Only 22,6 percent of children born in 2023 were vaccinated last year according to the mandatory vaccination schedule against measles, mumps, and rubella, although 95 percent is required for collective immunity.
Over half of children in their second year of life have been vaccinated against these infectious diseases in just three northern municipalities - Andrijevica, Gusinje and Plav.
Other municipalities, the Institute for Public Health (IJZ) claims, have achieved lower coverage. They warn that in some municipalities, low coverage is epidemiologically extremely dangerous, and the consequences could be far-reaching if health centers and the entire health system do not engage in solving the problem.
"The situation in Šavnik is particularly worrying, where coverage is zero percent, which requires a response from the competent health center in Nikšić, although the percentages (coverage) are drastically variable with the vaccination of just a few children due to the small number of children in this municipality," the Public Health Institute states.
Low vaccination rates were also recorded in Danilovgrad (6,7 percent), Nikšić (10,5 percent), Plužine (20,6 percent)... In the capital, XNUMX percent of children in their second year of life were vaccinated. Poor results were also recorded in Ulcinj, Zeta, Budva, Bar, Cetinje, Kotor, Tuzi...
Anti-vaxxers most vocal in the south and central region
According to the Public Health Institute, coverage of the BCG vaccine (against tuberculosis) among children increased slightly last year. The number of children vaccinated against hepatitis B also increased significantly, but these coverages, the Public Health Institute claims, are still significantly lower compared to the levels recorded during the previous decade.
"After a slight increase in MMR vaccine coverage was recorded in 2022, the downward trend from 2024 continued in 2023 and amounted to an alarming 22,6 percent. The loss of collective immunity among children, especially when it comes to measles, represents a serious public health risk with potentially devastating consequences in epidemic conditions," the IJZ said.
Epidemiologists argue that this situation requires an urgent, decisive and coordinated response from health authorities and all social actors, including international partners.
"The main reason for such low coverage is not so much the 'loud', but very present engagement of members of anti-vaccination groups who, despite falling ill and dying from measles during 2017 and 2018, especially in Serbia, continued to spread unverified and inaccurate information, disinformation and controversies regarding the safety of the MMR vaccine via social networks. The effect of anti-vaccination messages is most noticeable in the southern (coastal) and central regions, i.e. in the most touristically interesting parts of the country where the population lives with easier access to the internet and a large number of different anti-vaccination websites," the IJZ believes.
The low coverage, according to the IJZ, is also a consequence of parents' confusion due to the insufficiently strong and unanimous stance and response of the pediatric service to the increasing number of anti-vaccination messages, but also to the increasing number of requests from parents for education and information when it comes to the MMR vaccine, to which pediatricians, due to their workload and volume of work, and often inadequate training in communication skills, are unable to respond.
"It has also been observed that a certain number of pediatricians are uncritically inclined to establish temporary contraindications for child immunization, thus undermining the position of the profession and evidence-based medicine when it comes to the use of the MMR vaccine, which further increases parental confusion and postponement of vaccination. The Institute has repeatedly drawn the attention of health center administrations, as well as selected pediatricians, to such practices in previous years as part of continuing medical education, as well as during visits to health centers," the IJZ points out.
In accordance with the Program, revaccination with the MMR vaccine was also carried out for all children before starting or in the first grade of primary school (born in 2024) in 2018. Coverage with the second dose of the MMR vaccine among the 2018 generation was 68,4 percent, which is 0,19 percent less than the previous year.
Andrijevica is also the best when it comes to HPV vaccination
When it comes to the coverage of girls born in 2009 with the vaccine against the human papillomavirus (HPV), which causes cervical cancer, some municipalities have reached over 40 percent of those vaccinated. Thus, in Andrijevica, 44,8 percent of girls received the HPV vaccine, in Berane 42,3 percent, and in Cetinje and Gusinje 40 percent.
Ulcinj, Rožaje, Pljevlja, Šavnik and Mojkovac vaccinated less than 15 percent of girls, while there were no vaccinated girls in Plužine and Žabljak.
"When it comes to boys, their vaccination only began in February 2024, and only Podgorica, with 16,9 percent, has partially surpassed the coverage at the Montenegrin level, which is 6,7 percent," the Public Health Institute points out.
HPV vaccination in Montenegro began in September 2022 and until February 15, 2023, it was only possible for girls after the age of nine and before the age of ten.
Since February 2023, HPV vaccination has been expanded so that the primary target group includes all girls aged nine to 14, and in the same year it has also been made available to girls and young women in the age groups 15 to 18 and 19 to 26.
Since February last year, recommendations for HPV vaccination in Montenegro have been expanded to include girls and boys aged nine to 14 as the primary target group, girls and boys aged 15 to 18 as the secondary target group, and vaccination of girls and boys aged 19-26 is possible, with the same being primarily recommended for those who have not had sexual intercourse. For the first time, the immunization program has also recognized the possibility of vaccination of persons at particular risk, namely those aged 27 to 45.
"The achieved coverage among age cohorts at the state level is highest among girls born in 2013 at 33,1 percent, which is the age group with which the most work was done in terms of promotional and educational activities among parents, because vaccination began among nine-year-old girls in 2022," the Public Health Institute points out.
The official goal of the World Health Organization is to achieve 90 percent coverage among girls under the age of 15 by 2030, and the Public Health Institute plans to continue activities in the coming period aimed at raising the level of knowledge and awareness about the importance of preventing HPV infections and their consequences, with the expected support of the Ministry of Education, Science and Innovation.
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