ANNABERG-BUCHHOLZ (Germany) — Mr Sven Müller is proudly unvaccinated. He thinks Covid-19 vaccines are neither effective nor safe but a way to make money for pharmaceutical companies and corrupt politicians who are taking away his freedom.

Under state rules to stem coronavirus infections, he is no longer allowed to go to restaurants, to the bowling alley, to the cinema or to the hairdresser. From next week, he will be barred from entering most shops, too. But that has only strengthened his resolve.

“They can’t break me,” said Mr Müller, 40, a bar owner in the town of Annaberg-Buchholz, in the Ore Mountain region in the eastern state of Saxony where the vaccination rate is 44 per cent — the lowest in Germany.

Mr Müller personifies a problem that is as sharp in some parts of Europe as it is in the United States. If Germany had red and blue states, Saxony would be crimson. In places like this, pockets of unvaccinated people are driving the latest round of contagion, filling strained hospital wards, putting economic recoveries at risk and sending governments scrambling to head off a fourth wave of the pandemic.

Even as studies show that vaccination is the most effective way to prevent infection — and to avoid hospitalisation or death if infected — persuading those who are deeply sceptical of vaccines has proved all but impossible. Instead, Western European governments are resorting increasingly to thinly veiled coercion with a mixture of mandates, inducements and punishments.

In many countries, it is working. When president Emmanuel Macron announced in July that vaccine passports would be required to enter most social venues, France — where anti-vaccine sentiment was strong — was one of the least vaccinated countries in Europe. Today it has one of the highest vaccination rates in the world.

Prime minister Mario Draghi of Italy followed Mr Macron’s lead with even tougher measures. There, and in Spain, too, attempts by populist parties to stoke a broad-based anti-vaccine backlash have largely been snuffed out.

But regional resistance against the coronavirus vaccine remains. In Central and Eastern Europe — and in the German-speaking countries and regions bordering them — the problem is more stubborn.

In Italy, the northern province of Bolzano — bordering Austria and Switzerland, where 70 per cent of the population is German-speaking — has the country’s lowest vaccination rate. Experts have linked a sharp increase in infections there to frequent exchanges with Austria, but also to a cultural inclination among the population toward homeopathy and natural cures.

“There is some correlation with far-right parties, but the main reason is this trust in nature,” said Dr Patrick Franzoni, a doctor who spearheads the inoculation campaign in the province. Especially in the Alps, he said, the German-speaking population trusts fresh air, organic produce and herbal teas more than traditional drugs.

In fact, Germany, Austria and the German-speaking region of Switzerland have the largest shares of unvaccinated populations in all of Western Europe. About one in four people older than 12 are unvaccinated, compared with about one in 10 in France and Italy and almost none in Portugal.

Sociologists say that in addition to an influential culture of alternative medicine, the vaccine resistance is fuelled by a strong tradition of decentralised government that tends to feed distrust of rules imposed from the capital — and by a far-right ecosystem that knows how to exploit both.

Opposition to vaccines, said Ms Pia Lamberty of CeMAS, a Berlin-based research organisation focused on disinformation and conspiracy theories, is in some ways the long tail of the populist nationalist movements that shook up European politics for a decade.

“Radical anti-vaxxers are not a huge group, but it’s big enough to cause a problem in the pandemic,” Ms Lamberty said. “It shows the success of the far-right cheerleading on this issue and the failure of mainstream politicians to take it seriously enough.”

As a result, in parts of Europe, “whether you’re vaccinated or not has become almost a political identifier like in the United States,” she added.

In Austria, where the government has gone furthest in restricting the unvaccinated, a newly founded anti-vaccine party recently won three seats in a State Parliament in the north, long a stronghold of the far right. In France and Italy, anti-vaccine hot spots remain where national populists hold sway.

In Saxony, anti-vaccine sentiment and support for the far-right Alternative for Germany, or AfD — the strongest political force here — overlap significantly.

