Objectives The aim of the study is to explain in more detail the role of competent institutions, procedures and marketing authorisation types for COVID-19 vaccines. The research hypotheses are based on the established rules and procedures of the competent institutions in the European Union in order to produce and approve COVID-19 medicinal products and vaccines as soon as possible to prevent the spread of disease. The vaccination administration and consequences of vaccination at the level of the European Union are also monitored to gather as much information as possible about COVID-19. Material and Methods Detailed study of the existing literature and any officially available data concerning the vaccine authorisations within the European Union has been carried out, with a particular focus on the conditional marketing authorisation procedure. For the purposes of a better understanding of the need for an urgent fast-track vaccine approvals, the approved and available literature relating to the origin and emergence of COVID-19 disease has also been investigated. This part of the research was carried out by searching published laws, regulations and ordinances on the pages of the European Medicines Agency (EMA), the European Commission (EC), the Croatian Agency for Medicinal Products and Medical Devices (HALMED), the Croatian Public Health Agency as well as accredited databases, e.g. ScienceDirect, PubMed, Elsevier using the following terms: COVID-19 disease, coronavirus, SARS-CoV-2, COVID-19 vaccine, etc. Furthermore, the Regulativni zahtjevi za odobravanje cjepiva protiv bolesti COVID-19 u Europskoj uniji differences of the approved COVID-19 vaccines in European Union from the regulatory perspective and the proposed strategies and the distribution plan have been clarified. Results This research provides a detailed insight into the strict pharmaceutical quality requirements, safety and efficacy requirements in order to approve COVID-19 vaccines following urgent fast-track vaccine approvals procedures to prevent further contagion spread. The research also presented and analysed the most recent data about approved vaccines and further steps of the regulatory institutions in the European Union. Conclusion The current pandemic COVID-19 disease spread is a global crisis with a major health, social and economic impact. Therefore, it was necessary to make exceptional efforts to study and develop vaccines against COVID-19 in order to meet the requirements for marketing authorisation and availability as soon as possible. The following COVID-19 vaccines of different producers are currently authorised in the European Union: Comirnaty, Spikevax (previous product name: COVID-19 Vaccine Moderna), Vaxzevria and COVID-19 Vaccine Janssen. In addition, following the agreed strategy and vaccination plan in the European Union, the EMA shall collect all side effects of authorised vaccines, while the European Centre for Disease Prevention and Control shall monitor the efficacy of COVID-19 vaccines. Above written enables identification and assessment of new information to ensure the detection of potential risks and their prevention.