Addressing low vaccine uptake

Proposals should work to increase understanding of the determinants of low vaccine uptake in specific contexts situated in the EU and/or Associated Countries (AC) , and should develop strategies to increase vaccination rates of essential vaccines within these contexts. From this work, proposals should aim to develop a series of recommendations that national and regional public health authorities in the EU and/or Associated Countries could implement in order to increase vaccine coverage. Proposals should build on existing research, findings and available information in this domain, as well as existing guidelines and recommendations from public health authorities, including those from the European Centre for Disease Prevention and Control and WHO/Europe (such as ECDC reports and guidance on vaccine coverage and hesitancy[[https://ecdc.europa.eu/en/immunisation-vaccines/vaccine-hesitancy]] ""WHO/SAGE Working Group on Vaccine Hesitancy""[[http://www.who.int/immunization/programmes_systems/vaccine_hesitancy/en/]] WHO/Europe ""Guide to tailoring immunization programmes (TIP)""[[http://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/publications/2013/guide-to-tailoring-immunization-programmes]].

The approach taken should include a detailed examination of the causes of reduced vaccine uptake, and the design and testing of one or more interventions to improve vaccine uptake. Factors influencing vaccine uptake such as access, inequality, social/cultural influences and vaccine/vaccination-specific issues in specific population(s) that are identified as having lower than average vaccination coverage should be examined. Interventions to improve vaccine uptake should be based on existing high-quality research findings, with a sound hypothesis for why the chosen intervention(s) could be effective at increasing vaccine coverage in the target population(s). These interventions could be made in a wide variety of ways, for example content and style of online or offline media, educational material, modification of primary healthcare practices, access to vaccination, incentivisation, or any other strategies that are supported by a strong hypothesis. Also, the proposals should include a strategy for measuring the impact/success of the proposed interventions.

Finally, the findings of the project will be gathered into a clear and coherent set of recommendations that can be readily utilised by public health authorities in Europe to improve vaccine coverage. Proposals should include in their work the development of a strategy to ensure the implementation of these guidelines.

Proposals should take into account the specific contexts of the population(s) that they are studying, including factors such as age, sex/gender, religion, politics, geography, and socio-economic situation. Proposals should include partners from social science and public health-related disciplines. Proposals will also be expected to create links with other existing initiatives, both in Europe and internationally. This should include specific budget for networking, travelling to or organising meetings for researchers and other stakeholders that work on vaccine uptake challenges.

The Commission considers that proposals requesting a contribution from the EU of between EUR 2 and 3 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

Vaccines are one of the most important medical breakthroughs in the last 100 years. Every year vaccines save millions of people around the world from illness, disability and death, and they continue to be one of the most cost-effective ways to increase the health and wellbeing of their citizens. Despite this, vaccination uptake faces significant challenges across Europe, and these have increased in particular over the past 20 years. Recent studies have shown Europe to be the world region with the most negative views towards the safety and effectiveness of vaccines, and the importance of childhood vaccination[[http://www.ebiomedicine.com/article/S2352-3964(16)30398-X/fulltext]].

Recent figures on collected by the World Health Organization (WHO) show that in 2016 only one vaccine had a coverage rate of over 95% in Europe.[[http://www.who.int/immunization/monitoring_surveillance/data/gs_eurprofile.pdf]] Seasonal influenza vaccination also remains significantly below the 75% coverage target for older age groups.[[http://ecdc.europa.eu/en/publications/Publications/Seasonal-influenza-vaccination-antiviral-use-europe.pdf]]

Thus, coverage for many vaccines is below the recommended limit. Due to the low vaccine coverage rates, several EU Member States have faced considerable outbreaks of vaccine-preventable diseases in recent years. For example, more than 14,000 cases of measles were reported across the EU in 2017[[https://ecdc.europa.eu/sites/portal/files/documents/Monthly%20measles%20and%20rubella%20monitoring%20report%20-%20JAN%202018.pdf]], which is more than three times the number of cases reported in 2016. During the same period 50 people in the EU died due to measles[[https://ecdc.europa.eu/en/news-events/measles-cases-eu-treble-2017-outbreaks-still-ongoing]].

These figures highlight the urgent need to get to grips with vaccine uptake issues, whether uptake of existing or new vaccines. Research has an essential role to play in understanding the underlying causes of poor vaccine uptake, including vaccine hesitancy, and to develop strategies and guidelines to help Member States and Associated countries increase vaccination coverage. A detailed understanding of the obstacles to, and drivers of, vaccination uptake in various settings is necessary to provide appropriate recommendations.

• Contribute to increasing vaccine coverage in Europe, in particular in specific populations with low vaccine uptake and in specific contexts.
• Develop practical and readily implementable guidelines to aid national and regional public health authorities in the EU and Associated Countries to increase vaccination rates.
• Work towards meeting the goals on vaccination set out in President Juncker’s State of the Union address in September 2017[[http://europa.eu/rapid/press-release_SPEECH-17-3165_en.htm]], the EC Communication on strengthened cooperation against vaccine preventable disease (COM/2018/245)[[https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%3A2018%3A245%3AFIN]] and the Council Recommendation on strengthened cooperation against vaccine preventable diseases)[[http://data.consilium.europa.eu/doc/document/ST-14152-2018-REV-1/en/pdf]].