Alison Maassen and Alba Godfrey of EuroHealthNet explain the importance of the IMMUNION project in improving public knowledge and confidence around vaccines.
Vaccines are a cornerstone of global healthcare systems. According to the NHS, receiving the COVID-19 vaccine can reduce patients’ chances of being hospitalised with the virus by 85%. However, despite the frequency with which vaccinations are administered and all the benefits they bring in helping to prevent diseases, the discourse surrounding them can vary and hinder our understanding of health outcomes.
Fears around vaccine safety, as well as filtered advertising and a lack of concrete, evidence-based knowledge, have led in some cases to lower vaccine uptake and inequalities in the way information around vaccinations is shared. Likewise, great disparities remain in how the public access the information surrounding vaccinations and the way in which healthcare professionals, the media and government bodies communicate that information.
Not-for-profit partnership EuroHealthNet focuses on addressing the social determinants of health to combat and prevent inequalities throughout the health and care sectors. In a bid to facilitate a more collaborative approach to vaccination management and care, EuroHealthNet has established the IMMUNION project to support the European Commission’s Coalition for Vaccination programme. The two-year project seeks to improve public trust around vaccinations by working with various stakeholders, including healthcare professionals and media organisations, and therefore establish a holistic approach to vaccination coverage, ensuring fairer health outcomes at regional and national levels.
EuroHealthNet Project Co-ordinator Alba Godfrey and Programme Manager Alison Maassen tell HEQ about the importance of the IMMUNION project in improving public knowledge and confidence around vaccines.
How did the IMMUNION project come to be established? What are its goals?
The IMMUNION project was established as a response to a call for proposals by the European Union’s third Health Programme (2014-2020) to support the Coalition for Vaccination and contribute to the European Council’s 2018 recommendations on strengthened co-operation against vaccine-preventable diseases. Established by the European Commission in 2019, the Coalition for Vaccination brings together European networks of health professionals and students. It aims to support the delivery of accurate information to the public, combat myths around vaccines and vaccination, and facilitate the exchange of best practices on vaccination.
Led by EuroHealthNet, IMMUNION brings together members of the Coalition for Vaccination, as well as partners from across the EU, with the ultimate goal of strengthening collaboration between healthcare professionals and other stakeholders, communicate evidence-based information about vaccination and increase vaccine confidence and uptake. Specifically, it aims to:
- Share validated vaccination training materials and resources with health professionals and students across Europe
- Strengthen the existing European Coalition for Vaccination and its long-term sustainability and visibility
- Develop and provide training opportunities for health professionals and students on vaccination communication
- Enhance collaboration between public health institutions, health professionals and the media and foster evidence-based reporting on vaccination in the media
- Understand drivers of vaccine inequalities and address vaccination coverage issues in vulnerable and underserved populations
What are the primary factors slowing the progress of vaccine coverage in the EU? Which demographics are most at risk of remaining unvaccinated?
Despite many existing initiatives to increase vaccination coverage, rates in most EU countries are stagnating or even falling. Low vaccine uptake is a complex issue which requires attention to issues of trust, access (including access to information), acceptability, and affordability. Some of the key obstacles identified by a recent EU expert panel include concerns or fears about vaccine safety and side effects, social norms, exposure to rumours and myths undermining confidence in vaccines, failure by some health professionals to counter these myths and provide evidence-informed advice, and access barriers (e.g., poor availability, co-payments)1.
Variations in vaccination coverage are not equally distributed. In the four countries covered by the IMMUNION partnership, population groups which are particularly at risk include communities in rural areas or with low education (Romania), recently arrived migrants and Roma populations (Greece and Italy), and minority ethnic communities (Latvia). Inequalities in vaccination coverage are often symptomatic of broader health and social inequalities. Addressing them is key to increasing overall vaccination coverage and to ensuring greater equity in health outcomes at regional, national, and European levels2.
Across all four partner countries, IMMUNION will work closely with governmental institutions, health professionals, civil society and media organisations, and representatives of target communities to better understand perceptions and barriers which hinder access to health services and information. Through this ‘whole-of-society’ approach, we will identify specific challenges and develop and pilot communication and community engagement strategies in order to help increase vaccine knowledge and combat negative myths, thereby addressing inequalities and increasing overall vaccination coverage.
Have misinformation or vaccine hesitancy been an issue in the rollout of the COVID-19 vaccine?
The COVID-19 pandemic has presented many challenges in communicating evidence-based public health recommendations to the public, as rapid action has been required in the face of incomplete evidence. This has affected all COVID-19 prevention measures as can be seen in the politicisation of mitigation measures such as mask wearing. Misinformation has also proliferated during the pandemic, requiring constant factchecking and ‘mythbusting’ by governments and the scientific community.
