While many countries around the world began vaccinating their populations against COVID-19 earlier this year, in Kosovo we are still in very early days.

Kosovo received its first vaccine contingent of 24,000 doses of AstraZeneca — the most widely used vaccine in the world — on March 29 from the COVAX program (short for the COVID-19 vaccine access facility). It is worth noting that recently regulators have found a link between blood clotting and the AstraZeneca vaccine, however it is a very rare side effect. 

The program was established in April 2020 to provide low and middle income countries who are unable to make bilateral deals with the pharmaceutical manufacturers a batch of vaccines. In a nutshell, COVAX is a lifeline for countries who cannot easily get vaccines.

Kosovo welcomed the vaccines in a grand manner by holding a reception at the airport with the prime minister present. It should be noted that the doses received so far, barely cover the health professionals and only a fraction of the elderly aged 80 and above. These are the groups that have first priority to be vaccinated. An additional 100,620 vaccines are expected between April and June.

The problem with this narrative isn’t their arrival, it is their tardiness. The vaccines were originally supposed to come at the end of February. This is dangerous for all of us. Kosovo’s previous government showed a clear lack of leadership in obtaining the vaccine. 

It is a little over a year since the World Health Organization (WHO) declared COVID-19 to be a pandemic, and about five months since the Pfizer BioNTech vaccine was first developed. Meanwhile, Kosovo lagged behind in the efforts to get vaccines. 

This is in part a fault of our own since we are also the only country in Europe and beyond that saw a change in government in the midst of the first global lockdown. This fueled the chaos and uncertainty people experienced. It was the first hurdle Kosovo would face in the midst of the pandemic. The change in leadership instilled distrust in the authorities and as a result many people did not follow through with government recommendations on staying safe in a pandemic.

Some vaccines are here, the question is now what? 

The vaccination plan has been rolled out in three phases: The first 3% of the population or 54,000 health workers and elderly will be vaccinated along with the chronically ill; the second phase will cover 17% of the population or 306,000 people, prioritizing teachers and security personnel; and in the third, final phase, 50% of the population or 900,000 people including younger age groups will get the shot, according to the Ministry of Health’s National Health Plan for Vaccination. This protocol has been recommended by the WHO and Kosovo is following it to the letter.

The current location being used is “Salla 1 Tetori” where the majority of doctors and elderly will be vaccinated, and some of the medical staff will be vaccinated at the University Center hospital. After more doses are received, they will be distributed to family medical centers around Kosovo for other age groups to be immunized. 

While on the topic of the logistics of vaccination, an online service platform named “E-Kosova” has been launched where people sign up and wait their turn to be called for a COVID-19 vaccination. This received some backlash since the procedure, as simple as it may be, required some technical experience to upload a few documents. That proved to be a challenge for some of the elderly. It was then decided that this particular group will also be telephoned when their turn comes. 

There is plenty of room for improvement and of course criticism. However, from what I have observed visiting the facility where vaccination is currently happening, everything is running smoothly and flowing naturally. 

As of April 14, a total of 10,704 health workers and elderly received their first vaccine shot. What we are encountering on the ground though is yet another challenge. This comes as a direct result of the lack of investment in health care in Kosovo over the last decade: A huge reluctance to take the vaccine. According to a study conducted by the National Institute for Public Health (IKSHPK) — which is a part of the vaccination plan for Kosovo — as many as 70% of respondents are reluctant to take the vaccine.

I do have my reservations about the percentage presented in the study without reviewing the sample size and methodology used. However, there is a significant distrust that comes as a result of an overall lack of education about the importance of immunization. There is also a lack of effort from the institutions in tackling this problem before it becomes larger. This is not something we can blame on one particular government, but more of a poor collective effort from all leading governments over the last 20 years. 

The pandemic exposed the health care cracks

Before the pandemic was declared on March 11, 2020, health care was not even seen as a tertiary issue in Kosovo and this crisis exposed the vulnerabilities of the system. Almost 13 months since then, there is still a shortage of beds, staff and equipment. The country is now facing its second lockdown that is to last 12 days.

Many health professionals have also argued over the years that Kosovo is losing “its brain” by allowing doctors and nurses to migrate to other countries, a problem that we have not seen the end of yet. 

As lockdown proceeds one can argue about how we got here; what we can do to prevent another lockdown in the near future; and if this is the best course of action for the moment. 

The truth is there are no short and definitive answers to any question. We have witnessed an increase in mortality since the beginning of this year and a high case infection rate. We lack  vaccines to immunize a larger number of people, and the previous government eased many of the restrictions a month into 2021; so the current increase in restrictions seems to make sense. 

We saw that during the official 10-day-long national election campaigns in February — but even slightly before that — all of the political parties held large gatherings. These meetings were often held in facilities meant to cater for weddings, without a care in the world for public health.

The problem now is that most people are baffled as to why we must all bear the cost of that. I mention this because anger is perhaps how most feel. However, it is important to note that how we got here and what to do now are mutually exclusive questions. Solidarity is asked of us because people are dying and we can help prevent the deaths from increasing by following the recommendations we have known for over a year now: Wear a mask, wash your hands and socially/physically distance. 

It is important to add that the previous government — as blaming the current one that has taken office about three weeks ago is premature — did little or nothing to properly inform and educate citizens how to handle life during the pandemic, or what to do until we all get immunized. It is true there were some attempts at this broadcast nationally, however they lacked any real effort to follow through and reach all communities; the efforts were there, but lagging and were somewhat dry.

The many aspects of the vaccination diplomacy obstacles — some direct and some indirect — I believe, are of the utmost priority for prime minister Kurti’s leadership. His government needs to focus their immediate efforts on either buying vaccines or lobbying for donations from our allies. No other plan — let that be complete lockdown or no restrictions at all — will be without consequence. Whether that be in direct loss of human life, or indirect loss through economic decline. 

Only when Kosovo manages to immunize the majority of its population will we begin talking about stability — be that political or economic — and we can aspire for other things. Either way, mass immunization is the only out of the pandemic.

Feature image: Atdhe Mulla / K2.0.

Editor’s Note: The article was edited after publishing to clarify that many restrictions were eased in early 2021. The original version incorrectly stated that all restrictions were lifted by the government.