During February, a smallpox epidemic was declared in the surrounding countries, which set off the alarm for the Montenegrin health authorities.
Bosnia and Herzegovina continues to record alarming data on the number of patients. The epidemic of the viral disease started in the Tuzla Canton at the beginning of the year, where 214 children fell ill, and it is still spreading and increasing the number of cases. So far, 159 cases of measles have been reported in Sarajevo Canton.
According to the latest reports, about 370 children with measles were reported in the Federation of Bosnia and Herzegovina.
The epidemic was also declared in some cities in Serbia at the beginning of February. According to the data of the competent health institutions in the region, most of the patients were not vaccinated with the MMR vaccine.
In recent years, epidemiologists in Montenegro have been warning about the decline in the percentage covered by that vaccine, especially when it comes to the first dose.
The first dose of the MMR vaccine, according to the mandatory immunization schedule, is given at the age of 12 to 15 months.
Health centers in Montenegrin municipalities organize emergency vaccinations on weekends.
The percentage of vaccinated people in Podgorica is lower than the national one
The Institute for Public Health of Montenegro (IJZCG) told "Vijesta" that currently coverage of the first dose of the vaccine in children born in 2018 is 79,3 percent.
"For those born in 2019, the coverage is 74,1, for those born in 2020, 66,3, for those born in 2021, it is 45,5, and for children born in 2022, it is 17,4 percent. 63,7 percent of children born in 2017 were vaccinated with the second dose, which is significantly below the coverage of 95 percent and represents an aggravating and worrisome circumstance," emphasized the IJZCG.
It is also worrying that the percentage of vaccinated people in Podgorica is lower compared to the national coverage. Thus, 78,9 percent of children born in 2018, 71,1 percent of children born in 2019, and 63,3 percent of children born in 2020 were vaccinated.
Vaccine coverage of children born in 2021 in Podgorica is 41,7 percent, and in 2022, only 12,3 percent.
"In the light of the unfavorable epidemiological situation due to the appearance of smallpox in Serbia, Albania, as well as Bosnia and Herzegovina and Romania, which have declared an epidemic, IJZCG drew attention to the serious risk of smallpox importation and a potential epidemic in our country", it was announced from IJZCG.
They also warned that smallpox is an extremely contagious disease that manifests itself in rash, cough, runny nose, eye irritation and high body temperature.
"What accompanies smallpox represents the greatest danger, namely complications, first of all severe pneumonia, then ear infections, but also the most serious complications that can occur in the form of inflammation of the brain - encephalitis. Complications mean that there is an average of one death per thousand sick children in developed countries, while in less developed countries the rate is many times higher, and three to five deaths will occur out of one hundred sick children. Children under the age of two, pregnant women and people with a weakened immune system are at the greatest risk of complications and death."
Half of the children in Bar and Ulcinj are not vaccinated
In the territory of Bar, out of a total of 3.190 registered children born between January 1, 2017 and August 31, 2022, who are of an age suitable for vaccination with the first dose of the MMR vaccine, a little more than half, i.e. 1629 of them, were vaccinated, which is lower than the national average, which is about 64 percent.
That's what he told "Vijesta". Igor Galić, epidemiologist at the Health Center Bar.
472 out of a total of 639 children born in 2017 were vaccinated. Out of a total of 598 children born in 2018, 390 received the MMR vaccine. When it comes to children born in 2019, 568 of them 334 were vaccinated. Of the 547 children born in 2020, 250 were vaccinated. Of the 488 children born in 2021, they were vaccinated 141 children. Out of a total of 350 children in 2022, 42 children received the MMR vaccine.
Thus, 1.561 children, i.e. 48,93 percent, were not vaccinated with the first dose of the MMR vaccine in preschool age.
"On the territory of the municipality of Bar, out of a total of 639 registered children born from 1/1/2017 to 31/12/2017, whose age reached the age for vaccination with the second dose of the MMR vaccine, 52,58% of children, i.e. 336 of them, were vaccinated, which is lower than the national average, which is 62,93%. Therefore, there are 303 children of this age who have not been vaccinated with the second dose of the MMR vaccine, or 47,42 percent," said Galić.
He pointed out that in addition to regularly calling parents of children for mandatory immunization within the deadline, they also organize vaccination with the MMR vaccine on weekends without an appointment.
He said that the trend of coverage with the first dose of the MMR vaccine increases with age, which essentially indicates a problem in the timeliness of receiving the vaccine, which is characteristic of the immunization programs of all developing countries, given that parents decide to vaccinate only when "the child speak up”.
"The reason for this is the fear caused by the uncritical established opinion that the MMR vaccine can cause problems in the child's development, in terms of speech disorders or the appearance of autism. Of course, numerous studies point to the absence of a connection between vaccination with the MMR vaccine and the mentioned two entities," concluded Galić.
Director of Ulcinj Health Center Sadije Holaj she told "Vijesti" that in the last five years, 55,33 percent of children (804 children) were vaccinated in that municipality.
"The percentage of immunization with the MMR vaccine is low, because of the total number of children who should be vaccinated, 649 of them were unvaccinated for no reason," she said.
She assessed that the decision of parents not to vaccinate in recent years is influenced by prejudices about the MMR vaccine - that it is harmful to children's health and that it causes autism.
"I believe that informative and educational lectures should be organized in preschool institutions with parents and educators regarding the importance of the MMR vaccine and mass immunization in order to prevent the smallpox epidemic that seriously threatens us...".
Stevović: Misinformation confuses parents
The current coverage of children with MMR vaccination in Tivat is not satisfactory, the director of Tivat DZ told "Vijesta" Danica Stevović.
