulator, according to Carragher.
But now, there is a broader spectrum of key players than there was during the Cold War, with some countries turning to China, points out Joanna Hosa, deputy director of the Wider Europe Programme at the European Council on Foreign Relations.
She agrees that countries in the area clearly prefer vaccines from their political allies, but added that the efficiency of the vaccines is also an important dimension.
The Russian dilemma: 'Scientific evidence does matter here'
Russia was straight out of the gate in the COVID vaccine race, declaring it had registered a jab back in August 2020, but many scientists in the country and abroad questioned the decision to make it available for use before Phase 3 trials, which normally last months and involve thousands of people.
"That kind of backfired initially for Russia," Hosa explained, adding that this is why lots of countries "preferred the Western vaccines in the beginning ... because scientific evidence does matter here".
But when some in Eastern Europe and the Western Balkans saw that the Russians and Chinese vaccines were easier to obtain, they started to change their minds, she added.
Indeed, even some EU countries have got on board before Sputnik V is approved by the bloc's medicines regulator, with Hungary and Slovakia already receiving doses.
"Germany has also been considering producing Sputnik vaccines, repeating the mantra that it's in everybody's interests to have as many people vaccinated as possible in Europe and around Europe," Hosa said, and on March 9, the Italian-Russian Chamber of Commerce announced that the former will produce Sputnik V from July.
But no matter how dire the need for vaccines, some former Soviet states haven't been able to look past feuds with Moscow, least surprisingly Ukraine.
"Ukraine would not want to be dependent on its enemy - these countries are at war and the situation is just so emotional and the levels of trust are so low, at least from the Ukraine side," Hosa explained, saying that Kyiv had gone as far as legislating against the Russian vaccine so that just purchasing the jab is illegal.
There was a petition to go against the Russian vaccine "because it's seen as a national security threat", she added.
The Russo-Georgian War is also fresh in the minds of Georgians, according to the expert, "so their emotions are pretty high, too", which makes them more likely to plump for Chinese vaccines, or at least only a small overall percentage of Sputnik V uptake.
"Moldova is on the fence. While the current president is very pro-European, she doesn't want to have problems with Russia either," Hosa said, so "they might buy some doses, but it would not be the majority."
On the other side of the coin, Belarus has welcomed Sputnik V vaccines with open arms, because "they've not really got anything to lose, as they're not really courting the EU or any other countries and Lukashenko is betting on Russia".
In the meantime, the exiled Belarusian opposition leader, Sviatlana Tsikhanouskaya, has been negotiating to get Western vaccines for the Belarusians, but her actions are more symbolic as, even if she obtains some promises, the regime in Belarus is unlikely to accept them, according to Hosa.
Donations between countries — 'it has to be' political
The geopolitical relationships between countries are also at play when it comes to nations donating doses to those in need.
Serbia has been held up as one of the top vaccinators in the world, with the government making a point of saying securing jabs wasn't a political matter.
President Aleksandar Vučić recently told Euronews that "some vaccines that were coming from the East were even safer than those that we got from the West," adding "but all of them were great."
However, dig a little deeper and Carragher says "it has to be" political.
"Is he (Vučić) saving lives with vaccines? Yes, most likely and no one's disputing that, but there are political implications. We live in a real politic world, so you have to look at all of the implications," she said.
The Western Balkans expert says the Serbian president has given a "masterful" class in vaccine diplomacy, working with Europe, the US, China and Russia and using it to his advantage both domestically and politically.
He's donated vaccines within the region notably to North Macedonia, Montenegro, Bosnia - starting with the Serb majority side but then both entities - as well as sending vaccines to the Serb population in Kosovo.
"There's an ethnic component, there's a political component," explained Carragher, "and the Prime Minister of Serbia has linked these vaccine donations to greater regional integration, which on the face of it is a very general statement but Aleksandar Vučić is also one of the regional leaders at the head of this mini Schengen regional cooperation project and proposal, which some of the other Western Balkan countries remain very sceptical of."
On the other hand, Hosa says it hasn't gone unnoticed that Serbia has been "playing some geopolitical games within their own country" in working with China and Russia while being a candidate for EU membership, which could have led to worries about where this country really is going geopolitically — into the arms of Brussels, Moscow or Beijing.
The EU's public relations disaster
The European Commission's vaccination scheme has come under much criticism for its slow rollout.
For this reason, Hosa doesn't think some Eastern European governments' decisions to go it alone outside of EMA guidance will negatively impact their standing in the bloc or accession to the union.
In the Western Balkans, many countries didn't qualify for COVAX — the facility to coordinate purchases of jabs globally to ensure poorer countries were not priced out of the vaccine race — so were reliant on the EU deliveries.
When EU vaccines were slow to surface, Carragher thinks where countries chose to turn reflects the political leadership and their leanings.
"Albania and Montenegro were stalwarts in staying with the West, looking to the EU, looking to those institutions, and being more serious or dedicated to being NATO, EU, Western countries," she said.
"Whereas a country like Serbia has been totally willing to be working with whoever can best serve its domestic agenda."
She thinks the Western Balkans region has been repeatedly sidelined in its EU path and the pandemic has only served to exacerbate "the feeling that they have been forgotten", not only in terms of vaccine diplomacy but also the major fiscal spending to keep economies afloat.
"The EU was not the first to get vaccines into most of these countries and while it is very small numbers that we're talking about coming from other places, the symbolism matters," Carragher explained.
'What happens in Vegas, stays in Vegas'
While vaccine diplomacy may seem like a hot topic in the context of the pandemic, Hosa thinks we will forget who has bought from whom in time.
"What happens in Vegas stays in Vegas," she said. "Lots of things will be forgiven" because states were reacting to a global crisis.
Hosa says she is "cautiously optimistic" for the EU scheme in Eastern Europe and the Western Balkans as the bloc has bought so many doses, but says she would like to see concrete promises made, especially when it comes to the Eastern neighbourhood, which has "not been paid much attention yet".
Carragher adds that the choice of who to buy vaccines from isn't the only decision that could affect countries in the longterm.
"This isn't just about who's going to provide the vaccine this year," she said. "If you're becoming a manufacturer of a Chinese or Russian vaccine, that's a long term partnership — are there any other implicit or explicit strings tied to some of that vaccine diplomacy that have yet to be discovered?
While both experts think geopolitics have played a part in vaccine acquisition in the East, Carragher adds this was clearly not the only consideration for countries grappling with a deadly disease.
"In part, those (decisions) are just part of democratic pressures and the pressure to save lives, in some cases more than: 'Oh, we're going to pick Russia over that.'"
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