As deaths rise, vaccine opponents find a foothold in Bosnia

September 30, 2021

SARAJEVO, Bosnia-Herzegovina (AP) — Hospitals across Bosnia are again filling with COVID-19 patients gasping for air, and the country's pandemic death toll is rising. Yet vaccination sites are mostly empty and unused coronavirus vaccines are fast approaching their expiration dates.

When the European Union launched its mass vaccination campaign, non-member Bosnia struggled along with most other Balkan nations to get supplies. By late spring, however, hundreds of thousands of doses started pouring into the country.

But after an initial rush of people clamoring to get jabbed, demand for shots quickly slowed. It is now down to a trickle even though Bosnia has Europe's highest coronavirus mortality rate at 4.5%, according to Johns Hopkins University data.

Dr. Edin Drljevic, an infectious disease specialist at one of Bosnia’s largest hospitals, in Sarajevo, thinks the disconnect is partly a result of authorities failing to properly promote vaccination against COVID-19.

“At first, we only had negative publicity because of the failure to secure vaccines, but once the vaccines finally started arriving, mainly through donations, people became picky,” he said. So far, just under 13% of Bosnia’s 3.3 million people have been fully vaccinated, among the lowest shares in Europe. Even people willing to get inoculated are putting off shots so they can choose the vaccine they want instead of receiving whichever one is available.

Bosnia currently administers the Pfizer-BioNTech, Sputnik V, Sinopharm and AstraZeneca vaccines. AstraZeneca's product, while the most widely available, appears to enjoy the least trust because of extensive news coverage when numerous European countries temporary suspended its use due to concerns about possible, rare side effects.

“The bottom line is, people are poorly informed and lack up-to-date knowledge,” Drljevic said. With so few takers, over 50,000 AstraZeneca vaccine doses have already expired; an additional 350,000 doses are set to expire in October

The pandemic has amplified the many problems of the Balkan nation, which is still struggling to recover from a devastating interethnic war in 1992-95. Nearly half of Bosnia's people live under or close to the poverty line.

The country has an extreme shortage of doctors and nurses, as well as rampant public corruption. Several elected and appointed government officials are under investigation or on trial for suspected malfeasance in the procurement of needed medical equipment and supplies during the pandemic.

The high-profile cases make Bosnians susceptible to claims that their leaders are acting in concert with corrupt pharmaceutical companies and are “happy to sacrifice them” for personal gain, according to Slavo Kukic, a sociology professor at Mostar University in southern Bosnia.

“People in Bosnia generally distrust the authorities. They (have been) lied to and manipulated for the past 30 years, and it makes it easier (for the anti-vaccine movement) to convince them that it is wise to not protect themselves from the virus, that it is a risk worth taking,” Kukic said.

While vaccine hesitancy in Bosnia might be among the most extreme globally, the country is not the only one in Europe facing that problem. The International Federation of Red Cross and Red Crescent Societies voiced concern Thursday at low immunization rates in parts of the continent, calling for urgent action to tackle vaccine hesitancy and misinformation.

In a press release, it warned that disinformation about vaccines’ side effects and potential risks, coupled with the introduction of vaccine passes was “sparking anger and violence” and has led to “concerning incidents against medical services, media and the general public” in the United Kingdom and numerous EU member including Italy, The Netherlands, Poland, Slovenia and France.

"Without addressing people’s concerns and fears, vaccines may not find their way into the arms of those most at risk, even where doses are available,” IFRC regional director for Europe Birgitte Bischoff Ebbesen said. “Increased community engagement is needed to tackle vaccine hesitancy, myths and disinformation.”

In Bosnia, health professionals and vaccine recipients note the absence of a coordinated, hard-hitting national campaign to counter vaccine hesitancy. There are no public service ads, billboards, incentives or mass mailings encouraging people to get vaccinated or advising them how to do it.

Meanwhile, activists with strong anti-vaccine opinions dominate the discussion on social networks and in the comment sections of news sites. An opposition lawmaker, Lana Prlic, announced on Facebook last week that she had received her second dose of AstraZeneca vaccine and urged followers to get their shots as soon as possible “to protect themselves and others." Her post attracted over 28,000 comments in 24 hours, most of them filled with insults and misinformation.

Jagoda Savic, Bosnia’s most vocal anti-vaccination activist for over a decade, asserts with pride that her profile has grown during the pandemic. “People stop me in the street to say hello, to congratulate me and ask me to keep up the good work,” she said. “I get so many messages (of support) on Facebook that I can no longer respond to all of them.”

Savic claims that coronavirus vaccines were not put through standard safety testing before being approved for use, and that they have caused severe adverse reactions in 1.2 million people in the European Union, the U.K. and the United States.

Similar claims have been made in other countries, and scientists and health authorities have repeatedly rejected them. Savic countered that information from reputable sources may cause doubts about the “dangers” of vaccines, but “in their heart and soul, people know the truth.”

Bosnia has reported close to 240,000 confirmed cases and more than 10,500 deaths in the pandemic. Savic asserts the figures are inflated, arguing incorrectly that that molecular PCR tests — the primary method for diagnosing COVID-19 — produce a huge number of false positives.

“Unfortunately, I have the impression that we are simply letting anti-vaccination lobbies and movements highjack the public debate and spread misinformation that discourages people from getting immunized,” Bakir Nakas, a retired infectious disease specialist, said.

While waiting to get her second coronavirus vaccine shot in Sarajevo last week, cancer patient Mirjana Golijanin said she thinks some fellow Bosnians are refusing because they perceive such behavior as a way of opposing the powerful and rich.

“I think it is simply an expression of the need to offer some sort of resistance, even if all they are resisting is a vaccine,” Golijanin said.