"The number of timely vaccinated children under the age of two is 13,51 percent. The number of children vaccinated with both doses of the MMR vaccine up to the age of seven is 57,43 percent.
She pointed out that 83,94 percent of children up to the age of seven received the first dose of MMR, "which speaks of the small number of those who refuse vaccination".
According to Stevović, the critical age of children who have not been vaccinated is up to the age of two, even though they are the most vulnerable category then.
She pointed out that children from two to five years of age, children who have not been vaccinated, can have extremely serious complications, some even life-threatening.
When asked what activities Tivat DZ undertakes to explain the benefits of immunization to parents, Stevović said that every day, especially the pediatric teams, "try to educate and present scientific facts, understandable to laymen, through direct contact with parents".
"We are an affiliated partner of IJZCG in promotional campaigns related, among other things, to immunization. We also promote immunization through social platforms and local media. We are of the opinion, given that most parents delay, rather than refuse, the MMR vaccine, that the problem lies in poor communication and a large amount of misinformation".
Commenting on the increasing visibility of the anti-vaxxer lobby, Stevović said that "it is spreading thanks to the media, which should support science and scientific facts, as well as give space to immunization experts, not to persons with dubious educational qualities."
"Insufficient information, as well as a large amount of misinformation, confuses parents. The messages we send to them should be short, clear and striking. What confuses them the most and what is the way of action of the anti-vaxxers themselves is the so-called replacing theses, where it is not said that vaccines protect against deadly diseases, but only the unwanted reactions of vaccination are highlighted (the argumentation is based on incorrect assumptions). Media literacy education, as a term of importance in the new digital age, is key to recognizing and accepting information and distinguishing it from disinformation".
In Kolašin, the percentage of vaccinated is high, in Mojkovac it is falling
From the beginning of 2018 to the end of 2022, in the area of the Kolasin municipality, 80,87 percent of children received the MMR vaccine.
However, vaccination coverage among children born in 2022 is only 43,75 percent.
Director of the Kolasin DZ Milan Markovic says that the pediatric service has been making great efforts in recent years "to restore confidence in immunization to the level that once reached 99 percent of those vaccinated with MMR." He reminds that, despite the fact that there is a shortage of pediatricians in Montenegro, three doctors for children work in that institution.
"We believe that the decision of parents not to vaccinate their children, as is the case in all spheres of life, is mostly influenced by social networks, which spread misinformation and influence the formation of wrong opinions. We will try to maintain parents' trust in immunization and the health system, to find the most acceptable model for overcoming the obstacles that have influenced the decline of vaccination".
Vaccination coverage in the area of the Mojkovac municipality has dropped significantly over the past few years. While all children born in 2019 from that municipality were vaccinated, only slightly more than 40 percent of children born three years later received the MMR vaccine.
"Vaccination coverage for 2019 was 100 percent, for the younger year it was 86,79, while 76,19 percent of children born in 2021 received the MMR vaccine. When it comes to the year 2022, coverage of vaccination with the MMR vaccine is 40,43 percent," said the institution.
Budva: Parents postpone vaccination until school
Only 40 percent of preschool children in Budva received the first dose of the MMR vaccine, "Vijesti" was told in Budva DZ.
Out of a total of 1.711 children who have a chosen doctor born between 2018 and 2022, 772 received the first dose.
To the "furies" because it was said that the main problem is the fear of autism.
"We are doing everything to ensure that as many children of preschool age as possible receive the vaccine. The situation is completely different with children who started school, almost 95 percent of them received the vaccine. Namely, now we have a situation where parents postpone vaccination, so children only receive their first dose in the first grade, which was not the case before".
The institution is appealing for the media to be involved as much as possible so that preschool children receive the first dose of the vaccine.
Nikšić: Avoiding examinations to avoid immunization
In Nikšić, out of 4.173 children who should have been vaccinated with the MMR vaccine in the past five years, 2.374 of them were vaccinated.
This is what the head of pediatrics in Nikšić DZ told "Vijesta". Biljana Vučić.
"Vaccination coverage is 56,89 percent and that number is decreasing year by year. The lowest percentage of vaccinated children is under the age of two. Thus, the percentage of vaccinated children born in 2022 is only 7,34 percent, while the percentage of vaccinated children born in 2015 is 96,1 percent. What we constantly repeat and appeal to is that children should be vaccinated on time. However, parents often avoid scheduling an examination at the counseling center in order to delay their children receiving the vaccine around the age of three or four."
The number of vaccinated children in the municipalities of Plužine and Šavnik, for which the Nikšić DZ is responsible, is also low.
"In Plužine, out of 106 children, 60 (56,6%) were vaccinated, while the percentage is slightly higher in Šavnik - 61 (41%) of the 67,21 were vaccinated," said Vučić.
For collective immunity, coverage must be 95 percent
In order to acquire collective immunity against smallpox, it is necessary that the coverage of vaccinated children with the MMR vaccine be 95 percent or more, according to the DZ of Pljeval.
The percentage of vaccinated children in Pljevlja, aged 15 months to five years, is 78,6 percent.
"In general, the parents of children in Pljevlja do not refuse vaccination with the MMR vaccine, but postpone it for a later age, which creates space for smallpox, mumps and rubella epidemics to occur and for anyone who has not been vaccinated or has not overcome these diseases to fall ill from these diseases as well as those people who cannot be vaccinated either because of their age (infants under one year old) or because of the existence of contraindications... We see that the younger the children, the lower the vaccination coverage, so that the most unvaccinated children are born in 2022," states the Ministry of Health. .
The percentage of vaccinated children in Žabljak, aged 15 months to five years, is 75,6 percent.
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