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Towards equity in immunisation.

Tammy Boyce1, Amelie Gudorf2, Catharina de Kat3

  • 1Independent consultant, Cardiff, United Kingdom.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|January 17, 2019
PubMed
Summary
This summary is machine-generated.

Childhood immunisation rates vary across Europe, with suboptimal coverage linked to social determinants of health, not just parental refusal. Addressing inequities is key to improving vaccination uptake.

Keywords:
Europeepidemiologyimmunisationinequityoutbreakspolicypublic health policyschool outbreakssocial determinants of healthvaccines

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Equity

Background:

  • Routine childhood immunisation uptake varies significantly within and among countries in the WHO European Region, with declining rates in some areas.
  • National programmes, policymakers, and media often attribute missed vaccinations to parental demand or refusal, overlooking multifactorial causes.
  • Social determinants of health, including income and education, significantly impact immunisation coverage and general health outcomes, even in high-income nations.

Purpose of the Study:

  • To highlight that inequity, driven by social determinants of health, may hinder progress towards European Vaccine Action Plan (EVAP) targets.
  • To advocate for making immunisation inequities visible through data disaggregation and linkage with social determinant data.
  • To identify and address structural causes of suboptimal childhood immunisation uptake.

Main Methods:

  • Analysis of immunisation coverage data within the WHO European Region.
  • Disaggregating immunisation coverage data to reveal inequities.
  • Linking immunisation data with existing data sources on social determinants of health.

Main Results:

  • Suboptimal childhood immunisation coverage is multifactorial, with social determinants of health playing a crucial role.
  • Inequities in immunisation uptake exist and are influenced by factors like income and education.
  • Making these inequities visible is a critical first step toward identifying and eliminating structural barriers.

Conclusions:

  • National immunisation programmes must acknowledge and address social determinants of health to achieve optimal coverage.
  • Equitable delivery of vaccination services is a priority for the WHO Regional Office for Europe.
  • Disaggregating and linking data is essential for understanding and tackling the root causes of immunisation inequity.