The AfD has flatlined on a national level, but in the former Communist East, anti-vaccine sentiment has proved a natural fit for many constituents who often already have a deep suspicion of government, globalisation, big corporations and mainstream media.

“The vaccine polarises,” said Mr Rolf Schmidt, the mayor of Annaberg-Buchholz. “I hear it from morning till night: Everyone has their absolute truth and their own social media channel to reinforce that truth. The other side is all lies.”

So charged is the issue that Mr Schmidt will not say if he is vaccinated himself. “My big problem right now is to keep the social peace in this town,” he said.

In Annaberg-Buchholz, a onetime medieval metal-mining town near the Czech border, the split is visceral and visible.

Every Monday, hardline anti-vaxxers hold a small but noisy rally in the town centre. This week, there were some 50 protesters, shouting slogans like “the vaccine kills” and raging against the government in Berlin, which they say is a dictatorship like communism, “only worse”.

Many restaurants have rebellious messages in their windows blaming “political decisions” for tough new rules that exclude the unvaccinated from entry.

One of them is Mr Müller’s bar, Salon, where he serves more than 90 types of gin to patrons who are mostly unvaccinated like him, he says. A sign in the door cites the German Constitution and reads: “No matter whether (un)vaccinated, (un)tested, you are welcome as a HUMAN BEING!”

The sign turned him into a minor celebrity: People stop to take pictures, a cafe owner up the street copied his text.

Ms Karin and Mr Hans Schneider, two retired passersby who both grew up in Annaberg-Buchholz and who are vaccinated, said the only way to get sceptics to get the shot was to make it almost impossible not to. “It’s stupidity,” Ms Karin Schneider said. “You can’t argue with them; you have to get tough.”

In Germany, the incoming government wants to impose stricter rules against unvaccinated people, including mandating that they obtain a negative coronavirus test before using public transit.

But Austria has done the most, restricting the movement of anyone older than 12 and unvaccinated to traveling for work, school, buying groceries and medical care and giving the police power to check vaccination papers on the street.

“This is an unprecedented breach of our constitutional freedoms,” said Mr Michael Brunner, the head of MFG, the new anti-vaccine party.

Austria’s so-called lockdown of the unvaccinated was a talking point in Saxony, where many felt that the new restrictions coming next week were the same thing by another name.

Saxony was the first German state to exclude unvaccinated people from much of public life by requiring proof in most social venues of being either vaccinated or having recovered from a Covid-19 infection. Starting Monday, all nonessential shops will be off limits to them, too.

Many, like Mr Müller, feel betrayed by the government. “They promised that there would be no vaccine mandates,” he said. “But this is a vaccine mandate through the backdoor.”

A 10-minute drive from Annaberg-Buchholz, Dr Constanze Albrecht was injecting a dose of the Pfizer-BioNTech vaccine into the arm of a 67-year-old man. Dr Albrecht has been on the road with one of 30 mobile vaccination teams that crisscross Saxony to entice people to get a shot.

So far, there is no clear indication that the new restrictions have led to more demand for inoculations. Most shots Albrecht administered that day were boosters for people who were vaccinated months ago.

Many of those coming for their first shot make clear they feel coerced, Dr Albrecht said. One man said he was doing it only so he could keep taking his son to his sport club. A woman muttered that she “didn’t have a choice”.

Mr Schmidt warned that by singling out the unvaccinated, the government was sowing division. “This narrative, ‘Those bad unvaccinated people, they’re responsible for the increase in cases,’” he said. “It’s not helpful.”

Mr Schmidt would rather bring people together. He is lobbying to allow the town’s celebrated Christmas market to go ahead without restrictions on the unvaccinated — instead, a testing mandate for all.

In Annaberg-Buchholz, half of the booths are already up, on schedule to open Nov 26. But Mr Schmidt worries that it will yet be banned by the state government.

“That would be the last straw,” he said. “For our region, this is more than a Christmas fair, it’s who we are as a town and as a region. It’s a feeling, it’s an identity. Big cities don’t understand it.”

This article originally appeared in The New York Times.