Today at the European Health Forum, we were challenged to consider what actions should be taken to implement a life-course approach to vaccination across Europe. Many countries have been struggling with vaccine mistrust and misinformation. Measles outbreaks have led to dozens of avoidable deaths around the continent this year. Other countries, including my native country of Ireland, have seen major declines in HPV uptake. John Ryan of the European Commission emphasised at the outset that vaccination can save countries ten times more than the cost of the vaccines themselves. An important reminder of the relevance of this issue, even if preaching to the converted!
A series of four case studies were presented to inspire actions that could be taken across different European countries to improve vaccination uptake. Representatives of the European Patients’ Forum, UK’s Vaccine Confidence Project, Ethno-Medical Centre in Germany, and EU Pharmaceutical Group were put through their paces in a series of ‘TED talk’ style presentations. Emilie Karafillakis highlighted the strategies, which have worked best in reversing the decline in HPV uptake in Denmark. This resonated most with me, since in Ireland we have improved HPV coverage from 50% to 65% in the last 18 months. We are still a long way off the>80% coverage we had achieved in 2014, but by engaging with key stakeholder groups, getting on social media, and highlighting real-life personal narratives in our communication strategies we are finally counteracting much of the misinformation and scaremongering around this vaccine. Certainly, we learned and benefited from the Danish experience in this regard.
Ramazan Salman provided inspiration for actions, which can be taken to tackle low vaccination rates among migrant groups. It is clear, that health and cultural mediators play a key role here, and the MiMi project in Germany has engaged more than 400 of them working in dozens of different languages. This is something many other countries need to learn from. If we truly want to improve vaccine uptake among vulnerable migrant groups and ethnic minorities, then we need to engage with them in a culturally sensitive way, in a language they understand.
We continued the session in four groups, each focusing on one of the presented case studies guided by four key questions. My group tried to identify means of improving vaccine literacy among patients. With 10 different countries represented, there was no shortage of debate. We felt that it was essential to have a multi-stakeholder approach with real buy-in from patients, celebrities, politicians and the media, where possible. We need to use social media to our advantage, and do so in an organised way which counteracts misinformation, but which is also fun and that people can relate to. In Ireland, the most powerful advocates for vaccination, and perhaps the most accessible in terms of information, have been patients themselves who are affected by vaccine-preventable diseases. We need to harness their enthusiasm and give them a visible platform to convince the sceptics – often these are the most influential people.
In the wrap-up session, we were reminded of the challenge of vaccine hesitancy among healthcare professionals. As public health professionals, we need to improve education of this key group, respect any concerns they may have, and improve our information systems so that we can better understand this phenomenon. From the Irish experience, flu vaccine uptake has improved among nurses in recent years thanks to peer vaccinator initiatives. Greater empowerment of these professional groups to endorse vaccination, and to share accurate information among their peers, is perhaps one of the most effective strategies.
So what actions need to be taken to implement a life-course approach to vaccination? Clearly there is no single, simple answer, but we don’t need to reinvent the wheel. We know a lot about what works – let’s start putting it in to action.
This Blog was written by the Young Gasteiner Peter Barrett