In Serbia, COVID vaccine supply outweighs demand amid mistrust

With the third-highest rate of inoculations in Europe, Serbia is viewed as something of a Balkan success.

But the country has been struggling to find people to vaccinate.

Under Serbian President Aleksandar Vucic, Serbia has procured enough vaccines to inoculate its population of seven million, but supply is outpacing demand amid vaccine hesitancy.

Vucic announced in early March that Serbia had nearly 15 million vaccines, but by March 25, Serbian authorities told reporters that just 1.3 million people had been vaccinated.

Last weekend, thousands of foreigners from the region crossed borders to get free jabs in Serbia. In three days more than 22,000 foreigners were inoculated.

It was a pragmatic move.

As Prime Minister Ana Brnabic said later, between 20,000 and 25,000 of the AstraZeneca vaccines in the supplies were due to expire at the beginning of April.

But some criticised the development, including the United Against Covid group, an initiative formed by physicians in Serbia.

In a statement, the association wrote: “The priority should be to organise a campaign for the vaccination of its own population – which does not exist.”

The group also called for the government to tackle vaccine hesitancy, saying it should “systematically fight against the mindless anti-vaccination stances in government-controlled media”.

Thousands of vaccine-seekers from Serbia’s neighbouring states flocked to Belgrade after Serbian authorities offered free coronavirus jabs for foreigners if they show up over the weekend [Darko Vojinovic/AP]

Scepticism about the vaccines on offer in Serbia was so high that in early March, Vucic begged people to sign up for inoculations in a televised address.

“I beg you, get the vaccine. We have [vaccines] and we will have vaccines,” Vucic said, noting that uptake rates were as low as 9.5 percent in some areas.

Serbian epidemiologist Zoran Radovanovic told Al Jazeera that while Serbia’s procurement of vaccines has strengthened the leaders’ ratings, less attention has been paid to encouraging people to accept the shots.

“We have a populist government who thinks it’s more important not to lose votes [than to secure the health of its population],” Radovanovic said.

“That’s why contradictory messages are spread from pro-regime media since access is allowed for both vaxxers and anti-vaxxers.”

Conspiracy theories

According to some analysts, Serbians have the highest rate of distrust towards vaccines and the highest number of so-called anti-vax movements in the region.

In February, United Against Covid filed a criminal complaint against Serbian pulmonologist Branimir Nestorovic for violating the medical code of ethics.

As a member of Serbia’s coronavirus crisis staff group, he had spread falsehoods about the infection “continuously and persistently” to the public via the media, said the association.

He had called the coronavirus “silly” – meaning not dangerous, and claimed that people under 40 could not be infected.

In a May 2020 with a newspaper, he called on Serbians, except seniors, to step out into the streets to get infected, claiming the epidemic will end by June 15.

Empty chairs are seen at a temporary coronavirus vaccination centre at the sports hall of the Medical High School, in Novi Pazar, Serbia [Zorana Jevtic/Reuters]

According to a report in December by the Balkans in Europe Policy Advisory Group, a third of the European population believes COVID conspiracy theories.

In the Western Balkans, more than 75 percent of citizens believe in one or several of six false theories, which often spread on the internet in the form of fake news with dramatic warnings of vaccination dangers.

“They find a particularly fertile ground in our environment, where general mistrust and xenophobia are widespread,” Radovanovic said.

“It’s easy to manipulate a nation which has been deceived for three decades and no longer trusts anyone. Doubt is the natural state of things [here]. Unfortunately, distrust in the government has spread to all authorities including physicians, who earlier have traditionally enjoyed general respect.”

Molecular biologist of the Milan-based European Institute of Oncology Marija Mihailovic said campaigns should be launched to encourage uptake.

“Everyone should get a call, not just from one political party, but from all political parties,” Mihailovic said.

“The most sensitive generation is the one born before the technological boom … it’s unrealistic to expect that these people will sign up for the vaccines themselves,” she said, adding that the provision of at-home vaccinations may also boost rates.

Medical workers arrive to vaccinate locals with the Chinese Sinopharm COVID-19 vaccine in the village of Leskovik near the city of Nis, Serbia [Marko Djurica/Reuters]

Mihailovic added that some people simply do not understand the intricacies of vaccine approvals.

“The EMA (European Medicines Agency), which issues EU vaccine permits, comments on the safety and efficacy of the vaccine only when the manufacturer applies for the EU market,” Mihailovic said.

“Therefore, the current absence of EU permits for some vaccines has nothing to do with their effectiveness or safety, but simply reflects the fact that these vaccines have not applied for the EU market. These are political and economic issues rather than medical, and I think that’s something we have not talked about at all.”

Meanwhile, coronavirus cases continue to rise in Serbia.

The World Health Organization warned in late March that Serbia has the fifth-highest number of cases in Europe per 100,000 people.

Radovanovic said hospitals are full and health workers are exhausted, added that it was only now that the millionth citizen has received the two doses of the vaccine.

With just 15 percent of the total population fully vaccinated, this was “not enough to seriously affect the frequency of infection”.

Immunisation of 70 percent of the population is needed to achieve herd immunity, according to many experts.

Radovanovic said it was also important to note that along with hesitancy, mild lockdown measures – “among the weakest in Europe” – have also contributed to the growing caseload.

“Until [recently cafes and restaurants] was working at full speed and ski resorts were working undisturbed the whole time.”