By Vladimir Kolev, Policy Assistant, EPHA
Undoubtedly, vaccination is one of the biggest achievements in modern medicine, protecting us against infectious diseases, saving many lives and reducing illness. At the same time, it is a way to fight one of the biggest public health threats, namely Antimicrobial Resistance (AMR). The effectiveness of vaccines relies on a high percentage of the population being vaccinated to protect those who are not: the so called “herd immunity”. In order to attain and keep vaccination rates high, it is important to recognise and address the barriers to accessing vaccination in specific countries and for socially excluded groups.
Immunisation is an exclusive method of healthcare intervention, focusing on prevention at population level. In the European Union (EU), vaccination services are coordinated largely at the national level where different immunisation policies and strategies are in place, but the European Commission assists the countries in coordinating their programmes. “Vaccination is also a form of solidarity, with the many protecting the few, the healthier protecting the more vulnerable. Vaccines have contributed to the eradication or significant decline in a number of infectious diseases in the EU. To guarantee the safety of all Europeans, I call on the EU Health Ministers to step up the European coordination efforts as soon as possible and adopt the Council Recommendation in December. Together we can make Europe the safest place to live in.” declared Commissioner for Health and Food Safety Vytenis Andriukaitis in a statement on 23 October 2018.
One of the recommendations’ goals, which was issued earlier this year, is to facilitate access to vaccines for “the most vulnerable groups including the socially excluded and minorities, so as to bridge inequalities and gaps in vaccination coverage.” In some countries specific actions are taken for these vulnerable groups, including Roma communities, refugees and asylum-seekers, as stated in a report prepared for the European Commission on the organisation and delivery of vaccination services in the EU. The variety of national vaccination policies and the obstacle this creates in a cross-border context presents a further reason for the establishment of the new Joint Action on Vaccination (JAV) that was launched in Paris in September.
The Council Recommendation also notes that “the Commission One Health Action Plan20 supports the EU Member States in their fight against AMR and calls for streamlined pathways for the authorisation of new antibacterial agents, and to boost the research and development of new vaccines for pathogens associated with antimicrobial resistance.” Immunisation can diminish the effects of AMR by preventing infections and avoiding the need of antimicrobial use for a long period. Notably, childhood vaccination can reduce the likelihood of having to use antibiotics to combat infections. Given lower vaccination rates in the Global South, it is equally important that asylum seekers and other categories of migrants in Europe are adequately received and provided with free vaccination services. The same applies to other marginalised groups, e.g. people living with vulnerabilities, on low incomes, with little education or experiencing other socioeconomic hurdles. The World Health Organization’s guide on improving vaccination services for vulnerable groups (Roma, migrants, pregnant women and people with religious reservations) is proof of the solid effort that is being made to reach disadvantaged groups.
Although it is clear that the need to boost collaboration between European countries, the necessity to reach the most excluded groups and to maximize coverage, as well as the critical role vaccines play in preventing multi-drug resistant infections is firmly on the agenda of European and national policymakers and lot is being done, there is still a lot of work ahead to ensure a healthier Europe in which everyone has equal access to vaccination.