Lack Of Information On Vaccinations In Bosnia Affecting Local And Regional Vaccination Drive

Bosnia-Herzegovina already had political, social, and economic issues before the COVID-19 pandemic. Now, however, there are new issues with the national vaccination efforts, which include lacking an adequate vaccine supply, difficulty tracking who is vaccinated, and a fight against vaccine misinformation. These issues not only affect local progress but also regional efforts to end the pandemic.

Bosnia received vaccine doses from the international COVAX program and imported about 530,000 doses, according to the Civil Affairs Ministry. With a population of just under four million, this number is not enough to immediately vaccinate vulnerable groups. The latest data from the World Health Organization, as of this posting, shows that 315,780 vaccines have been administered. The data does not specify if these are first or second doses. Officials in Bosnia can confirm only “about 180,000 people getting a first dose and a mere 50,000 receiving their second injections,” according to RFE/RL.

One of the factors affecting the low vaccination rates is Bosnian residents traveling to Serbia to get vaccinated. When Serbia announced in March that it would give vaccines to foreigners, about 30,000 people “crossed the Bosnian-Serbian border in the span of about three days,” RFE/RL notes. One challenge is that Bosnian authorities have no way of tracking who got (or will get) the vaccine in neighboring Serbia and not everyone that gets vaccinated wants to report that data. This makes it a challenge to track down anyone already vaccinated, meaning that Bosnian officials should focus on those that intend to get the vaccine. Before that, Bosnian authorities must establish a streamlined system that will help gather the information.

Not everyone has or plans to use Serbia’s service. Some residents feel that they either “receive a vaccine from a former enemy or wait months to get one at home,” Axios reports. This has to do with lingering wartime fear. During the Yugoslav wars of the 1990s, Belgrade backed Bosnian Serbs in their ethnic cleansing campaigns against Bosniaks (Bosnian Muslims) in pursuit of a greater Serbian state. Some, such as Dzeneta Saric, say she was ten years old when her father was “killed in captivity by Serbian soldiers” but “had no choice now but to get vaccinated in Serbia.” Axios also reports that others, such as Imran Bezdrob, have preferred to wait in Bosnia to receive their shot despite the slower rollout.

Another factor making vaccinations complicated has to do with the country’s administration of healthcare systems. The country’s two autonomous entities, the Muslim and Croat federation and the predominantly Republika Srpska (and self-governing Brcko District) oversee the healthcare system, according to RFE/RL. For instance, in the federation, “most health-care duties have been delegated to the cantons, Brcko keeps largely to itself, [and] the Republika Srpska runs a highly centralized health-care system that sometimes relies on resources from neighboring Serbia.” There have also been instances of mismanagement and scandals, leaving many Bosnians unsure of how to approach getting the vaccine.

 It is crucial to have vaccination rate information as experts say that it helps see which groups are getting vaccinated and which are not. It leads to targeted strategies helping reach those that cannot easily access the vaccine and figure out ways to make it happen. It also helps see which groups are putting off getting the vaccine. This is a major issue in various parts of the world, but in southeastern Europe, it is more pronounced as it has one of the highest rates of vaccine hesitancy in the world, according to a report from the Balkans in Europe Policy Advisory Group (BiEPAG). 

The lack of information from central authorities also makes data from the government less reliable. If Bosnian officials are not sure about the numbers they have gathered, it is unlikely to instill confidence in the local populations. For that to change, Bosnian authorities must find ways to safely gather data and guarantee confidentiality. RFE/RL reports that “Republika Srpska’s health authorities… hope to launch cooperation soon with Serbia’s Public Health Institute that will include a request for data on the number of Bosnians who got vaccinated there.” There has not been a similar initiative in the Muslim Croat federation, which will be necessary if they also seek key vaccination data.

The next steps would involve cooperation with the populations in both entities along with transparency about data gathering, methods of ensuring confidentiality on personal details, and having a central location such as a website for Bosnians to view this data. Bosnia is already “expecting more than 500,000 vaccines from the U.S. in July as part of the Biden administration’s first wave of donations,” according to Axios. These vaccinations can serve as a way for Bosnian authorities to test any data gathering system in the works, as is the case for Republika Srpska. Its success will depend on the will and cooperation of all parties involved, including residents.

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