The waning of public confidence in vaccination worldwide is a cause for concern and a major challenge for public health experts. Vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of services. Factors include lower acceptance of the limited risks, lack of reliable information, differences in approach to evaluation and implementation of new vaccines, media controversies, and propaganda.
Currently, Europe is facing avoidable measles outbreaks in a number of countries owing to vaccine hesitancy. Worse still, Europe is exporting measles to other parts of the world. Some EU countries are also at high risk of a sustained polio outbreak, putting the current EU polio-free status at risk and undermining the global polio eradication initiative. Seasonal influenza vaccination coverage in the majority of EU countries are significantly below the agreed objective of 75 % for the elderly, despite preventing up to 37,000 deaths each year in the EU.
Action at EU level
Vaccination policy is a competence of national authorities however, the European Commission supports EU countries to coordinate their policies and programmes. To support EU countries in maintaining or increasing rates of vaccination, the EU Commission:
Enhanced EU cooperation
A workshop on Seeking new partnerships for EU action on vaccination hosted by DG SANTE in May 2017 explored how cooperation at EU level can increase vaccine coverage, address shortages, and strengthen routine immunisation programmes. 121 participants from EU countries, the European Commission, the European Medicines Agency, European Centre for Disease Prevention and Control, European Parliament, key international organisations (WHO, UNICEF), industry and healthcare participated.
Joint Action on vaccine hesitancy
The European Commission is reinforcing its support to national vaccination efforts to increase coverage, including through the preparation of a Joint Action on vaccination co-funded by the Health Programme (€3 million).
Launching in 2018, the Joint Action will address vaccine hesitancy. It is coordinated by INSERM (France) and 24 countries (among them 20 EU) are partners. It aims to improve vaccination coverage in the EU, by:
- Strengthening the interaction of Immunisation Information Systems (IIS) to increase surveillance capabilities and increase vaccine coverage
- Testing the feasibility of Europe-wide MMR vaccine coverage using data from IIS to identify immunity gaps
- Assessing European reminder and recall systems
- Enforcing supply and stock management, through harmonisation and mapping
- Elaborating procedures and methods to establish needs and vaccine procurement
- Analysing and evaluating financing mechanisms for sustainable purchase and stock
- Developing a plan to anticipate changes in vaccine recommendations and demand
- Developing a concept for a data warehouse for EU-wide vaccine sharing
- Establishing a collaborative platform to define priorities for research and development
- Mapping existing priority setting tools such as WHO R&D Blueprint, CEPI, UK Vaccine Network, EC/IMI, BARDA, Global Health Innovative Technology Fund
- Identifying mechanisms to improve funding and increase research cooperation across the whole value chain
- Developing a systematic overview and analysis of the current climate of vaccine hesitancy, activities and best practices
- Creating sustainable mechanisms for analysing research on barriers/enablers to high/low vaccine coverage, best practices and lessons learned
- Providing and analysing data from social media and web resources to inform real time monitoring of public vaccine confidence.
The Joint Action will work towards strengthening cooperation of national immunisation advisory groups (NITAGs) with a view to increasing transparency and trust in the decision-making process regarding the introduction of new vaccines.
Future EU incentives on vaccination could tackle vaccine hesitancy in the context of the growing impact of digitalisation and social media, using vaccines as the case study for combating fake news in the EU. Better aligned vaccine schedules could also help to increase trust and confidence in vaccination programmes and vaccines.