Immunization funding across 28 European countries

Abstract

Disease prevention and improving vaccination coverage in Europe are key elements contributing to resilient health systems and ensuring better health outcomes for all. The aim of this study was to describe the immunization funding landscape across all European Union 28 countries (EU28). Areas coveredData collected in a targeted literature review supported descriptive analysis on the different indicators that were looked at: vaccines included in the EU28 national immunization programs (NIP), national immunization funding, immunization funding per capita (2015-2019) and percentage of healthcare budget allocated to immunization. Expert opinionImmunization funding represents a small proportion of total healthcare spend in Europe (median 0.3%). In the context of the current COVID-19 pandemic, demographic changes and the potential introduction of new vaccines; the need for adequate financing of immunization programs will be important, to establish resilient immunization systems and provide sustainable protection of the population against vaccine preventable diseases.

Improving Vaccine Assessment Pathways and Decision Making in the Polish Immunization Program

“…Poland is a late adopter of new vaccines, with a time to access of > 6 years [ 2 ], and is a country in which the budget for vaccinations per capita is low in comparison to other countries with a similar gross domestic product [ 6 , 7 ]. In the period studied, the time for population vaccine access in the NIP was as high as 15 years in the case of a vaccine against human papillomavirus (HPV).…”

“…For example, Poland is the only country in the EU still using whole-cell pertussis vaccines in primary immunization. Multiple vaccines are recommended in the schedule without or with limited public funding [ 6 , 34 ]. However, evidence was generated but not neglected; it frequently did not lead to decision making due to a lack of resources.…”

“…Multiple factors and stakeholders shape the immunization landscape in European countries, which differ significantly by immunization budget, country-specific policies, institutions, population access modalities, and funding pathways. Most studies evaluating country policies and decision-making processes focus on Western countries [ 3 , 4 , 5 ], which allocate more resources to immunization programs than Central and Eastern European (CEE) countries [ 6 ]. Public immunization financing data are limited, reporting methods vary [ 6 , 7 ], and a high proportion of total health expenditures are out-of-pocket and private insurance payments [ 8 ].…”

“…Most studies evaluating country policies and decision-making processes focus on Western countries [ 3 , 4 , 5 ], which allocate more resources to immunization programs than Central and Eastern European (CEE) countries [ 6 ]. Public immunization financing data are limited, reporting methods vary [ 6 , 7 ], and a high proportion of total health expenditures are out-of-pocket and private insurance payments [ 8 ]. Also, information about the functioning of healthcare systems, the macroeconomic impacts of vaccination programs, and even the disease burden is largely lacking.…”

A review of the sustainability of vaccine funding across Europe and implications for post-COVID policymaking

“…Despite the overwhelming benefits of vaccines on population health and economy, only a small fraction of healthcare budgets is currently allocated to vaccines in Europe. It has been recently estimated that 20 of the 27 Member States of the European Union spend less than 0.5% of their healthcare budget on immunisation [4] . Approaches to routine vaccine funding and the underlying budget-setting process vary greatly across European countries, affecting resilience of the overall vaccine ecosystem and its flexibility to integrate new vaccines in national immunisation programmes (NIPs).…”