Weekly Briefing, Vol. 39, No. 3 (RS), April 2021
Anti-vaccine activism in Serbia
Abstract
Primarily thanks to its extraordinary ties with China and then Russia, Serbia was among those countries that had opportunity to secure necessary contingents of COVID-19 vaccines in order to keep lives of its citizens. But, in spite of that as well the fact that citizens already since January 10th 2021, got opportunity to make an on line appointment for immunization, three months later we hardly have reached 40% of vaccinated people. Knowing that foreigners are trying to get their way to Serbia in order to receive any of five available vaccines, it is very disappointing that Serbs are not aware of the importance of mass vaccination but instead are hardly influenced by the anti-vaccine lobby.
Vaccine paradox: plenty of vaccines and lack of will
While most of the world struggles to secure enough Covid-19 vaccines, Serbia faces a different battle — how to persuade its citizens to be immunized. Serbia even has a plenty of vaccines available that it has even offered them to any foreigner who can get into, sparking an influx of thousands of “vaccine tourists” from neighboring countries. This no so common situation resulted from of a diplomatic shuffle between East and West that saw Belgrade secure deals for nearly 15 million vaccine doses which is more than enough for its population of seven million.
With around three million doses of Pfizer, AstraZeneca, Sputnik V and Sinopharm delivered to country and two million of those that are about to be delivered, one of the most off stream European countries has quickly found itself among the continent’s fastest vaccinators.
However, so far reached results are not satisfactory. Less than a quarter of population eligible to receive the precious shot has applied for one. After the first wave, when were vaccinated all those who applied immediately after it became possible, the pace started to stall. As an illustration, in the last two weeks of March, the number of people receiving their first dose dropped to around 12,000 daily, roughly half the number over the same period in February.[1]
With high stock of vaccines, at the beginning of April Serbia took the highly unusual step of offering foreign citizens the chance to apply to have the shot. Even the migrants have also been offered the vaccine. For Serbian citizens there are everyday calls from the authorities that those who had still not been inoculated just has simply to show up without an appointment.
“I beg you, people, get a vaccine,” where the words that Serbian President Aleksandar Vucic said to the people. He repeated that Serbia has lots of vaccines and that will get more, but the people must decide to take them.
No matter if being a supporters or opponents of the Serbian ruling party and its president, there are significant number of medical workers, doctors in the first line, that are warning people how important is to be vaccinated.
Disastrous anti-vaxxer influence
According to Serbia’s leading epidemiologist Predrag Kon, lack of interest is “solely a consequence” of anti-vaccine misinformation being spread online by fear mongers.[2] “I’ve been doing this job for many decades and I have seen their power of persuasion,” Kon said, adding that “one or two percent” of the anti-vaxxers “can easily affect up to 50 percent of the undecided”.[3]
Anti-vaxxers are a symbol of today’s pervasive doubt. While acute suspicion is useful in terms of caution, because it tangibly defines the danger and cost-effectiveness criteria for their removal, chronic anti-vaxxer’s suspicion is parasitic. Its only tangible criterion of reality is the attitude of the majority in society and the conflict with it. Anti-vaxxers are therefore very prone to conspiracy theories.
Psychological studies link anti-vaxxers to conspiracy theories, stubbornness towards restriction of freedoms, disgust towards needles, but not to the level of education. The tendency to pessimism also plays a role, as the stubbornness and the Dunning-Kruger effect.[4] In Serbia, surprisingly, the attitude towards vaccination follows the attitude towards Vučić, whose supporters (53%) are more inclined to vaccination than the opposition (13%), but overall one third refuses, the other hesitates, and the third accepts.
Anti-vaxxers have different motives. Hesitants are not against vaccination in principle, and they prove that by getting vaccinated earlier, but they refuse “unverified” vaccines. What would be the check that would convince them, they do not specify. Generally speaking, anti-vaxxers are a “colorful” group of different levels of concern, but many concerned pretend to be rational (“while Serbian Torlak produced vaccines…”), so they smuggle among the hesitant.
The paradox of the anti-vaccination strategy is that resistance to regular vaccinations does not indicate the number of anti-vaxxers that erupt when a new virus imposes the urgent creation of a new vaccine: the faster the production, the faster and stronger the doubt about quality; the slower the production, the greater the epidemic. That is why the strategy must have long-term measures before the epidemic and emergency after its outbreak.
Serbia’s Health Minister Zlatibor Lončar has even suggested banning content that undermines the vaccination process from social media platforms, while the police have cracked down on vaccine sceptics, detaining five of them last week for “causing panic”. But, it is a fact that Serbia has long been a hotbed of misinformation, fuelled by low levels of trust in government and other institutions tainted by corruption and a lack of transparency and therefore there is need to create another prone of campaign that will deal with that issue.
