Grasping the opportunity to discuss the benefits and (perceived) risks of vaccination at the European level also creates an opportunity to highlight the rigorous EU regulatory checks and balances which ensure that only safe and effective medicines are approved. As is so often the case in public health policy, today’s regulatory system is borne of earlier tragedies, to make sure that episodes like the Thalidomide scandal can never happen again. Given that the success of the regulatory framework can only be judged by the relative absence of such tragedies, the wider public might often take this vital safety net provided by the EU for granted.
Health workers are a welcome focus in the package, with an important recognition that investment is needed (by national governments) in increasing uptake of immunizations within the health sector, including continuous training to ensure health workers are well informed. This is essential to protect workers and the functioning of health systems as a whole, and therefore doubly important for patients and their families. The Communication recognises that health workers are a most trusted source of information for the general public, who can discuss concerns with patients and families and combat myths.
An issue that EPHA particularly highlighted is barriers to accessing vaccinations. In some EU countries, out-of-pocket payments and informal payments (even bribes) remain a real barrier to accessing any medical treatment, which keeps many people away from preventative programmes. We also pointed out the access barriers to healthcare in general which face marginalised groups, as revealed by EPHA’s recent survey of Roma communities, and the work of EPHA members including Medecins du Monde and Praksis with people without health coverage and refugees. We emphasised that low uptake in these groups can only be tackled by removing the barriers to accessing healthcare and that there are practical case studies of working with communities via health mediators, to assure them of their rights and allay specific concerns. The Commission has committed to “Identify the barriers to access and support interventions to increase access to vaccinations for disadvantaged and socially excluded groups” and the draft Council recommendation includes a focus on “community-based providers” to reach the most vulnerable.
The package also includes some very practical proposals, reflecting some suggestions from EPHA, for example exploring how EU funds can better support national and regional health service capacities, looking into the high cost of vaccines in some countries, enabling national governments to work together to build up emergency stocks, data sharing on coverage of different population groups to identify gaps, monitoring public confidence in vaccines, and exploring the potential of big data to monitor for any potential side-effects. Perhaps most noticeable to the public, there is a proposal to set up a electronic vaccination card, recognisable across the EU, as part of a broader push for electronic patient records. Meaning that vaccination records don’t get lost when travelling or moving between countries and health workers can easily check vaccination status.
Top-level EU interest and action on infectious diseases is a welcome signal. This raises expectations for overdue action on HIV, TB and Hepatitis, in line with the SDG target 3.3 to end preventable epidemics. Whilst recognising that the EU may not interfere with the way national governments run or fund their health services, this package shows the vital supporting role of the EU when it comes to common health threats. But there are other areas where the EU must also act to prevent even greater suffering and loss of life, notably chronic diseases and antimicrobial resistance (AMR), which are an even bigger cross-border challenge. Indeed the first point of the Parliament’s Resolution notes that vaccines could play a role in heading off the spread of AMR. The vaccination package must only be a first step: the case for action and urgency to tackle other causes of premature mortality are even stronger.