By Ivana Rapajić Moran, the author is a PhD candidate at the Faculty of Pharmacy, University of Belgrade, and CEO of Altitude Healthcare
Once upon a time, Serbia, together with the other former Yugoslav republics, had one of the highest vaccination coverage rates. Vaccines are an achievement of civilisation. They have made it possible to eradicate diseases such as smallpox, control epidemics, and extend life expectancy.
In public discourse, vaccines too often behave like film stars: in times of crisis, we admire them and seek them out as saviours, whilst in quieter times, they become targets of sharp and unfounded criticism – until a new epidemic forces us to admire them once again.
Regrettably, scientific debate in Serbia and across the world has all too frequently been replaced by media spectacle and sensationalism. Anti-vaccine narratives spread by individuals and members of the academic community – such as Professor Valentina Arsić Arsenijević, Vice-Dean for Science at the Faculty of Medicine, University of Belgrade – as well as politicians like Donald Trump and Robert F. Kennedy Jr, are scientifically baseless.
A history of misinformation
The most famous example is the controversial Dr Andrew Wakefield, author of the retracted 1998 article in The Lancet, which triggered global panic over the MMR (measles, mumps, and rubella) vaccine. The paper was later deemed unethical and inaccurate, retracted from scientific records in 2010, and Wakefield lost his medical licence. It was established that the data was falsified, children had been subjected to unethical procedures, and the research was conducted in breach of regulations. Nevertheless, his story continued to attract public attention, particularly through his relationship with Australian supermodel Elle Macpherson, which further heightened the media visibility of anti-vaccine ideas.
In Serbia, a similar role in the public sphere is played by Dr Branimir Nestorović, whose statements about vaccines and the pandemic have frequently sparked controversy. His appearances, though popular, have contributed to misinformation, confusion, and mistrust among a segment of the public. When scientific debate turns into a media spectacle, the consequences are severe: we see a decline in vaccination coverage and the resurgence of diseases that were previously under control.
Contrast: Serbia and Hungary
Once upon a time, Serbia, together with the former Yugoslav republics, boasted one of the highest vaccination coverage rates. MMR vaccination coverage in Serbia dropped from over 95 per cent to around 81 per cent in 2016, and in Belgrade and Niš to just 60 per cent in 2017. How many times have we heard that children receive their first vaccinations only before starting school, while at an earlier age parents refuse to vaccinate their children for fear of autism – even though vaccination is a legal prerequisite for enrolling a child in nursery?
What Yugoslavia (and Serbia) once had, Hungary, for instance, still maintains today. Hungary has one of the highest MMR vaccine coverage rates in Europe, where the latest figures show that coverage among infants in their first year of life remains stably above 95 per cent – well above the herd immunity threshold. This is the result of long-standing mandatory immunisation and well-organised public healthcare.
In contrast to Hungary, Serbia experienced a drastic reduction in coverage. During the 2017–2018 measles epidemic – about which Dr Zoran Radovanović recently wrote – Serbia recorded more than 5,000 cases and 15 deaths, predominantly children. It is therefore crucial to reiterate that the MMR vaccine is safe and has no link whatsoever to autism. Claims regarding its harmfulness stem from a paper that was retracted long ago, and since then, more than 20 major epidemiological studies have shown no connection between the MMR vaccine and autism. The World Health Organization, the CDC, and the European Centre for Disease Prevention and Control all confirm the safety of the MMR vaccine. The scientific consensus is clear, and public health must not be held hostage to glamour, populism, or sensationalism.
Prevention is better than cure
Measles (morbilli) is far more than a “simple rash”. This illness can cause a series of serious complications, particularly in children under 5 years of age, adults over 20, pregnant women, and immunocompromised individuals. The most common complications are pneumonia, encephalitis, and death, while in the long term, it can lead to a rare, fatal brain disease known as SSPE (Subacute Sclerosing Panencephalitis). SSPE occurs when the measles virus remains in the brain and reactivates years later, causing progressive damage to the nervous system. In local lore, this is known from the stories of our ancestors who mentioned that some of their children simply began to “fade away” and eventually died. Thus, measles is one of the deadliest childhood diseases when vaccination is not carried out. According to a notice from the “Dr Milan Jovanović Batut” Institute of Public Health of Serbia, a case of measles was registered in Serbia this month.
