‘I am begging you, get the vaccine’: pockets of fear emerge in Serbia | Serbia

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Serbia’s most famous citizen, the tennis champion Novak Djokovic, has been vocally cautious about vaccines. A government adviser on the pandemic told media last March that Covid-19 “exists only on Facebook”. When cases of measles spiked three years ago, authorities blamed the influence of a powerful anti-vaccination lobby.

Serbia is an unlikely candidate for continental Europe’s most vaccinated nation so far. But since January the western Balkans nation has raced ahead of most of the world, delivering more than 31 jabs for every 100 people, according to statistics from Our World In Data, leaving countries such as Germany (13 doses per 100 people) and Canada (10.8 doses) in its wake.

Its success has illuminated the pockets of the country where suspicion of the vaccine is proving stubborn, forcing Serbian authorities to confront a question that might await others in the Balkans and eastern Europe, where polls show that hesitancy to get the jab is a significant force. Once supply of doses outstrips demand, how do you convince sceptical communities to be vaccinated?

Fewer than eight vaccinations per 100 people have been administered in Novi Pazar, the largest city in Sandžak, a rural region and centre for the country’s Bosniak minority, despite at least four different vaccines on offer.

Medical workers treat a Covid-19 patient in Novi Pazar, Serbia.
Medical workers treat a Covid-19 patient in Novi Pazar, Serbia. Photograph: Zorana Jevtic/Reuters

“I think it’s too early to say the vaccine is safe,” says Semin Martinovic, 20, on the streets of Tutin, a town in Sandžak. “Around the world there are lots of examples of side-effects, and there is also the question of which is the most effective. In my area, people are afraid.”

Misinformation is rife in a country the European parliament has called a launchpad for Russian disinformation campaigns, and so is mistrust in a health system that, under the cold war-era communist regime, made mass vaccinations mandatory. Jabs for childhood diseases are still a legal requirement but eschewed by many.

“There is a lot of half truths on social networks, or blunt lies about the vaccines,” says Ervin Corovic, a physician and head of a health centre in Novi Pazar. “We had to fight for years with people that did not wanted to vaccinate children. We got good results with that, but then the pandemic came and those anti-vaccine voices became loud again.”

Quick Guide

Covid vaccine side-effects: what are they, who gets them and why?

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What are the most common side-effects from the Covid vaccines?

According to Public Health England, most side-effects from the Covid vaccines – Pfizer/BioNTech and Oxford/AstraZeneca – are mild and short-lived. These include soreness where the jab was given, feeling tired or achy and headaches. Uncommon side-effects include having swollen lymph nodes.

Why do the common side-effects occur?

“The sore arm can be either due to the trauma of the needle in the muscle, or local inflammation in the muscle probably because of the chemicals in the injection,” said Prof Robert Read, head of clinical and experimental sciences within medicine at the University of Southampton and director of the NIHR Southampton Biomedical Research Centre.

“The other common side-effects – the muscle aches, flu-like illness and fatigue – are probably due to generalised activation of the immune system caused by the vaccine. What this means is that the white blood cells that are stimulated by the vaccine to make antibodies themselves have to secrete chemicals called cytokines, interferons and chemokines, which function to send messages from cell to cell to become activated.”

Are blood clots a side-effect of the vaccines?

There have been some cases of blood clots or low platelets among recipients of both Oxford and Pfizer vaccines, but Dr Phil Bryan, vaccines safety lead at the MHRA, said this was to be expected. “These are not uncommon events, we expect some of these to happen,” he said. “The rates of venous thromboembolism are not occurring at greater frequency after either vaccine than the rates in an unvaccinated population.”

However, the MHRA and other bodies are investigating reports of a rare type of blood clot on the brain called cerebral venous sinus thrombosis (CVST). On Thursday the MHRA said there had been five cases of CVST occurring with lowered platelets among men aged between 19 and 59 out of 11 million people who had received the Oxford jab. One of the men is known to have died.

Bryan said the Oxford and Pfizer vaccines were highly effective in preventing symptomatic Covid infections, hospitalisations and deaths. “Where we are now is that no causal association with what is still an extremely rare medical event has been proven for the Oxford University/AstraZeneca vaccine,” he said. “What we do know is that these are highly effective vaccines and we still have a huge burden of Covid disease in the population. So right now the balance of benefits and known risks of the vaccine are favourable.”

Nicola Davis Science correspondent

Residents know what Covid-19 can do. Novi Pazar and the surrounding region have been among the hardest hit in Serbia, where about 4,900 deaths have officially been recorded but the true figure is thought to be higher. An emergency situation was declared last July when hospitals exceeded their capacity. “[They] were overcrowded, there was a lack of equipment in them,” says Corovic.

Covid-19 rates in the country are climbing again, and regional officials are racing to avoid another crisis, blanketing local media with advertisements for the vaccine, sending mobile teams to villages in rural areas, and easing bureaucratic requirements to receive the jab.

Years of jostling for strategic influence in Serbia between China, Russia and western Europe has translated into a bonanza of vaccine deals from manufacturers. “We have more vaccines on offer than those who applied for them,” the prime minister, Ana Brnabić, told media last week.

A woman receives a dose of the Chinese Sinopharm Covid-19 vaccine in the village of Leskovik near the city of Nis, Serbia.
A woman receives a dose of the Chinese Sinopharm Covid-19 vaccine in the village of Leskovik near the city of Nis, Serbia. Photograph: Marko Đurica/Reuters

Its president, Aleksandar Vučić, a bulldozing leader whose dominance of institutions that led a watchdog to conclude Serbia is no longer a democracy, has characterised the abundance of vaccines as a personal triumph.

“I am begging you people, call to get the vaccine,” he said in an address this month. “We have them and we will have them even more, I am begging you like a God, take it.”

In a country polarised by pro-European Union elements and those who favour Russia, the buffet of vaccines on offer has helped to overcome some scepticism, says Milan Krstić, associate professor in political science Belgrade.

“Whether people prefer the eastern powers, like China or Russia, or western ones like the EU or US, it plays into their choice of vaccine,” he says.

Vučić has said he will choose to take the Sinopharm formulation “out of spite”, to thumb his nose at EU regulators who are yet to approve the Chinese vaccine for emergency use.

That vaccines have become so politicised, and synonymous with one political figure, is a source of concern for some public-health experts, who fear the early success of the country’s vaccination programme may be obscuring a low ceiling – short of the 70% thought to be required to achieve herd immunity.

“It was important for the regime to show that Serbia has more vaccines than other countries, but at the same time we have neglected the crucial part: educating people about the vaccine,” says Zoran Radovanović, an epidemiologist.

“Education about vaccine before mass vaccination is like artillery during war. You start breaking the enemy’s line with artillery. In this case, that would be education. But this has not been the case in Serbia.”

Hafta Ichi
Source: The Guardian
Keyword: ‘I am begging you, get the vaccine’: pockets of fear emerge in Serbia | Serbia

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