Comparative analysis of pre-Covid19 child immunization rates across 30 European countries and identification of underlying positive societal and system influences

Abstract

This study provides a macro-level societal and health system focused analysis of child vaccination rates in 30 European countries, exploring the effect of context on coverage. The importance of demography and health system attributes on health care delivery are recognized in other fields, but generally overlooked in vaccination. The analysis is based on correlating systematic data built up by the Models of Child Health Appraised (MOCHA) Project with data from international sources, so as to exploit a one-off opportunity to set the analysis within an overall integrated study of primary care services for children, and the learning opportunities of the ‘natural European laboratory’. The descriptive analysis shows an overall persistent variation of coverage across vaccines with no specific vaccination having a low rate in all the EU and EEA countries. However, contrasting with this, variation between total uptake per vaccine across Europe suggests that the challenge of low rates is related to country contexts of either policy, delivery, or public perceptions. Econometric analysis aiming to explore whether some population, policy and/or health system characteristics may influence vaccination uptake provides important results—GDP per capita and the level of the population’s higher education engagement are positively linked with higher vaccination coverage, whereas mandatory vaccination policy is related to lower uptake rates. The health system characteristics that have a significant positive effect are a cohesive management structure; a high nurse/doctor ratio; and use of practical care delivery reinforcements such as the home-based record and the presence of child components of e-health strategies.

Incorporating heterogeneity in farmer disease control behaviour into a livestock disease transmission model

“…Ethical approval was granted by the University of Warwick Biomedical and Scienti c Research Ethics Committee (BSREC 100/ [19][20] prior to commencement of the study.…”

“…People are well known to show different behaviours with respect to disease control; for example people can be mutually cooperative (acting for the bene t of both the self and other people), or show parasitism (gain bene t from other people taking action) 18 . This is seen for human infections where there is considerable variability in the uptake of vaccine or the decision to vaccinate children 19,20 , and this concept translates to farmers with the decision to protect their livestock. The heterogeneity in farmer behaviour for disease control is in part due to psychosocial and behaviour factors.…”

Incorporating Heterogeneity in Farmer Disease Control Behaviour into a Livestock Disease Transmission Model

“…People are well known to show different behaviours with respect to disease control; for example people can be mutually cooperative (acting for the benefit of both the self and other people), or show parasitism (gain benefit from other people taking action) (Bshary and Bergmüller, 2008). This is seen for human infections where there is considerable variability in the uptake of vaccine or the decision to vaccinate children (Cellini et al, 2022;Dolby et al, 2022), and this concept translates to farmers with the decision to protect their livestock. The heterogeneity in farmer behaviour for disease control is in part due to psychosocial and behaviour factors.…”