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Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022–1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01–1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09–0.88), current smoking (OR = 8.64; 95% CI = 2.43–30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50–8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64–1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination. [ABSTRACT FROM AUTHOR]

The Republic of Serbia applied the booster dose of the following COVID-19 vaccines: BNT162b2 mRNA (Pfizer-BioNTech), Sinopharm BBIBP-CorV (Vero Cell®), Gam-COVID-Vac (Sputnik V) and ChAdOk1 nCoV-19 (AstraZeneca). We aimed to examine the immunogenicity and reactogenicity of the booster dose and identify factors related to immune response and adverse events. Panel study, conducted during August and September 2021, included 300 persons receiving the booster dose at the Institute of Public Health of Serbia. Blood samples were taken on the day of receiving the booster dose, and after 7 and 28 days. When applying homologous regimen, the average increase in anti-spike immunoglobulin G was 8782.2 (after 7 days), 1213.9 after 28 days, while 9179.5 (after 7 days) and 16,728.1 after 28 days of heterologous regimen. Sinopharm BBIBP-CorV (p < 0.001) and Sputnik V (p < 0.001), age 65 and over (p = 0.001) and currently smoking (p < 0.001) were independently associated with lower levels of anti-spike immunoglobulin G. Female sex (OR = 1.77; 95%CI = 1.01–3.12), previous COVID-19 infection (OR = 3.62; 95%CI = 1.13–11.63) and adverse events after the second dose (OR = 2.66; 95%CI = 1.33–5.32) were independently associated with intense systemic adverse events 7 days after. Booster dose significantly increased antibodies titers, especially 28 days after heterologous regimen, without a significant increase in reactogenicity. [ABSTRACT FROM AUTHOR]

A National Immunization Technical Advisory Group (NITAG) is a multi-disciplinary body of national experts that provide evidence-based recommendations to policy-makers to assist them in making informed immunization policy and programme decisions. During the COVID-19 pandemic, NITAGs faced many challenges in making evidence-based recommendations for COVID-19 vaccines due to the rapidly evolving situation with new vaccine products available in a short time period and limited data on vaccine effectiveness. The authors reviewed the process used by Serbia's NITAG, which is called the Serbian Expert Committee on Immunization, to develop COVID-19 vaccine recommendations during the pandemic. The article examines the challenges and successes faced by the committee. Serbia's expert committee used the best available evidence to develop over forty recommendations on all aspects of COVID-19 vaccination. These expert committee recommendations facilitated the early procurement and successful roll-out of COVID-19 vaccines, guidance for vaccination of individuals at the highest risk, and high COVID-19 vaccination coverage in the country. The availability of five COVID-19 vaccines in Serbia was an advantage for the successful roll-out but posed challenges for the expert committee. Serbia's expert committee plans to use the experience and best practices developed during the pandemic to improve and expand its work moving forward., Competing Interests: Author MR was employed by WHO Country Office Serbia. Authors SS, LM, and LJ-C were employed by WHO Regional Office for Europe. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Markovic-Denic, Popadic, Jovanovic, Bonaci-Nikolic, Samardzic, Tomic Spiric, Rancic, Sankar Datta, Mosina, Jancic, Vukomanovic, Jovanovic, Vukomanovic, Antic, Veljkovic, Saponjic and Jacques-Carroll.)

BackgroundAnalyses of temporal trends in immunisation coverage may help to identify problems in immunisation activities at specific points in time. These data are essential for further planning, meeting recommended indicators, monitoring, management and advocacy.AimThis study examined the trends of mandatory vaccination coverage in the period 2000-2017 in Serbia.MethodsData on completed immunisations were retrieved from annual national reports of the Institute of Public Health of Serbia during the period 2000-2017. To assess the trends of immunisation coverage, both linear and joinpoint regression analyses were performed. A probability p < 0.05 was considered significant.ResultsOver the period 2000-2017 linear regression analysis showed a significant decline in coverage with the primary vaccination against poliomyelitis, diphtheria, tetanus, pertussis and measles, mumps, rubella (MMR) (p ≤ 0.01). In the same period, coverage of all subsequent revaccinations significantly decreased, namely, first revaccination for pertussis (p < 0.01); first, second and third revaccination against diphtheria, tetanus and poliomyelitis (p < 0.01); and second dose against MMR before enrolment in elementary school (p < 0.05). Although linear regression analysis did not show change in vaccination coverage trend against tuberculosis (Bacillus Calmette-Guérin; BCG), hepatitis B (HepB3) in infants and diseases caused by Haemophilus influenzae type b (Hib3), the joinpoint regression analysis showed that the coverage declined for BCG after 2006, HepB3 after 2010 and Hib3 after 2008.ConclusionTo achieve and keep optimum immunisation coverage, it is necessary to address barriers to immunisation, such as the availability of all vaccines and vaccine-hesitancy among parents and healthcare workers in Serbia.