Background: Recording real-time data of vaccinations performed, vaccine stocks, and adverse events following immunization is a particularly useful activity in the effective development of any vaccination campaign or vaccination program, guiding the decisions of public health authorities. The aim of this paper is to present the benefits of the National Electronic Registry of Vaccinations in providing useful information for the optimization of healthcare vaccination policies, specifically related to COVID-19 vaccination. Methods: We performed a descriptive study using data available in the reports generated from the National Electronic Registry of Vaccinations regarding COVID-19 vaccinations performed between 27 December 2020 and 31 December 2021. Results: A total of 27,980,270 doses of the COVID-19 vaccine were distributed. Of these, 15,757,638 (56%) were administered in 4545 vaccination centers: 7,882,458 as the 1st dose (50%), 5,878,698 as the 2nd dose (37%), and 1,996,482 as the 3rd dose (13%). More than 25% of the total doses were administered to people over 65 years of age. A total of 41% of the population received at least one dose of the COVID-19 vaccine. A total of 4083 adverse events following immunization were reported. Conclusions: The existence of a National Electronic Registry of Vaccinations containing accurate information on vaccinations performed in Romania offers the opportunity to obtain a clear picture of vaccination status that will significantly contribute to the optimization of vaccination strategies and programs.

A cluster of two confirmed cases of anthrax were reported in October 2011 from a small village with a population of 3,400 people, in south-eastern Romania. One was a fatal case of cutaneous and anthrax meningoencephalitis, while the other had cutaneous anthrax. Both cases had been exposed to one Bacillus anthracis-infected cow via consumption of its meat or being involved in its slaughter.

Botulism is a priority disease worldwide because it has a very severe course of evolution that can lead to death. This paper aims to describe the main epidemiological characteristics of botulism cases confirmed in Romania over 14 years (2007–2020). We performed a retrospective study using the publicly available national surveillance data and reported to the National Institute of Public Health. A total of 325 cases of foodborne botulism were reported in Romania, with no infant or wound botulism. Most of the cases (125, 38.5%) were reported among young adults (25–44 years old), over half (205, 63%) of them living in rural areas. The incriminated food item was identified in 161 cases; in most cases (145, 90%) the food item was prepared in the household. The main food category was represented by meat and meat-based products (94, 68.6%). In almost all cases the identified type was BoNT/B (230/231, 99.5%). Fifteen deaths were recorded, and the case fatality rate was 4.6%. Botulism cases were reported annually in Romania. Surveillance data are essential for implementing control measures and adapting educational campaigns according to existing needs.

Tetanus is a life-threatening, vaccine-preventable disease caused by tetanospasmin and tetanolysin, which are potent neurotoxins produced by Clostridium tetani, an anaerobic, spore-forming bacterium. Due to the widespread presence of spores in the environment, the disease cannot be eradicated. However, global tetanus prevention initiatives have contributed to a significant decline in tetanus incidence worldwide. Aiming to present the tetanus trends in Romania, we conducted a retrospective analysis of the tetanus surveillance data. During the study period (2010–2023), 97 cases of tetanus were reported in Romania (median: 6.5; IQR: 5–7) with an average incidence rate of 0.03 per 100,000 inhabitants (95% CI: 0.02–0.04; range: 0.01–0.09). The highest incidence rates were recorded among people aged 1 to 14 years old (0.09 per 100,000 inhabitants, 95% CI: 0.06–0.13; range: 0.00–0.20), male (0.05 per 100,000 inhabitants; 95% CI: 0.03–0.06; range: 0.03–0.12), and from rural areas (0.05 per 100,000 inhabitants; 95% CI: 0.03–0.08; range: 0.01–0.17). A decline in the number of tetanus cases of 7% by year was observed, which is supported by the statistical analysis showing a p-value of 0.005 (IRR: 0.93; 95% CI: 0.88–0.98). However, the same decline in tetanus incidence was not supported by the statistical analysis (IRR: 0.93; 95% CI: 0.44–1.98; p = 0.9). Forty-seven tetanus deaths were recorded, with an average case fatality ratio of 42% (95% CI: 25.62–57.92; range: 0–100), showing a decreasing trend of 9% by year (IRR: 0.91; 95% CI: 0.89–0.93). Although the annual number of tetanus cases in Romania has shown a slight downwards trend, its situation has remained relatively stable, as shown by the tetanus incidence. Moreover, the case fatality rate continues to be high. Therefore, our study emphasizes the importance of achieving high vaccination uptake among children and adolescents, raising awareness of the importance of booster doses in adults, and improving the management of tetanus-prone wounds.

Foodborne botulism, caused by ingestion of pre-formed botulinum neurotoxin, is the most common form of botulism. While large outbreaks linked to commercial foods are rare, smaller outbreaks associated with home-processed products are more frequent, reflecting local dietary habits and traditional preservation practices. The aim of this paper is to provide a public health overview of reported foodborne botulism outbreaks in Romania over an 18-year period to raise awareness among clinicians and public health officials. Between 2007 and 2024, a total of 337 foodborne botulism cases were reported in Romania, of which 43% (147) were related to 55 outbreaks (median number of cases per outbreak: 2; IQR: 2–3). Most outbreaks were reported in Bihor County (11 outbreaks with 29 cases) and its neighboring county, Satu Mare (seven outbreaks, accounting for a total number of 20 cases). Outbreak-related cases were observed in younger persons with a median age of 31 years (compared to 45 years for sporadic cases) and were statistically significantly associated with consumption of pork products (p < 0.001). Fifteen deaths occurred (case fatality ratio: 4%), including three outbreak-related cases (case fatality ratio: 2%). These findings highlight the ongoing public health challenge of foodborne botulism in Romania and the need for robust surveillance, targeted educational initiatives in high-incidence counties to deliver information about safe food preparation and preservation practices, and the continuous availability of botulinum antitoxin supplies.