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How vaccine doubts have put the handbrake on Serbia's rapid rollout

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By Slavica Tuvić
People wait in line for a COVID-19 vaccine during the vaccination at Belgrade Fair makeshift vaccination center, Serbia, Monday, Jan. 25, 2021.
People wait in line for a COVID-19 vaccine during the vaccination at Belgrade Fair makeshift vaccination center, Serbia, Monday, Jan. 25, 2021.   -   Copyright  Credit: AP
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Just six months ago, Serbia was patting itself on the back for its rapid vaccine rollout, which in February was the second-fastest in Europe.

Powered by plentiful supplies of the Pfizer, AstraZeneca, Russian Sputnik and Chinese Shinopharm vaccines, it raced ahead of EU countries. In fact, Serbia was in such a strong position it even began offering jabs to people over the border in Croatia, North Macedonia, Montenegro, Albania and Bosnia and Herzegovina.

But now vaccine hesitancy is checking Serbia's progress.

From January 23 to February 23, Serbia put more than 1.1 million jabs in arms. In the month to July 22, 400,000 vaccines were administered.

Serbia's per capital vaccination rate was second only to the UK's at the start of the year. Now most EU countries have overtaken it.

The latest figures show 49% of Serbia's population have had one dose of the vaccine.

Vaccine scepticism

The mistrust of the COVID vaccine in some parts of Serbia has got so bad that at some centres, foreigners outnumber locals.

That is the case in the southern city of Nis, according to Milorad Jerkan, a health centre director. He told Euronews that 520 foreign nationals were vaccinated on one day in July, compared with 480 Serbia residents.

It was very different from the start of the year.

“We all can recall the queues when the vaccine first came," said Darija Kisic Tepavcevic, from the Serbian Crisis Centre.

"Today, there are no crowds at any vaccination points. It takes us 10 days to get up by one per cent. The pace has slowed down very much compared to how many vaccines are available to us, but also relative to what extent research has so far shown the vaccines to be powerful and effective."

In the major cities of Belgrade, Nis and Novi Sad, a 50% vaccination threshold has been crossed, but there are places where the immunisation rate is worryingly low -- only 13.92% of the population has been vaccinated in the southern municipality of Tutin. The best situation is in Belgrade's central municipalities, where the percentage has reached nearly 75%.

While the slower vaccination rates are partly down to the holiday season, the main reason is a clear distrust of vaccines. People think "something is behind it" and it has polarised society. Rarely do entire families agree.

Anti-vaccine doctors

It is not just on social media where the pro- and anti-vaccine extremes are seen. Some doctors show their mistrust in them and frequently appear on television. They even say "coronavirus does not exist" and "COVID vaccines poison people for the profit of some interest groups.

At a protest against COVID restrictions in March, involving a few hundred people, allegations that vaccination was part of a "depopulation plan" by world powers. The rally was held in Belgrade's Republic Square and none of the attendees wore a mask or respected physical distance. The opponents of vaccination believe they cause sterility and even that this is how the population becomes microchipped.

Epidemiologist Dr Zoran Radovanovic of the United Against Covid Association blames the authorities for neglecting the education of citizens and for allowing misinformation about vaccinations to be spread via social media and often on television.

"The focus was on obtaining the vaccines and education was ignored," Radovanovic told Euronews. "In all the public health institutes, there are health education units and, in this case, they have not done their job. They were expected to figure out how to approach young people, to come up with a campaign on social media, where young people are the most active. That has not happened.”

The battle to get young people vaccinated

It's mainly the young age group where vaccination is at its lowest. In the 18-30 age group, 18.4% have been vaccinated, compared to around 70% in the over 65 age group.

"We have missed a chance," Mirsad Djerlek, Serbia's health ministry state secretary, told Euronews.

"With the holiday season, people seem to have forgotten about vaccination. Our task is to find new models to encourage the citizens during the summer."

Djerlek believes the solution lies in creative ideas: for instance by giving vaccinated people discounts or free concert tickets, travel vouchers, but also educating them about the coronavirus itself.

"Research has shown that about 60 per cent of young people are hesitating to get vaccinated. We should use the opportunity to explain to them that by getting vaccinated they will protect themselves, but also the others," Djerlek added.

One of the attempts to get young people to vaccinate was to organise two famous festivals - Arsenal in Kragujevac and EXIT in Novi Sad. Visitors -- mostly young and from Serbia -- had to present a vaccination certificate, a certificate of having already had COVID or a negative test.

Tens of thousands of people visited one of the two festivals, but neither the restrictive measures to enter the concerts, nor the fact that they had to allocate about €75 for a PCR test, and slightly less for an antigen test, motivated young people to get vaccinated.

Serbia -- beyond providing citizens with the choice of four vaccines -- have tried to offer other incentives to get jabbed.

In March, Serbians were offered €25 to get the jab. Another attempt saw shopping vouchers given away at a mall for the first 100 people vaccinated.

Serbia fearing an uncertain autumn

The main reason the vaccination stalemate is worrying experts is the spread of the Delta strain in Serbia, which is increasing the number of patients by 20% each week. This suggests that a new epidemic wave has already begun in this country, and experience from the previous period suggests it will be in full swing in about a month and a half.

Thus, prevention measures have already been taken at Kragujevac's University Clinical Centre, but also in healthcare institutions in Leskovac, Nis and Pirot, where a notice has been received from the Ministry of Health that all employees who have not been vaccinated against COVID-19 must be tested at their own expense before returning to work after an absence of more than seven days. The decision sparked a revolt among unvaccinated healthcare professionals, largely due to the cost of the €75 test, which is a major expense.

Apart from the fact that half the nation has not yet been vaccinated, Serbia also plans to introduce a third dose of the vaccine to better protect citizens from the disease in autumn. The National Body for Immunisation has reached an agreement in principle about administering an additional dose to vaccinated citizens whose immunity has been undermined by other diseases, primarily auto-immune ones, those undergoing immunosuppressive therapy, as well as patients with transplanted organs. An additional dose will be recommended for those over 80, who have a disease, but also to slightly younger citizens who have cardiovascular diseases and have not developed antibodies.

Serbia will certainly face the fourth wave better prepared, as two COVID hospitals in Belgrade and Krusevac have already been built, and a third one is being built in Novi Sad, which will be completed by the autumn. This will increase the capacity of COVID hospitals to 3,000 beds, which means that the situation from last fall, when the health system was about to collapse, will not repeat itself.

The Director of the new Covid hospital in Batajnica, Dr Tatjana Adzic Vukicevic, says that, like any healthcare worker, she is concerned about the immediate future and what may befall us if we are not vaccinated more widely.

"We have this unique privilege to have enough types and quantities of vaccines and we should use it," Dr Adzic Vukicevic told Euronews.

Epidemiologists say collective immunity requires the vaccination of 70% of adult citizens, ideally 80%. As it stands, this is a goal that will be difficult to achieve in Serbia.

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