S2E4. A successful vaccination campaign. In 1972
The smallpox epidemic in Yugoslavia was eradicated in ten days. Almost 50 years later, the Balkan countries are showing serious difficulties in their COVID-19 immunization campaign
Hi,
welcome back to BarBalkans, the newsletter with blurred boundaries.
It has not been an easy summer, considering the humanitarian crisis in Afghanistan and the wildfires that devastated South-eastern Europe.
Although it has remained in the background, another emergency is still present. Namely, the COVID-19 pandemic, that we have been living for a year and a half.
A few months after the last analysis by BarBalkans, it is time to find out how the Western Balkan countries are dealing with the vaccination campaign.
Because this is the only way out of this emergency.
One case of epidemic in the recent European history - which had Yugoslavia as its epicenter - proved clearly how important vaccination campaigns are.
Fighting smallpox in 10 days
March 14, 1972.
An epidemic broke out in Yugoslavia.
«What the electron microscope revealed during the night left no doubt. The square-shaped cell structures, the same on the eight samples from the same region of Kosovo... it could not be a coincidence. It was smallpox».
This is Dr. Ana Gligić’s testimony, former laboratory director at the Torlak Institute in Belgrade, specialized in virology.
Smallpox is an infectious disease, whose transmission occurs through inhalation of an airborne virus. Its lethality rate is 30/35%.
Smallpox is the first disease to be eradicated in the history of humankind (in 1980). In the 20th century caused the death of more than 300 million people worldwide.
In the Balkan peninsula and in whole Europe, the last case dated back to 1930.
But in the spring of 1972, the Yugoslav authorities had to tackle an almost forgotten health crisis with very little time available.
Active outbreaks spread in Belgrade, Kosovo, Vojvodina, the Sanjak of Novi Pazar, northern Montenegro and even in Slovenia.
According to the official version, patient zero was the Kosovar Ibrahim Hoti. He set off on a pilgrimage to Makkah (the Hajj) and he stopped in Baghdad on his way home by bus. There he contracted the virus, from an infected merchant.
Smallpox recently reappeared in the Middle East. On the recommendation of the World Health Organisation (WHO), the Socialist Federal Republic of Yugoslavia only allowed air travel to the holy sites in Arabia.
On February 15, he came back to his village, Danjane, where he spread the virus among relatives and other random people.
Like Latif Mumdžić, a 29-year-old teacher from Tutin, a small town near Novi Pazar (Serbia). He met Hoti by chance on a bus in Kosovo.
Mumdžić got sick on March 3. He showed smallpox symptoms: backache, stomach ache, vomiting, sore throat and then red patches on his skin. He was transferred from the hospital in Novi Pazar to Belgrade.
He died on March 10, after having infected about 40 people. The cause of death was not immediately identified, because his family did not want him autopsied.
When his brother developed the same symptoms, the doctors realised it was smallpox. The Torlak Institute certified it.
The Yugoslav machine set in motion.
The response was drastic and based on vaccination and information campaigns.
A crisis unit was set up within three days.
Vaccination of the inhabitants in western Kosovo began immediately, while the village of Danjane was quarantined. On March 18, medical personnel in Belgrade was also immunized.
A week later, the embargo on information was lifted. It had been imposed in order not to undermine the tourist season in Dalmatia and to avoid the risk of social tensions arising from the risk of Kosovars being perceived as “plague spreader”.
The population received detailed explanation on how to behave.
About 16 thousand people were quarantined. In the meantime, employees in at-risk sectors - hotels and restaurants, transport, police - were immunized.
At this point, the systematic vaccination of the Yugoslav population began.
The information campaign created confidence in the system: people crowded to be vaccinated.
18 out of 22 million Yugoslavs were vaccinated. In just ten days, from 20 to 30 March.
The epidemic was under control in record time and saved thousands of lives: only 37 deaths were recorded.
The police and the army checked vaccination certificates of drivers entering and leaving the cities and guarded train stations.
A month later, on April 30, the Yugoslav authorities announced the end of the epidemic.
50 years later
Almost half a century has passed since April 30, 1972. But we are still talking about an epidemic - or rather, a pandemic.
No longer of smallpox, but of COVID-19.
This is an infectious disease, caused by the SARS-CoV-2 virus (that belongs to the Coronavirus family).
Since December 31, 2019 - when it was first identified in Wuhan (China) - 218 million cases and 4.5 million deaths have been recorded worldwide.
As regards the Western Balkans, the most severe impact was in early June 2020, with the outbreak of the second wave:
To date, the overall toll is 2.211.407 cases and 42.632 deaths, as it follows:
Albania: 147.369 cases and 2.501 deaths
Bosnia and Herzegovina: 214.759 cases and 9.815 deaths
Croatia: 374.803 cases and 8.338 deaths
Kosovo: 146.880 cases and 2.525 deaths
Montenegro: 115.956 cases and 1.732 deaths
North Macedonia: 177.399 cases and 5.964 deaths
Serbia: 766.279 cases and 7.307 deaths
Slovenia: 267.962 cases and 4.450 deaths
However, it is more significant to analyze how the Balkan countries responded in terms of vaccination campaign.
Compared to the beginning of April, in all the Western Balkans at least the vaccination campaign has started.
This is thanks to the relaunch of the European Union’s role and of the COVAX Facility (led by the World Health Organization and aimed at ensuring equitable access to COVID-19 vaccines for low- and middle-income countries).