Mumps is a viral disease most commonly recognised by painful swelling of the salivary glands, particularly the parotid glands, leading to the characteristic swelling of the cheeks and neck. It is transmitted via respiratory droplets through sneezing, coughing, talking, or close contact. In males, the disease can cause testicular inflammation (orchitis), and in females, inflammation of the ovaries (oophoritis), while more severe complications include meningitis, encephalitis, pancreatitis, and even permanent hearing loss. In pregnant women, mumps increases the risk of miscarriage, particularly in the first trimester. Although the illness often passes without severe consequences, the potential complications mean that MMR vaccination remains a vital protective measure, providing over 90 per cent effectiveness and preventing outbreaks in collective environments.
Rubella (German measles) appears to be a mild illness in children and adults, but in pregnant women, it can have catastrophic consequences for the foetus. Consider this example: if an unvaccinated pregnant woman enters a lift, and someone inside has symptoms of a cold – namely an acute rubella infection – and coughs, sneezes, or speaks in her presence, the pregnant woman will develop symptoms that manifest as a transient cold. However, the infection will severely impact the foetus, particularly during the first trimester of pregnancy. This is precisely why vaccination prior to pregnancy plays a crucial role, protecting both the mother and the unborn child from complications that cannot be cured, only prevented.
The most severe outcome is Congenital Rubella Syndrome (CRS), a group of birth defects in newborns that most commonly manifests as hearing loss, cataracts and other eye defects, cardiac malformations, intellectual disabilities, developmental delays, and damage to internal organs, to name but a few. Paradoxically, funds for the treatment of some of these potential consequences in children are frequently raised through SMS text campaigns and charitable appeals, whereas timely vaccination could prevent them entirely. Instead of shaking our heads helplessly at billboards, we should remember the age-old wisdom that “prevention is better than cure” – preventing through vaccination rather than treating through text message donations, prolonged hospital stays, increased expenses, and parental absence from work, all of which weaken the wider community.
Where is vaccine development heading?
While we continue “reading yesterday’s newspapers” arguing over matters that should not even be open to debate today, modern medicine and science are advancing at full throttle thanks to new technologies. At a time when trust in old, proven vaccines like MMR is declining, the medical world is entering a new era of “cancer vaccines”.
Basic education makes it clear to everyone that vaccines exist as preventive measures. Vaccines are like an insurance policy: we take them “just in case”, providing peace of mind.
New medical frontiers are shifting towards using vaccines as treatments, rather than solely as proven preventive measures.
These vaccine therapies, often described as “cancer or tumour vaccines”, do not work preventatively like traditional vaccines; instead, they are custom-made for each individual patient. Their goal is to train the immune system to recognise the genetic fingerprint of a tumour and destroy it. The most prominent example stems from a partnership between Merck and Moderna, whose preparation mRNA-4157 (also known as V940 or intismeran autogene) in combination with immunotherapy demonstrated success in Phase 3 clinical trials for melanoma.
The Russian cancer vaccine, also announced in the media as an innovation in mRNA technology, differs in its approach as it relies more heavily on universal antigens. Although there are currently no publicly available scientific publications directly describing the Russian mRNA “cancer vaccine”, announcements regarding it stem primarily from statements by the Russian Ministry of Health and the Gamaleya Institute, alongside media reports of cooperation with Serbia.
In Serbia, however, trust in vaccines remains insufficiently strong. The causes are multi-layered: ranging from the legacy of anti-vaccine campaigns and the spread of misinformation on social media, to a lack of clear communication from healthcare institutions, and a political context in which vaccines are frequently instrumentalised in the style of global populist movements. The consequence is that even vaccines proven over decades to have saved millions of lives, such as the MMR vaccine, face public distrust.
How to restore trust in Serbia?
Recommendations based on best practices in countries that have achieved high vaccination coverage highlight the need for a systemic approach that ensures effective health protection and safeguards the population from vaccine-preventable diseases in the long term. Such an approach not only preserves public health but also strengthens economic stability, grounded in the principle that “only a healthy nation drives a healthy economy”.
Key components of restoring trust include:
- Transparent communication based on scientific evidence
- Active involvement of primary care doctors, alongside pharmacists as the most accessible healthcare professionals, as trusted experts
- Public campaigns that connect vaccination with the values of solidarity and responsibility
- Digital tools for tracking and reminding patients
This model has proven most effective in countries that have managed to align health policy with broader social and economic goals.
Vaccines are an achievement of civilisation. They have made it possible to eradicate diseases such as smallpox, control epidemics, and extend life expectancy.
As the world turns its attention towards cancer vaccines, Serbia must solve a fundamental problem: how to restore trust in vaccines in general. Trust in vaccines serves as a benchmark for trust in institutions – in this case, healthcare. For without trust, even the most advanced technology will not have the opportunity to deliver on its promise.
(Danas, 09.09.2026)
https://www.danas.rs/dijalog/licni-stavovi/vakcine-obecanja-nepoverenje/
