ENVI Committee exchange of view

Vaccination in the EU: benefits and barriersProf Mike Catchpole, Chief ScientistEuropean Centre for Disease Prevention and ControlENVI Committee 17 June 2015, European Parliament, Brussels

December 2004 October 2012

Why do EU Member States have vaccination programmes? To protect the health of Europeans

Finland - reported measles, mumps, and rubella through November, 2007, since 1915 for measles, 1943 for mumps, and 1957 for rubella*

*Peltola et al Measles, mumps, and rubella in Finland: 25 years of a nationwide elimination programme Lancet 2008; issue 8 vol 12; 796–803

Through MMR vaccination

measles complications averted Hospitalisations: 1 per 5 cases Otitis media: 1 per 11 casesPneumonia: 1 per 12 casesEncephalitis: 1 per 1,000 casesSubacute sclerosing panencephalitis: 1 per 100,000Deaths: 1 per 1,000 to 5,000 cases

mumps complications avertedHospitalisations: 1 per 25 casesMeningitis: 1 per 12 cases Bilateral orchitis: 1 per 30 casesEncephalitis: 1 per 300 casesPancreatitis: 1 per 500 casesHearing impairment: 1 per 300 to 1,000 cases

rubella complications avertedCongenital rubella syndrome: 1 per 400 casesPost-infectious encephalopathy: 1 per 500,000 cases

Vaccines used in EU are highly safe

Vaccination policy in Europe is not achieving its public health goalsExample: elimination of measles in Europe by 2010, 2015, 2020 (?!)

Source: TESSy data on measles cases reported 1 January – 30 April 2015; Measles vaccine coverage (two doses, 2012 – 2013)

EU citizens still die from vaccine preventable diseases! The threat continues

Why vaccination targets are not met (1): Vaccine hesitancy

• Influenced by issues of confidence (level of trust in vaccine or provider), complacency (do not perceive need for vaccine) and convenience (access).

• Hesitant citizens may: i) accept all vaccines but remain concerned; or ii) refuse or delay some vaccines; or iii) refuse all vaccines

• Results of the ECDC study:– Main concern/ fear: vaccine safety– Hesitancy among healthcare professionals

Vaccine safetyconcerns

Incidence of disease

Source: Rapid literature review on motivating hesitant population groups in Europe to vaccinate, ECDC, 2015 (under editing).

Why vaccination targets are not met (2):

Under-served population groups

Photo credits: www.vam.ac.uk/moc/images/image/36307-popup.html, by Eithne Nighingale http://www.flickr.com/photos/87563734@N00/ by Henri Weisen

Why vaccination targets are not met (3):

Vaccine availability• Currently, almost one third of Member States have

reported difficulties in procuring vaccines for the vaccination of infants against pertussis (whooping cough).

• Three out of nine influenza vaccine producers in EU closed production in the last two years (Baxter, Crucell & Cantacuzzino).

Strengthening prevention and control: What ECDC is currently doing

2015 will aim at: Supporting in responding to the existing and

upcoming Council Conclusions on immunisation

Providing evidence-based communication tools for reaching hesitant groups

Fostering exchange of knowledge to strengthen vaccination programmes - VENICE project

Coordinating and supporting EU-wide VPD network

Supporting Member States with country visits upon request

ECDC works in a multi-disciplinary approach…

…to support and strengthen prevention and control efforts on vaccine preventable diseases (VPDs) in the EU/EEA.

What more can be done at EU level?

• Support for EU level projects on key issues such as:– vaccine hesitancy– under-served populations – immunity gaps etc.

• EU action to further improve evidence-base for public health (national and EU level) decisions on vaccination policy

– ECDC guidance– Robust vaccine monitoring data