Moreover, Serbia’s strategic charity action to the other countries of the region continued, thanks to the success of the first phase of the vaccination campaign and the wide availability of jabs:
Jabs of the AstraZeneca, Pfizer/BioNTech, Moderna and Sputnik V vaccines has began to arrive more regularly.
Health workers and the most fragile people were secured and then it was possible to start with the rest of the population.
It is now early September, five months later.
But the situation is not encouraging.
Let’s look at the share of people who received at least one dose of COVID-19 vaccine, in other words those who will be fully immunized in a few weeks.
The country with the highest percentage is Slovenia, with 47.9%.
It means less than one half of the Slovenian population, while the EU average is more than six out of ten Europeans (64.6%).
We must not forget that herd immunity - the percentage of immune individuals that prevents an infectious disease from spreading epidemically - shall be considered reached with at least 70% vaccination coverage.
The Western Balkans are far behind.
Also Serbia (43%) and Croatia (42.2%) are above the threshold of four people vaccinated out of ten citizens.
One third of the inhabitants of North Macedonia (35%) and Montenegro (33.7%) received at least one dose of vaccine.
Less than one third in Albania (28.9%) and in Kosovo (27.9%).
The situation in Bosnia and Herzegovina is almost tragic: only 17.4% of the population is vaccinated. The same level as in the UK in the first half of February.
The Balkan countries are clearly facing serious delays in the vaccination campaign. Equally for those who started well, for those who have difficulties in the supply chain, but also for those who can count on the coordination of the European Union.
After the first period of enthusiasm that lasted until the beginning of June, the share of vaccine doses administered in Serbia has substantially lowered (the increase in the last three months has been 5%).
The general skepticism to be vaccinated and the uncoordinated information campaign are slowing down the pace. Many doctors are among those who are against the vaccination campaign: this is another factor that weighs on public opinion.
In Bosnia and Herzegovina, the political-administrative division between the Federation and Republika Srpska is creating health disasters.
The mortality rate is the highest in the world, just behind Peru and Hungary.
Long before the COVID-19 crisis, WHO warned that «the Bosnian health system provides only hypothetical coverage» to many citizens.
The Presidency has no legal power to negotiate directly with manufacturers, while a parliamentary initiative to speed up amendments to the law on public procurement of vaccines failed in May.
With all this inefficiency and lack of political accountability, the country is totally dependent on international aid.
But the public authorities do not even know exactly how many citizens are vaccinated, as neighboring Serbia tries to extend its influence over the Bosnian Serb entity by offering jabs that are about to expire.
In Slovenia and Croatia - two EU Member States - a new wave of COVID infections has been monitored for weeks.
The worsening epidemiological situation is making the governments in Ljubljana and Zagreb worry. During the summer, they were unable to keep up with the other EU Member States when it came to mass vaccination campaign.
Although the two countries will count on the EU Digital Certificate to avoid new lockdowns and to guarantee journeys within Europe - like North Macedonia, whose national certification has been recognised by Brussels - the problems of the spread and the new mutation of the virus do not disappear.
This is precisely why the vaccination campaign is needed.
We should turn back the clock 50 years and take a page out of the management of the smallpox epidemic in Yugoslavia.
The scale of COVID-19 is certainly greater, as for a pandemic.
But we have already all the tools to fight it.
It is a matter of responsibility. Both personal and collective.
Pit stop. Sittin’ at the BarBalkans
We have reached the end of this piece of road.
Pfizerr, Monderna, Astra Zenecca and Sputnjik 6.
No, we are not drunk. These apparently misspelled COVID-19 vaccines are actually the names of new cocktails that our host put on our bar, the BarBalkans.
And it is all true.
They were created in a Croatian bar - the Roots Juice & Cocktail Bar - in the heart of Zagreb.
The owner, Tomislav Perko, came up with the idea while drinking Penicillin, a well-known cocktail made all over the world.
Why not update it?
He drew inspiration from the four most widely used COVID-19 vaccines - Pfizer/BioNTech, Moderna, AstraZeneca and Sputnik V - and thought about a characteristic ingredient.
In other words, the alcohol base of each cocktail comes from the country where the vaccine is produced.
American whisky and Jägermeister for the German-American Pfizerr. Bourbon for the American Monderna. Gin for the Anglo-Swedish Astra Zenecca. Vodka for the Russian Sputnjik 6.
«Cocktails are strong, we don’t recommend more than two doses per person», Perko suggests. «But apart from morning hangover, there are no major side effects».
Let’s continue the BarBalkans journey. We will meet again in a week, for the 5th stop.
A big hug and have a good journey!
BarBalkans is a free weekly newsletter. Behind these contents there is a lot of work undertaken.
If you want to help this project to improve, I kindly ask you to consider the possibility of donating. As a gift, every second Wednesday of the monthyou will receive a podcast with an article about the dissolution of Yugoslavia.
Every month you can listen to the preview of BarBalkans - Podcast on Spreaker and Spotify.
Pay attention! The first time you will receive the newsletter, it may go to spam, or to “Promotions Tab”, if you use Gmail. Just move it to “Inbox” and, on the top of the e-mail, flag the specific option to receive the next ones there.
As always, I thank you for getting this far with me. Here you can find all the previous newsletters.
BarBalkans is on Facebook, Twitter and Instagram. The updated archive is on Linktree.