The COVID-19 pandemic has gone on to provide a stark illustration of how infectious diseases can go on to cause serious illness, put pressure when it comes to health systems, and also disrupt the economy. The pandemic also went on to show as to how the fear when it comes to infection for oneself or loved ones can go ahead and generate anxiety as well as depression.1 It brought into focus many weaknesses as well as inequities that must be addressed if one is to build resilient systems, and at the same time prioritise preventative health, and, as a matter of fact, be ready to respond to the next crisis when it comes.
But one has also seen many positives in how the authorities, institutions, and policymakers responded with urgency and creativity, putting an unprecedented focus when it comes to adult vaccination, setting up new vaccination points, mobilizing pharmacists in order to provide convenient access to vaccination, and at the same time tracking outbreaks along with vaccine uptake.
Though COVID-19 goes on to circulate in every EU country, it is rather time to consider the legacy when it comes to this pandemic. The question therefore is: What lessons can one go on to learn from this shock to the system pertaining to the execution of routine vaccination programs?
One of the biggest threats one goes on to face is a return to business as usual. The pandemic went ahead and prompted millions of adults to go ahead and engage with immunization services for the very first time in many years. If one goes on to fail to harness the momentum generated since 2020, history is surely going to record it as a missed opportunity.
Capturing momentum from the COVID-19 pandemic
While this happens to be a chance to reinvent immunization systems so as to protect people of all ages, one knows that human beings can indeed be complacent. Let us look into the report on the State of Vaccine Confidence in the EU 20222 which was published by the European Commission in November 2023.
The study, which happened to be conducted by the Vaccine Confidence Project, is the third in a series that looks at public perceptions of vaccines in 2018, 2020, and 2022. It shows that after massive gains in vaccine confidence in 2020, especially towards the seasonal influenza vaccine, attitudes have largely returned to pre-pandemic levels.
It should also be taken into consideration that, while most people across Europe trust vaccines, there are major differences between countries as well as age groups. There is a vaccine confidence gap, if one may call it so, between people older than 65 and those in the 18-34 age group; the younger group happens to be less confident now than it was in 2018. Alongside the contribution of complacency, pandemic-fueled polarization when it comes to vaccine conversations, especially online, may have had a pretty negative impact on those who happen to be most reliant on social media for information.
The study also happens to put the spotlight on differences between countries, with countries such as Portugal and Spain reporting the highest levels of confidence, and Slovakia and Latvia reporting the lowest. Because of this, it perhaps doesn’t come as a surprise that vaccine coverage for flu as well as COVID-19, specifically for adult vaccines, happens to be markedly better in the western EU Member States than in the countries in Central as well as Eastern Europe.3,4
The report also goes on to show that the improvements in confidence seen in 2020 have indeed faded. One should also be concerned that the public may go on to view immunization as a primary concern when it comes to children’s health.
After the pandemic, which happened to prove the urgency of vaccinating older as well as vulnerable people, it is time to go ahead and raise adult immunization to the same level of priority that one goes on to attach to protecting children against vaccine-preventable diseases.
Protection for all: The significance when it comes to preventative health
As one moves away from crisis mode, there is indeed a new era for routine life-course immunization. In order to achieve this, one needs sustainable financing when it comes to vaccines that happen to be recommended for people of all ages. In spite of the current economic situation, this must therefore be viewed as an investment and not a cost. Indeed, for €1 of public money that gets invested in vaccines for people aged 50 and above, governments can go ahead and expect to gain €4 in future economic revenue.5
Moreover, as the winter has illustrated, preventing flu, pneumococcal disease, RSV, COVID-19, and other life-threatening or debilitating respiratory illnesses happens to be essential to health system resilience. In various EU Member States, hospitals as well as primary care services were overwhelmed by patients who suffered from preventable viral illnesses, thereby adding to the pressure on healthcare workers as well as disrupting elective procedures.
It is indeed vital in the interests of equity throughout Europe that new vaccines promptly go ahead and reach people, in spite of where in Europe they happen to live. The fact is that while Europeans in Belgium as well as France wait less than two years in order to access newly approved vaccines, those in countries such as Croatia and Estonia have to wait more than six years.6
This is not only unfair, but it goes on to send the wrong signal when it comes to the priority one attaches to preventative health. And, with over 100 vaccine candidates within the pipeline7 most of which are going to target adults, it is critical that there happen to be a pathway to public funding when it comes to innovative vaccines, thereby recognizing their absolute value.
Timely data happens to be required
One needs to set vaccine uptake targets along with collect data so as to monitor progress. At present, one knows too little when it comes to rates of disease as well as vaccination.
The Pneumococcal Vaccination Atlas8, which happened to be published in January 2024 by the Coalition for Life-Course Immunization and the International Longevity Centre, goes ahead and gives out striking differences when it comes to the vailability of data on vaccine coverage among children and adults throughout Europe. It goes ahead and reveals a patchwork of recommendations as well as reimbursement policies, with disparities between the availability of pneumococcal vaccines when it comes to children and older people. The fact is that, as is too often the case, older people happen to be missing out.
It is well to be noted that among the positive elements when it comes to the pandemic response happened to be the availability of timely as well as harmonised information on case numbers along with vaccination uptake throughout all EU Member States. The European Centre for Disease Prevention & Control’s COVID-19 Vaccine Tracker9 goes on to give out timely, granular, publicly accessible information that’s broken down by country as well as age group. It demonstrates the vaccination uptake for the entire population, adults only, as well as over-60s.
The lasting legacy when it comes to the pandemic is the establishment of systems to collect and share data for all vaccine-preventable diseases. This would go on to support evidence-informed policymaking as well as prompt action in order to intervene when an outbreak takes place or pre-emptive local campaigns when the vaccine uptake happens to be too low.
Immunization at the crossroads
At the policy level, there happen to be reasons when it comes to optimism that the EU has accelerated the shift towards life-course immunization. In December 2024, EU health ministers went ahead and agreed to European Council Conclusions10 that look forward to enhancing adult immunization campaigns and, at the same time, establishing an expert forum when it comes to vaccine hesitancy.
Meanwhile, the HPV vaccination, as far as adolescent girls and boys are concerned, will go on to play a central role when it comes to addressing cervical cancer, which is a priority of the Europe Beating Cancer Plan.11 By way of making sure that the national cancer plans monitor the status when it comes to HPV and Hepatitis B vaccination, the EU can go on to play an oversight as well as a coordination role when it comes to raising standards throughout Europe.
These initiatives are indeed welcome. This is indeed a spirit one should go ahead and apply to all vaccine-preventable diseases, not just COVID-19, and that too at times of crisis, and not just HPV vaccination within the context of eliminating cervical cancer as a public health concern.
The fact is that routine life-course immunization should be viewed as an essential service. Public confidence when it comes to vaccines must be fostered on an ongoing basis, with timely, free, and equitable access to new, recommended vaccines. And one needs to strengthen immunization information systems so as to make sure of a data-driven future as far as preventative health is concerned.
In order to succeed, one indeed knows what is needed, and that’s a political will, an adequate as well as sustainable immunization budget, and also data on program performance.
It is worth noting that if one truly believes that preventative health happens to be better than cure, now happens to be the time to show it.