Additional problem is posed by the wing of medical workers, i.e. doctors that also belong to anti-vaxxer group. Unfortunately, it is not the problem only connected with the Covid-19 vaccine. For instance, Serbia hardly avoided possible catastrophic situation when recently came up a very loud group of opponents of MMR that, mainly through social networks, frightened parents with (un)real consequences.
Unfortunately, situation is similar in other Western Balkan (WB) countries. It seems that main disease and a threat to human health in WB is a conspiracy! According to survey conducted in October 2020 by the Balkans in Europe Policy Advisory Group (BiEPAG), more than half of those questioned in the region not planning to get vaccinated.[5]
Serbian citizens don’t trust the way the state is communicating about the vaccines while suspicions are also fanned by a handful of doctors, some of whom have garnered hundreds of thousands of followers on social networks and are regularly given space in national media.
Low percent of immunized people and new virus variants
Virologists warn that slow immunization combined with a raging pandemic is the most dangerous combination for developing new variants, including ones that could become resistant to the vaccine.“ We have to be aware that the vaccination process needs to be faster than the virus”, virologist Ana Banko told public broadcaster RTS.[6]
Serbian president, Vučić, who recently has been vaccinated, in his manner, believes that once he finally gets vaccinated “half a million” citizens will follow his example in just a week. Still, doctors are less optimistic, they not believe that a scenario with a sudden, massive interest in vaccination is likely at all and that vaccinating of the desired 65-80 percent of the population will remain a distant goal.
An additional reason of awareness is constant mutation of the virus. After Alpha, Beta and Gamma variants, the newest detected variant is Delta that is highly contagious and mostly affects younger people. Therefore, it is necessary to work on informing people that vaccinated people are less prone to severe cases of disease no matter which variant of corona virus caused it.
Conclusion
Apart from pursuing everyday vaccination campaign, Serbian authorities must focus on preventing the influence of the anti-vaxxers. Long term measures are necessary in order to decrease the number of anti-vaxxers to insignificant level. It is up to the cultural policy to bring closer process of vaccination to majority of people, to remind them about the past and some extremely difficult diseases when vaccines saved the entire population likewise the smallpox epidemic in then Yugoslavia in 1972.
There is no need to discuss about legality or justice in implementation of such measures. There are many cases worldwide: the abolition of social assistance for those who do not vaccinate children (e.g. Israel, Australia) or the ban on entering schools (USA, EU) and other public institutions. Of course, the measures can be various, but all with the aim to suppress anti-vaxxerism as a threat to national security.
[1] According to the available data offered by Serbian Ministry of Health, on April 6th, 2021, 1.484.777 people has been vaccinated with at least on dose, while 1.112.489 has been vaccinated with two doses. https://www.zdravlje.gov.rs/vest/355355/informacija-o-aktuelnoj-epidemioloskoj-situaciji-u-vezi-sa-korona-virusom-u-republici-srbiji-za-06-april-2021-godine-.php, accessed on 05/05/2021.
[2]“Kon o antivakserima: Oni su uvereni da su u pravu, a nisu ni svesni da jako mnogo greše”, TV Prva, 22/03/2021, https://www.prva.rs/vesti/info/333548/kon-o-antivakserima-oni-su-uvereni-da-su-u-pravu-a-nisu-ni-svesni-da-jako-mnogo-grese, accessed on 05/05/2021.
[3] Ibidem.
[4] The Dunning–Kruger effect is a hypothetical cognitive bias stating that people with low ability at a task overestimate their ability. As described by social psychologists David Dunning and Justin Kruger, the bias results from an internal illusion in people of low ability and from an external misperception in people of high ability; that is, “the miscalibration of the incompetent stems from an error about the self, whereas the miscalibration of the highly competent stems from an error about others”. Kruger, Justin; Dunning, David (1999),“Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments”, Journal of Personality and Social Psychology, 77 (6): 1121–1134.
[5] “The Suspicious Virus: Conspiracies and COVID-19 in the Balkans”, Florian Bieber, Tena Prelec, Dejan Jović and Zoran Nechev, Balkans in Europe Policy Advisory Group, October 2020, https://biepag.eu/wp-content/uploads/2020/12/Conspiracies-and-COVID19-in-the-Balkan-English-2.pdf , accessed on 05/05/2021.
[6]Dr Banko: “Vakcinacija je JEDINI IZBOR za kraj pandemije, pet sojeva ZABRINJAVAJU”, 30/03/2021, https://www.blic.rs/vesti/drustvo/dr-banko-vakcinacija-je-jedini-izbor-za-kraj-pandemije-pet-sojeva-zabrinjavaju/8tkql9q, accessed on 05/05/2021.