Ensuring equitable access to COVID-19 vaccines

EPHA publishes new recommendations to ensure vaccine equity across the EU

In the light of a more comprehensive and global vision of health, the current pandemic has proven to intensify many pre-existing social and health disparities worldwide as well as within the European Union, directly impacting the lives of many underserved communities, such as people experiencing homelessness or living in precarious conditions, those without residence or with irregular migration status (such as refugees, asylum seekers, and undocumented migrants), persons with disabilities (whether physical, sensory, intellectual or psychosocial disabilities) and their support network, including personal assistants, interpreters and family carers, prisoners, Roma, ethnic minorities, and sex workers. 

Existing barriers to healthcare has also hindered these groups’ access to COVID-19 vaccines: the lack of tailored information campaigns, geographical and infrastructural impediments, as well as administrative difficulties, coupled with low political commitment to mitigate the effects of the pandemic continues to raise concerns many vulnerable communities continue to be excluded from national vaccination deployment strategies.

EPHA’s recommendations, which follow our recent calls for action to ensure vaccine equity, to the European Commission and the European Centre for Disease Prevention and Control (ECDC), set out how EU Member States and European policymakers stakeholders can ensure more equitable distribution and uptake of the COVID-19 vaccines in vulnerable communities in six different areas:

  • Data Collection: Better assessment of needs and collection of data concerning the demographics of vulnerable and marginalized communities, as well as quantitative data measuring healthcare access, health status and qualitative data measuring the quality of services vulnerable groups receive and their experience within the social and healthcare systems, vaccination programmes and essential services 
  • Information delivery: Targeted information campaigns in accessible languages and formats which address both vaccine safety and vaccine access
  • Vaccine deployment and accessibility: Tackling geographical obstacles such as “hospital deserts,” by using “non-traditional” locations and mobile vaccination teams to carry out vaccinations (for example: shelters, whilst guaranteeing the optimal conditions for vaccine safety
  • Administrative facilitation: Cutting red tape to ensure vaccination registration systems should be as simple as possible with limited or flexible documentation requirements and encouraging communities to seek vaccination by providing expert healthcare workers or health mediators to support vulnerable patients during the vaccination process
  • Post-vaccination medical follow up: Providing reminders for people deemed difficult to reach for a second dose, and prioritising single-dose vaccines for more mobile communities or those experiencing homelessness
  • Partnering with civil society and community organisations: Collaborating with civil society stakeholders on data sharing and collection, involvement in policy development, direct outreach to vulnerable groups (through the design of easily accessible awareness-raising campaigns), as well as provision of supportive essential services and assistance   

In addition the recommendations call on the European Commission to issue guidance which highlights the the risks faced by disadvantaged population groups confronting distinct as well as overlapping barriers to accessing mainstream health systems, as well as using COVID-19 recovery funds to fund vaccination campaigns targeted to those who are being left behind. The European Centre for Disease Prevention and Control (ECDC)  can also play a crucial role in the collection of data on vaccine deployment amongst hard-to-reach populations and facilitate exchange of best practices.  In the longer term, the ECDC could also help tackle health inequalities across Europe by improving the quality of data monitor access for key populations, by using relevant equity-related indicators.

Without more concerted action, the exclusion of vulnerable communities from national vaccine rollout strategies will jeopardize their chances for survival and good health, putting them at particular risk of morbidity and mortality, as well as disproportionately shaping their economic activity and stability, affecting generations to come. It is not only a question of putting into practice European values of fairness and solidarity as failure to take action, will also having repercussions on the wider community’s ability to recover from COVID-19. Public health, after all, means protection of the population as a whole and health for everyone.

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