Naturally, these same issues have affected the COVID-19 vaccine rollout. The unprecedented speed at which a number of effective vaccines were developed and approved (including novel mRNA vaccines), logistical challenges due to limited supply and different vaccine characteristics, and the huge target population for vaccination made communication around COVID-19 vaccines more difficult and opened opportunities for misunderstanding. This was further complicated after links were made between some of the COVID-19 vaccines and serious – though extremely rare – blood clots.
Despite these communication challenges, the vast majority of Europeans still intend to receive COVID-19 vaccines. The extent and issues of vaccine acceptance and hesitancy vary considerably across countries with specific local social and cultural patterns3. The media has a critical role to play in helping to foster trust in the COVID-19 vaccines and vaccination more generally.
Accurate, careful reporting is crucial, and requires sensitivity to managing the public’s expectations, understanding genuine concerns, making the science accessible, and avoiding ‘false balance’ which undermine legitimate, evidence-based recommendations. Over its two-year course, IMMUNION will foster collaboration between organisations of public health professionals, health professionals and students, and the media, in the aim of enhancing coverage of and reporting on vaccination by media, and ultimately of improving public knowledge and confidence on vaccination.
IMMUNION will also set up a ‘Find an Expert’ database, which will allow journalists and other stakeholders to find and contact verified experts on matters of vaccine safety and communication from across Europe. Already, project partner EURACTIV Poland has developed a hub on its website, on which it regularly posts articles covering vaccine and public health-related issues.
What are the benefits of collaboration and sharing vaccination training resources across the EU?
While many people receive information about vaccination from the media, surveys consistently report that health professionals are the most trusted source of information on vaccines for the general public4. Despite this, health professionals (including doctors, nurses, pharmacists, dentists, and public health professionals) may sometimes lack knowledge and confidence in vaccines and receive insufficient training on vaccine communication.
Ensuring that evidence-based, high quality information and training opportunities are made available to health professionals, and that they are made aware of and take up these resources and opportunities, is critical to enable them to communicate confidently with parents and communities about the benefits of vaccination.
IMMUNION will consolidate previous and ongoing initiatives by bringing together resources for health professionals in one easily accessible online platform (the SEKI Platform). The platform will be widely disseminated, in particular through IMMUNION’s close collaboration with the Coalition for Vaccination.
“It is important to enhance co-operation and sharing of information on vaccination between European countries but also encourage collaboration between different professions,” said Professor Dr Frank Ulrich Montgomery, President of the Standing Committee of European Doctors (CPME), a member of the IMMUNION project coalition. “This way doctors and other healthcare professionals, who play a key role in working towards higher vaccination coverage rates, have better opportunities to learn more and keep themselves updated on vaccination-related information. Moreover, better knowledge and better access to information can also increase healthcare professionals’ own vaccine confidence.’’
The project will also build on learnings from the EU Joint Action on Vaccination to develop and deliver a ‘Training of Trainers’ workshop to professors and trainers in medical, nursing and pharmaceutical programmes, to help improve the confidence of health professionals and students on communicating about vaccination with patients, addressing their concerns about common myths. Recordings from the four live workshops will be made available on our website for all to benefit from.
“Building on expertise gained from previous and parallel ongoing projects is a crucial asset in improving communication about vaccination,” commented University of Antwerp Professor Pierre Van Damme. “As the confidence of the general public in frontline health care professionals is key, we increasingly need to pay attention in training the generations of future and current health care professionals on communication about vaccines and vaccination. This will help consolidate and increase the immunisation rates all over Europe.”
Collaboration is crucial. Recent reports5 highlight how the quality of communication training on vaccine promotion for the health workforce differs from country to country, with some countries championing the fight against disinformation regarding vaccines while others are still below the minimum standards. However, as the COVID-19 outbreak highlighted, diseases do not know borders and action at EU level is needed to face common challenges.
1 Vaccination Programmes and Health Systems In The European Union, Expert Panel on effective ways of investing in Health (EXPH): https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/020_vaccinationpgms_en.pdf
2 Childhood, health inequalities, and vaccine-preventable diseases, EuroHealthNet, April 2018, updated April 2019: https://eurohealthnet.eu/sites/eurohealthnet.eu/files/publications/EuroHealthNet%20Factsheet%20on%20Vaccination%20_%20April2019.pdf
3 European Centre for Disease Prevention and Control Rollout of COVID-19 vaccines in the EU/EEA: challenges and good practice. 29 www.ecdc.europa.eu/en/publications-data/rollout-covid-19-vaccines-eueea-challenges-and-good-practice#no-link
4 De Figueiredo A, Karafillakis E, Larson HJ. State of vaccine confidence in the EU+UK 2020, European Union, 2020.
5 The organisation and delivery of vaccination services in the European Union (2018), European Observatory on Health Systems and Policies, European Commission, 2018: https://ec.europa.eu/health/sites/health/files/vaccination/docs/2018_vaccine_services_en.pdf
This article is from issue 18 of Health Europa. Click here to get your free subscription today.