By Preethi Murthy, Communications Officer, MOMENTUM Routine Immunization Transformation and Equity; and Stefan Mandic-Rajcevic, Serbia Country Lead, MOMENTUM Routine Immunization Transformation and Equity

In December 2020, as COVID-19 vaccines became available, Serbia struggled to achieve widespread vaccination. There was limited information about protective measures for health professionals, the public was asked to comply with strict curfews, and mixed messages were being delivered through non-medical sources. Trust in health professionals and scientists remained high, but skepticism toward politicians, government officials, and religious leaders prevailed within the general population. Priority groups, including people with chronic diseases and pregnant women, were among those who were reluctant to be vaccinated. Health professionals themselves were hesitant to accept or recommend vaccination because there was a lack of reliable information sources. Later in the pandemic, COVID-19 messaging fatigue deprioritized immunization, even among medical professionals. A strategy to increase vaccine demand was needed.

MOMENTUM Routine Immunization Transformation and Equity in Serbia worked with local partners to develop a strategy designed to build health professionals’ confidence in recommending COVID-19 vaccines and increasing awareness of the importance of vaccinations. The strategy situated COVID-19 vaccination within a broader set of healthy lifestyle behaviors, advocating for vaccination as essential to a long and healthy life. MOMENTUM developed an accredited continuing medical education (CME) course on basic immunology, COVID-19 vaccination as part of a healthy lifestyle, and quality patient care for health professionals. This course was adapted to local contexts and included a series of community engagement workshops for priority populations. The course and workshops were coordinated with in-country civil society partners in districts and municipalities with low vaccine coverage.

MOMENTUM also organized a COVID-19 scientific advisory group to review and convey reliable health information.  Members included prominent and well-respected faculty from the University of Belgrade Institute of Microbiology and Immunology, and Faculties of Medicine, Pharmacy, and Philosophy. The main role of the scientific advisory group was to provide accurate, up-to-date, and relevant COVID-19 information to health professionals and the public in Serbia through press conferences and media appearances. These fora provided journalists with accurate information and helped to dispel the circulation of rumors and misinformation. The advisory group also responded to questions and comments about immunization and health topics beyond MOMENTUM-supported media appearances and helped MOMENTUM develop and submit the CME training course for accreditation.

With the release of the bivalent COVID-19 vaccine at the end of 2022, MOMENTUM organized media appearances including a press conference for the advisory group to speak about the new vaccine’s benefits, efficacy, and safety, and answer audience questions.

At the press conference, Ana Banko, a virologist at the University of Belgrade and COVID-19 advisory group member said, “A clear and unambiguous attitude presented to the general public in a timely manner is a model for communication. The ability to ask questions of experts in various fields of medicine and public health…has a higher probability of instilling the trust necessary for following recommendations and guidelines and understanding the role of prevention in preserving one’s own and collective health.”

Journalists attended and appreciated these media appearances. A second press conference in January 2023 was cited by 13 news outlets and included the headline: “Parents Should Be Afraid of Diseases, Not Vaccines.” MOMENTUM organized additional conferences in August and October to convey to the Serbian public the importance of healthy lifestyle behaviors, the need for communication between doctors and patients, and of booster doses to protect from new COVID-19 variants.

As health journalist Jelena Spasić said, “It is important to organize press conferences so that through journalists, the public hear precise, accurate, and relevant information about immunization, its importance, and other aspects including adverse effects. In a crowd of charlatans, dilettantes, and hunters… who dominate social networks and, unfortunately, numerous media, the word of an expert in the field, with a diploma and knowledge, is invaluable. If even one viewer/reader adopts it, it is worth it!”

Through these behavior-led strategies and partnerships with journalists, MOMENTUM has aimed to enhance the public’s access to evidence-based, timely information. MOMENTUM’s comprehensive strategy is strengthened by the support of the advisory group, who are working collectively to address vaccine confidence in Serbia.  The scientific advisory group experts are looked to as experts in the immunization field and have been interviewed and quoted by multiple journalists and media outlets across the region. Moving forward, the scientific advisory group will continue to work within academic structures on risk communication, community engagement, and infodemic management to promote accurate and timely health information about immunization and other relevant topics. By leveraging expert voices and integrating vaccination into broader health discussions, MOMENTUM is building trust, increasing public understanding, and aiming to increase vaccine uptake in key priority populations in the country.