Since vaccination coverage in Serbia has been decreasing and health professionals have been identified as the most important factor in making decisions about immunization, vaccination knowledge and attitudes of students, especially medical students, are of particular interest. A cross-sectional survey was carried out on three groups of 509 Belgrade University students (medical, law and engineering students). The data were collected using an on-line questionnaire posted to student groups and included the Vaccine Knowledge Questionnaire and Attitudes Toward Vaccination Scale. This survey also included questions about demographic characteristics and perceived negative experiences. Multiple linear regression analysis was performed. There was a significant difference in the Vaccine Knowledge score (F=40.48, p<0.01) among the three groups of students. Medical students (N=251, Mean=4.47, SD=1.71) had significantly higher mean knowledge scores than did law (N=128, Mean=2.80, SD=1.56) or engineering students (N=130, Mean=3.98, SD=1.81). Compared with the law (Mean=49.77, SD=10.23) and engineering students (Mean=57.62, SD=12.21), medical students (Mean=59.52, SD=9.62) also had significantly higher attitude scores (F=37.56, p<0.01). These findings demonstrate general positive attitudes of Serbian students toward immunization. However, some knowledge gaps were identified. Multivariate analysis showed that those who had better vaccine knowledge, those who studies medicine, those who attended at university for more years, and those who do not know someone who had a negative experience with vaccines were more likely to have positive attitudes toward vaccination. Considering the growing vaccination hesitance in the general population, this is an important result that indicates that medical students are possible important participants in future public health campaigns. A strong association between vaccine knowledge and attitudes implies recommendations to introduce a specialized vaccination curriculum at both the undergraduate and graduate levels of medical study.

Financial reimbursements after receiving the coronavirus disease 2019 (COVID-19) vaccine have been criticized in the literature. This strategy has been described as payment to receive the vaccines, undue inducement, and unethical. We are aware that healthcare workers who work in primary healthcare, prevention, and public health may encounter similar reasons from people who refuse vaccination against COVID-19. For this reason, we are compelled to clarify these claims and provide arguments for all healthcare workers who might be challenged by such reasoning. In this critical review, we discuss why the claims against financial incentives that have been presented in the literature are erroneous.

Few countries provided multiple COVID-19 vaccines for their citizens right from the start of mass immunization. In Serbia, four vaccines were available. Circumstances in which people had several options to choose from are unique. The purpose of this study was to identify motivators behind COVID-19 vaccination and the choice of COVID-19 vaccine among people who were immunized against COVID-19. Qualitative interviews with 35 vaccinated people aged > 18 years were conducted in May 2021 at the Institute of Public Health of Serbia, a reference institution for vaccination. Interviews were audio-recorded, transcribed and data were analyzed using qualitative content analysis. Four topics emerged: 1) Decision to receive COVID-19 vaccine; 2) Sources of information about the vaccine; 3) Choice of the COVID-19 vaccine and 4) Anti-vaccination sentiment around the vaccinated people. Participants were classified in two groups: those who were determined to receive the vaccine and those who were hesitant. People who were hesitant decided to receive the vaccine after reviewing the information collected from various sources, especially physicians. Although some participants accepted any vaccine regardless of their characteristics, there were others who had explicit preferences. These preferences stemmed mainly from their beliefs about particular vaccine’s efficacy and safety, COVID-19 status (previous infection), living or lifestyle circumstances (residence or travel abroad), doctor’s recommendation (underlying health status) or trust in expertise of that particular manufacturer’s country of origin. Opting for appropriate vaccine was motivated by reasons specific to various individuals, which enabled them to make choices in line with their preferences and values.

Background: Introduction of vaccines against COVID-19 has not encountered expected acceptance. The uptake of COVID-19 vaccines in Western Balkans countries is lagging behind the European Union average. The aim of our study was to assess the intention to get vaccinated against COVID-19 in the population of unvaccinated adult citizens of five Western Balkans countries, and to explore factors that influence the vaccination intention. Methods: Cross-sectional study was conducted in the period from July to October 2021. The questionnaire was shared through online social media. Intention to get vaccinated against COVID-19 was measured by a single item assessing the likelihood of getting vaccinated on a 5-points Likert scale. Linear regressions were conducted with socio-demographic characteristics, presence of chronic diseases and attitudes towards COVID-19 vaccination as independent factors. Results: The largest proportion of unvaccinated respondents willing to get vaccinated in the future was observed in Montenegro and Albania (40.4% in each country), while in the Serbian sample, the willingness to get vaccinated was the lowest (22.6%). Socio-demographic characteristics were not significantly associated with the intention to get vaccinated against COVID-19 in most of the countries. In Albania, Bosnia and Herzegovina, North Macedonia and Serbia the strongest determinant of COVID-19 vaccination intention was the higher sense of social responsibility. Conclusions: Vaccination interventions and campaigns aiming to improve the COVID-19 vaccine uptake should be focussed on specific set of factors in each country, appealing to social responsibility as most prevalent determinant of vaccination intention in Western Balkans.