The trend in national childhood immunization program coverage throughout Serbian communities in Kosovo and Metohija from 2003 to 2022: pre-COVID-19 period vs. COVID-19 pandemic.

Background: The childhood immunization coverage in Serbian communities in Kosovo after the 1999 armed conflict has not been investigated. The study purpose was to evaluate the trend of immunization coverage with vaccines from the national childhood immunization program in Serbian communities in Kosovo and Metohija from 2003 to 2022.
Methods: Data were retrieved from the annual reports of the Public Health Institute of Kosovska Mitrovica received through notifications from the primary health centers where vaccines are being administered. Data were analyzed using the linear regression and join-point regression models.
Results: In the examined period, a significant decrease in vaccination coverage was observed for the following diseases: diphtheria, tetanus and pertussis (DTP), polio, as well as measles, mumps and rubella vaccines (MMR), then, the first revaccination for DTP and polio, the second revaccination against diphtheria and tetanus for children (DT) and polio, and the third revaccination against diphtheria and tetanus for adults (dT), as well as the second dose of the MMR vaccine. During the COVID-19 pandemic, a significant decrease in coverage was observed for primary vaccination against: DTP, polio and hepatitis B, first and second doses of the MMR vaccine, as well as the first and second revaccination for DTP and polio, and the third revaccination for dT.
Conclusion: A decline in coverage with DTP, MMR, polio and hepatitis B vaccines was observed between 2003 and 2022. This was even more pronounced during the COVID-19 pandemic. Further research on individual-level factors contributing to lower vaccination coverage is warranted.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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