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\begin{document}

\title{The second round of a population-based seroprevalence study of
anti-SARS-CoV-2 antibodies and the assessment of COVID-19 vaccination in
the Republika Srpska, Bosnia and Herzegovina}



\author[1]{Jela Acimovic}%
\author[2]{Biljana Mijović}%
\author[2]{Srđan Mašić}%
\author[3]{Miroslav Petkovic}%
\author[2]{Dragana Puhalo Sladoje}%
\author[3]{Darija Knežević}%
\author[1]{Jelena Đaković Dević}%
\author[2]{Dragan Spaić}%
\author[2]{Jelena Vladićić Mašić}%
\author[2]{Dejan Bokonjić}%
\author[4]{Mirza Palo}%
\author[5]{Aisling VAUGHAN}%
\author[5]{Richard Pebody}%
\author[6]{Anthony Nardone}%
\author[3]{Ranko Škrbić}%
\affil[1]{Public Health Institute of the Republic of Srpska}%
\affil[2]{University of East Sarajevo Medical Faculty}%
\affil[3]{University of Banja Luka}%
\affil[4]{World Health Organization Office in Bosnia and Herzegovina}%
\affil[5]{World Health Organization Regional Office for Europe}%
\affil[6]{Epiconcept SAS}%


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  \date{May 21, 2024}


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\begin{abstract}
Introduction: The aim of the study was to assess the seroprevalence of
SARS-CoV-2 in the Republika Srpska, Bosnia and Herzegovina, after five
waves of COVID-19 and one year after introduction of vaccination to
better understand the true extent of the COVID-19 pandemic and role of
vaccination in achieving herd immunity. Methods: The population-based
study was conducted from December 2021 to February 2022 in a group of
4,463 individuals from the Republika Srpska. Total anti-SARS-CoV-2
antibodies were determined in serum specimens using the Wantai total
antibody ELISA assay and Kantaro Quantitative IgG assays. Results: The
overall cumulative seroprevalence was 94.6\%. Of all participants,
61.3\% were vaccinated against COVID-19. Significantly higher
seroprevalence rates were observed among vaccinated participants. Among
various professions, the highest seroprevalence was found in the service
industry (98.1\%), education (98.0\%) and healthcare (96.9\%). This
study found that 2.2\% of vaccinated participants, and 3.6\% of
individuals with SARS-CoV-2 positivity during 2021, had no detectable
IgG antibodies. Both seroprevalence and antibody titres were
significantly higher in people with hybrid immunity. Conclusion: Our
findings reveal a 2,3-fold increase in seroprevalence of SARS-CoV-2
antibodies due to infection and vaccination, comparing to the first
study performed one year earlier. This study provides better
understanding of the SARS-CoV-2 transmission and highlights the
important role of the vaccination in achieving the population immunity.
Periodically conducted population-based seroprevalence studies are
important for assessment of surveillance system performance and public
compliance with vaccination policies. Keywords: COVID-19, SARS-CoV-2
antibodies, seroprevalence, population-based study, Bosnia and
Herzegovina, UNITY, SEROPREV.%
\end{abstract}%



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