Read the interview to Catharina de Kat

Background

The implementation of a multitude of immunization programmes in Europe over the last 30 years reduced illness and death due to vaccine-preventable diseases. Cases of measles were reduced by more than 90% between 1993 and 2007; and since 2002, Europe is polio-free (Source: http://www.euro.who.int/en/media-centre/events/events/2016/04/european-immunization-week-2016/background).

The fact that some vaccine preventable diseases have disappeared or are very rare following these vaccination programs can lead to parents believing there is no more need to vaccinate. Therefore, it is of huge importance that events like the European Immunization, helping maintain vaccination awareness and giving accurate and understandable information on immunization, exist. In this way, public confidence in immunization is less susceptible to be influenced by groups, websites or campaigns against vaccination. By acknowledging that every child deserves a healthy start in life, countries can use the European Immunization Week to increase awareness of the importance of immunization and to strengthen their immunization systems.

Project description

The European Immunization Week (EIW) was initiated in 2005 by the WHO Regional Office for Europe, in collaboration with key stakeholders in Europe, including the United Nations Children's Fund (UNICEF) and the European Centre for Disease Prevention and Control (ECDC). The program is also supported, at national level, by ministers and ambassadors, and at regional level, by Her Royal Highness Crown Princess Mary of Denmark, the WHO Europe’s Patron and WHO Regional Director Zsuzsanna Jakab. Participation and engagement of these public figures to regional events of the EIW help increase awareness of the importance of immunization to the attention of decision-makers, parents, etc. and consequently, increase immunization coverage.

Several immunization partners support the initiative by providing countries with assistance for implementation activities at the national and sub-national level, including associations of health professionals, non-governmental organizations (NGOs) and civil society organizations.

The main objectives of this programme are to increase awareness of the importance of immunization and to increase vaccination coverage, with a particular focus on vulnerable or underserved populations (e.g. Roma and migrant communities, prisoners, refugees, young people etc.).

From its beginning in 2005 with eight pilot countries, EIW expanded each year to become a region-wide initiative including all 53 member states[1] of the Europe WHO region in 2015. Each participating country implements activities to inform and engage key target audiences and also to address the challenges regarding immunization, with a special focus places on activities reaching vulnerable populations.

Examples of such activities are:

• For the general public, vulnerable groups, parents and caregivers:
  
  • Organization of events such as theatre performances, concerts, sports events or press conferences highlighting key messages; 
  • Dissemination of printed, video or other online information materials on the benefits of immunization; 
  • Organization of  specific outreach activities or catch-up immunization campaigns for vulnerable or underserved groups;
  • Organization of information campaigns on eventual changes to immunization programs e.g. shift to electronic vaccination registration;
  • Use of social media channels to disseminate key messages, generate discussions and answer vaccine-related queries or concerns.

• For health care professionals:
  • Organisation of training sessions for relevant health care staff, locally or nationally;
  • Dissemination of information material to health care workers, as well as guidance tools to educate parents about immunization.

• For policy and decision makers:
  • Organisation of workshops with political decision-makers discussing the challenges of immunization as well as providing information on the benefits of immunization;
  • Development of information materials containing relevant data and cost estimates to sensitize decision-makers to immunization-related challenges and issues.

• For the media:
  • Organization of press conferences to sensitize media to immunisation- related key issues and to generate positive media attention on the importance of vaccination; 
  • Organization of workshops informing journalists about immunization, in order to get a balanced media coverage.

The European Immunization Week takes place each year in April. Several countries across the WHO Europe Region participate actively in this event, using the opportunity to promote immunization, either through communication campaigns or by vaccination of groups at high-risk.

2009

For instance, in 2009, 37 countries participated to the EIW, out of which 30 involved the Health Ministries in the projects planning phase; half involved mass media to raise awareness of immunization and EIW activities. Other countries involved medical associations, other ministries, some NGOs, the UNICEF and other United Nations agencies, and the ECDC. Main important themes of this EIW event were: vaccination in vulnerable populations, awareness of vaccination safety and importance in the general population, education of health staff, and increase in knowledge about immunization among politicians and decision makers.

2015 – 10^th Anniversary of the EIW

In 2015, the EIW celebrated 10 years since its creation, and represented a great opportunity to raise awareness on the fact that despite a generally high European immunization coverage, there are still vulnerable communities or groups that remain under-immunized. The need to close these immunisation coverage gaps as soon as possible was the main theme of the EIW 2015.

The following examples are an illustration of actions being taken in several countries to identify and address gaps in immunization coverage, showing commitment at local, regional and national levels to improve the current status of immunization (Source: http://www.euro.who.int/en/media-centre/events/events/2015/04/european-immunization-week-2015/european-immunization-week-2015-commitment-to-immunization/commitment-to-close-immunization-gaps):

• Small-scale approach more effective in closing immunity gaps in the Netherlands:

A health survey among parents waiting in line during one of the mass immunization day (September 2014) in the region was conducted in order to attempt transforming health services to better server parents and their children.  Findings of this survey support the assumption that it was time to move immunization services out of massive gym halls and closer to people's lives and homes.  

• Tailored Immunization Programme (TIP) implementation in the United Kingdom:

Public Health England (PHE) together with the community, immunization service commissioners – National Health Service (NHS) England – and health providers, conducted a WHO tailoring immunization programme (TIP) project during 2014–2016 in the attempt to better understand reasons for current suboptimal coverage of children’s immunizations within this community. This project aimed to provide evidence-informed recommendations to immunization commissioners and providers, enabling better tailored to the needs of the community health services.

• Estonia’s Working Group on Communication of Infectious Diseases works to minimize impact of misinformation

In Estonia, leading authorities and partners in immunization activities discussed with WHO/Europe in March 2013 to attempt to identify national immunization programme threats and opportunities in terms of immunization advocacy and communications capacity and coordination. Meetings included key decision-makers at the Ministry of Social Affairs, the Health Board, the State Agency of Medicines, the Estonian Health Insurance Fund, the Estonian Society of Infectious Diseases and the Estonian Society of Family Doctors.

This resulted in the official establishment in March 2014 of the Working Group on Communication of Infectious Diseases, aiming to organize effective communication activities and messages as well as risk and crisis-communication campaigns in the area of infectious diseases.

For the EIW 2016, an online forum (http://www.immunize-europe.org/) was created where all stakeholders and other interested parties can share information on country activities, share experiences/resources and lessons learned, or interact through discussion on immunization related topics.

Lessons learned and challenges

An evaluation of the program was conducted in 2009, after its fourth edition; reporting on the activities in the participating countries (37) and their impact on the immunization coverage and awareness (Source: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/2010/evaluation-european-immunization-week-2009 ).

Of the participating countries, 90% considered the EIW 2009 a completely or partially successful event. Primary reasons being cited for problematic and/or less successful campaigns were: overlap with Easter holidays, the H1N1 influenza pandemic, late cancelations, lack of funding and plan changes following government changes.

Concerning the impact on vaccination coverage and awareness, one third of the participating countries reported increases in routine immunization coverage following the EIW 2009, with more than 60 000 people in specific target groups immunized in 11 countries. Nineteen countries expressed their confidence in an eventual increase of immunization coverage following the EIW 2009. However, all responders stressed out the fact that, most probably, the EIW would not have a long term impact on immunization coverage; thus, it is necessary to have an annual initiative.

Status of the project

The project is still ongoing; the European Immunization Week takes place every year. The next event is scheduled for the week of 23-29 April 2017, together with other WHO initiatives in the European Region as well as the World Immunization Week.