Scope and Purpose
Imunization is one of the greatest success stories in public health, saving millions of lives every year. Vaccines are considered as one of the most powerful and cost-effective tools of infectious disease outbreaks prevention and control. Although the benefits of vaccines far outweigh the risks and vaccination has made an enormous contribution to human health, vaccination coverage has, according to the WHO, plateaued in recent years and has even dropped since 2020. The vaccine hesitancy is a wicked problem being ranked by the WHO among the 10 biggest threats to health. The size and scope of the issue was further highlighted during the COVID-19 pandemic. COVID-19 vaccine hesitancy has been substantially influenced by diverse factors, among which concerns about the perceived safety and effectiveness of the vaccine, exacerbated by the rapid spread of misinformation, may prevail in a number of Member States.
Building on the Council Recommendation on strengthened cooperation against vaccine-preventable diseases from 2018 and valuable lessons learned during last years of COVID-19 pandemic, the Czech Presidency of the Council of the EU intends to address this unfavourable trend. Stagnating vaccination rates and increasing reluctance to vaccinate could pose a major problem in the future, as in the context of global development, specifically climate change, the emergence of new diseases and new health crises can be expected. Even though immunization programmes are in the competence of Member States, given the cross-border nature of infectious diseases and the common challenges faced by national immunisation programmes, a more coordinated EU approach would be beneficial to prevent the spread of epidemics and vaccine-preventable diseases more effectively. This intention to strengthen EU cooperation to prepare for upcoming challenges and support joint efforts to tackle vaccination hesitancy and increasing public confidence in vaccination is reflected in the draft of Council conclusions on vaccination, which is to be submitted for adoption by Health Ministers at the EPSCO Council in December.
The Conference will provide a platform for Member States and relevant stakeholders from the European Commission and EU agencies, representatives from WHO, European healthcare professionals‘ and patients‘ organizations, vaccine producers and other relevant experts to discuss some practical aspects of the draft of Council conclusions on vaccination and several other key issues that require increased attention.
The Conference program focuses on the following thematic blocks:
- Building vaccine acceptance through communication
Vaccination is one of the few activities in the field of disease prevention that meets all the conditions set by contemporary „evidence-based“ medicine, and its questioning is one of the fashionable but totally undesirable phenomena of post-modern society, which emphasizes the freedom of individual decision-making without the necessary balance of duties and responsibilities, in the sense of the principle of solidarity with the society in which they live.
The power and negative impact of disinformation on vaccination uptake was felt most significantly during the COVID-19 pandemic. According to the WHO, the flood of false or inaccurate information about the virus, which is spreading rapidly through social media, can cause confusion, create mistrust and undermine an effective public health response.
Although the problem of disinformation and vaccine hesitancy has been significantly highlighted during the COVID-19 pandemic, we should not limit it only to COVID-19. Already in 2019, President of the European Commission Jean-Claude Juncker held a global vaccination summit in Brussels in response to the growing number of people, particularly in Europe, who are refusing to have their children vaccinated because of false information filling social media. Global leaders and health experts agreed at the summit that eliminating the spread of fake news and misinformation on vaccination is as important task as ensuring the availability of vaccines.
With this in mind, we should build on the outcomes of the summit and make use of experience we have gained in recent years to make the fight against mis and disinformation more effective in order to increase vaccination uptake.
- The role of primary care in communication
Prevention of infectious diseases through vaccination, particularly for children, has been in the hands of general practitioners for children and adolescents over a long period of time. In recent years, however, the first recommendations for adult vaccination have been established. This change of mindset was advanced, on the one hand, by the use of existing vaccines for adult vaccination (specification of vaccine dose rates, re-vaccination intervals, specification of duration of protection) and also by the development of new vaccines indicated for use in adults. At the same time, the changes in the epidemiology of certain diseases, such as the shift in pertussis from childhood to adulthood, advanced the discussions as well.
The experience with the COVID-19 pandemic can help us modernize current paradigms and approaches to vaccination. At a time when large numbers of people needed to be vaccinated in a relatively short time, Member States came up with a number of innovative solutions, whether in the form of setting up vaccination centres, making vaccination available in pharmacies or involving general practitioners (GPs) more intensively.
We should draw on this experience and make use of the momentum, especially in the case of the more intense involvement of GPs. A simple argument can be made that the GPs have traditionally been regarded by society as the first line of care. Also, various opinion surveys have shown that the GPs are seen as the ones who should provide patients with information about vaccines, and subsequently should be in charge of its administration.
- EU expert forum on tackling vaccine hesitancy
Vaccine hesitancy is complex and context specific varying across time, place and vaccines and it cannot be addressed by a one fit all solution. On the contrary, it is necessary to take a comprehensive approach and involve all relevant actors in order to come up with a successful solution. Member States, at the meeting of the Working Group on Public Health (High Level) on 26 July 2022, expressed support for the establishment of an Expert Group to address the topic of vaccine hesitancy. It was stressed that the problem of vaccine reluctance must be addressed comprehensively, involving experts from several sectors, e.g. education experts, communication experts, behavioural experts, etc.
The Presidency has reflected this request in the draft of Council conclusions on vaccination to be adopted by Health Ministers at the EPSCO Council in December. The aim of the Conference is to discuss the practical form of this group to best fulfil its purpose.
- Future of vaccination: accessibility and development of innovative vaccines
The latest scientific evidence shows that climate change and human health are closely linked. The threat of infectious diseases is increasing as data show that environmental changes are worsening respiratory health problems, increasing the spread of diseases which are now absent in certain parts of the EU and promoting antimicrobial resistance. The health impacts of environmental change also disproportionately affect underserved populations. Research and development of new vaccines, known as preclinical and clinical trials, is a complex, long- term process during which the safety, efficacy and quality of a new product are examined. Before a vaccine reaches the market and patients, it goes through three phases of testing. Its properties and capabilities are tested at dozens of research centres across the world and in collaboration with many physicians and volunteers.
If we do not want to face spread of further epidemics in the future, we should take advantage of the situation and focus on research and development of new vaccines for diseases that can be expected to spread in the EU in the context of climate change.
- Vaccination in digital age
Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. Although the Regulation on European Health Data Space is currently under negotiation and is expected to deepen the digitalisation of health systems in the EU, we should already be discussing ways to use the benefits and achievements of digitalisation in order to improve vaccination coverage in the EU. The COVID-19 pandemic made it clear that Member States benefit from joint collaboration. Particularly the establishment of the EU Digital COVID Certificate was an important milestone. Ministers of Health have expressed their support for establishment of an EU Vaccination passport during the Informal meeting of Health Ministers in Prague organized by the Czech Presidency in September this year. Ministers also stressed that this instrument should not be used to restrict cross-border movement, but rather to promote its facilitation.
It is obvious that the COVID-19 pandemic has accelerated the developments and the time has come to discuss the opportunities that digitalisation offer us to improve vaccination rates in the EU.