EuroHealthNet has updated its factsheet on childhood, health inequalities, and vaccine preventable diseases. It covers the current state of vaccination and inequality, what action is being taken at international and national levels, and what else can be done.
Not all people in Europe benefit equally from the many advantages of vaccinations. Social and financial inequalities in society are reflected in immunisation uptake. Whether or not a child is vaccinated is influenced by wealth, parental education level, place of residence, and gender.
According to 2014 data, 1 in 10 children in the European region remain vulnerable to potentially life-threatening diseases having not received a basic set of vaccinations. However, there are signs that since then the situation is changing rapidly: measles cases in Europe tripled between 2017 and 2018, and we have seen a 288% increase in suspected measles cases in the first 3 months of 2019 compared to 2018.
Some groups of children are less likely to be vaccinated than others. Migrant and refugee children (roughly a quarter of the migrant population in Europe) are considered to be at greatest risk. Roma children, and children of families facing multiple vulnerabilities are also less likely to be immunised.
EuroHealthNet members across Europe are taking action.
They are working to improve communication with the public, particularly with communities which experience vulnerability. For example, in Sweden, information, training, and dialogues are being held in minority languages; in Greece, community campaigns are being designed specifically for different socioeconomic groups; and in Scotland, social media and a fact-based website are being used for clear information sharing, meanwhile they are conducting research with certain minority groups.
National and regional institutes are also participating in ongoing training and education for the health care workforce, integrating routine checks on vaccination status in health consultations, and are taking steps to overcome underlying socio-economic determinants of vaccination gaps relating to financial and statutory accessibility.
Internationally, the European Commission’s ongoing actions, which began in 2018 are welcome. The current Joint Action on Vaccination is also expected to provide strong results.
More can be done. EuroHealthNet has listed 10 areas for action
- Grant free of-charge access to specific health services,
- Integrate universal access to childhood immunisation into policies designed to benefit groups facing multiple vulnerabilities,
- Revise legislation and policies which restrict access to childhood vaccination for marginalised populations.
- Promote appropriate legislation and actions, and provision of a legal commitment to public funding for immunisation.
- Design childhood immunisation services with respect to principles of accessibility, adequacy, and cultural sensitivity. Integrate childhood immunisation services into a wider child-centred early years and transition-to-adolescence system.
- Strong health systems are needed to deliver and to improve immunisation coverage and equity. Public and health workforce resilience to vaccine safety fears can be improved through increased capacity-building within immunisation programmes.
- Ensure responsive, inclusive, participatory and representative decision-making to boost confidence in childhood immunisation among the public. Address vaccine hesitancy and other barriers in accessing vaccination.
- Invest in health promotion and disease prevention, and in improving health literacy, focusing on those children and families in greatest need. Address underlying inequalities when addressing vaccine hesitancy among various population groups.
- Invest in comparable data at local, regional, and national level that can be used to measure inequalities in childhood immunisation coverage.
- Align local, regional, national, and European level actions on sustainable vaccination policies with work on health inequalities and sustainability.