Achieving and maintaining high vaccination coverage in Europe: the challenge remains
Outbreaks of measles across Europe in recent years are a sign that immunisation programmes are not reaching all children. Pockets of unimmunised children among disadvantaged groups and vaccine sceptics are often implicated in larger outbreaks, and most measles outbreaks in Europe are imported from another European country.
National immunisation programmes vary across the EU and coverage rates are lower in some countries than others. These national differences make the monitoring of vaccine safety and the evaluation of a programme’s effectiveness and impact very difficult.
To improve things, we need to increase collaboration between national immunisation programmes and harmonise monitoring and reporting systems. We also have to strengthen surveillance for vaccine-preventable diseases. This is particularly important for the elimination of measles and rubella.
Immunisation programmes can become victim of their own success. Some vaccine-preventable diseases have become so rare that parents, and sometimes even health professionals, fail to realise the benefits of immunisation. It is important to remind people and policy makers of how devastating the consequences would be if measles, rubella or polio made a comeback.
Unscientific claims about vaccines that are spread by anti-vaccine activists should be met with scientific evidence and concise messages. Consequently, it is important to have clear procedures for vaccine safety monitoring. A good example was the monitoring of adverse events of the new influenza vaccines used during the 2009–10 pandemic, jointly carried out by the European Medicines Agency (EMA), ECDC, and several national institutions in charge of vaccines.
A majority of Europeans appreciate the benefits of vaccines and trust the information and recommendations from immunisation programmes. A challenge for national programmes is to maintain and strengthen this trust in an environment where the risks and consequences of not being immunised are shifting out of focus.
Communication and vaccine delivery strategies need to address all these challenges. Programmes need to tailor their approaches to reach both vaccination sceptics and socially disadvantaged groups. Scientific evidence on the benefits and safety of vaccines should be made easy available to enable both policy makers and the public to make informed and rational decisions.