Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities (RIVER-EU) is a 5-year (2021-2026) project funded by the Horizon 2020 Research Programme. Our main goal is to collect evidence on health system determinants of high and low vaccine uptake in eight specific contexts. This evidence will be used to identify and/or develop interventions to reduce barriers to vaccine uptake in underserved communities and increase trust in the health system.

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Welcome to the biannual RIVER-EU project newsletter. It brings you the most important project achievements and other related and relevant information on equitable access to vaccination.

Barriers and enablers to vaccine uptake: evidence from a systematic literature review

As part of the RIVER-EU project, our focus is on increasing the uptake of two vaccinations – Measles, Mumps, Rubella (MMR) and the Human Papilloma Virus (HPV) – among disadvantaged populations in Europe.

To create effective interventions that specifically address the needs of underserved populations, it is essential to first understand the health system barriers and enablers that prevent access to care services. We conducted a thorough assessment of previous research to collect a set of comprehensive data, specifically relating to the health system barriers and enablers around the MMR and HPV vaccination among disadvantaged communities to understand the effects.

Health system enablers to child vaccination in Israel: empowering example of the Arab minority in Israel

Populations that come from lower socio-economic background, migrant communities or belong to cultural or religious minorities usually achieve substantially lower vaccine uptake compared to the general population​. However, there are some underserved populations that do achieve vaccine coverage similar or higher than the general population​. The Arab minority in Israel is one such example.

Providing important insights into health system enablers, this research explores HPV and MMR vaccination uptake among the Arab minority in Israel. We aim to use these findings to create health system recommendations that can benefit other underserved populations who experience low vaccination rates in Europe.

Curated training system for European health professionals is launched

We are delighted to announce that the SEKI platform (Strengthening Education & Knowledge on Immunisation) is now live!

A living resource that is regularly updated, the platform provides curated training for health professionals in Europe, currently including a list of suggested training courses on both general and specific vaccination topics (e.g., COVID-19, adolescent immunisation, vaccine safety, pharmacy-based vaccine administration and so on).

This platform is critical to ensure that RIVER-EU’s outcomes contribute to long-term changes as it strengthens leadership and capacities of health professionals to engage with the community to implement locally viable solutions.

Vaccine equity and effective communication: why it matters

Many things depend on the power of conversation – including vaccine equity. A reliable way to foster unity and close the inequality gap is to form strong relationships with underserved populations.

In Slovakia, the Roma community continues to face high levels of social exclusion, discrimination, and inequalities – all of which lead to a severe distrust with those from outside. Such barriers present a significant challenge when reaching the Roma people, particularly when raising awareness around healthcare initiatives such as increasing the uptake of the HPV vaccine.

Raising awareness of global decline in vaccination rates: European Immunization Week 2023

RIVER-EU’s goal was to increase public awareness of the alarming global decline in vaccination rates during European Immunization Week. There was a particular focus on child vaccination uptake, including raising awareness on making sure any missed doses were taken, this was done in collaboration with a group of EU-funded projects. Each of the nine project that took part offer a unique set of research findings, practical solutions, or policy level recommendations to support European countries to improve access to vaccination services for all.

What are we working on now?

We are conducting a transferability analysis of interventions that are likely to be successful to address selected barriers to vaccination in the five communities that experience low vaccine uptake. The results of this work will support the development of coherent interventions.

We are also preparing a workshop titled “A participatory approach to identifying vaccine uptake interventions with underserved communities” at the 16th European Public Health Conference 2023 taking place in November in Dublin.

More news from the project

• European Commission’s consultation webinar on vaccine-preventable cancers – RIVER-EU project contributes.
• Daniela Fiľakovská, RIVER-EU country coordinator for Slovakia, participated in a multistakeholder roundtable discussion that set the next steps to facilitate higher HPV vaccine uptake in Slovakia.
• We are currently working towards the next steps in the project. This next stage aims to prepare coherent and implementable interventions within the five targeted underserved communities. To support partners in the preparatory phase and implementation process, four communication workshops took place in Zeist, Košice, Zielona Góra and Athens to engage the community leaders and staff carrying out the field work.
  

Additional updates

• "Addressing Determinants of Immunization Inequities Requires Objective Tools to Devise Local Solutions" Vaccines 11, no. 4: 811 was published and explores the importance of removing barriers to vaccination for underserved individuals. Datta, Siddhartha Sankar, Federico Martinón-Torres, Nino Berdzuli, Niyazi Cakmak, Michael Edelstein, Simon Cottrell, and Mark Muscat. 2023.
• “Are we having the wrong conversation about vaccine hesitancy?”. In this article featured in VaccinesToday, Alison Maassen (WP7), argues that ‘vaccine hesitancy’ should be considered as a type of vaccine inequality & solutions to ‘hesitancy’ should be targeted towards addressing systemic political, socio-economic, and health barriers.
• JITSUVAX project annual report 2023 contains information about the 'look-up tool' website which contains responses to and evidence against common disinformation about vaccination, as well as a summary of progress on the development of the Empathetic Refutational Interviewing technique and the online games designed to 'inoculate' people against misinformation.
• PROTECT-Europe project aims to increase the uptake of HPV vaccines in Europe. You can contribute to project’s study on co-administration opportunities of the HPV vaccine with other vaccines or adolescent health services. The study seeks to examine the situation in different contexts and to understand the major opportunities and barriers to HPV vaccine co-administration. Please fill out the survey (takes only 5 minutes) by the 10th of July.
• The EU-funded research network VACCELERATE has created a survey targeted at professionals with expertise in vaccinations, with the aim to identify barriers to participation in vaccine trials among pregnant and lactating women, children and older adults (over 65 years old). The results of this survey should improve our understanding on what hampers the access to vaccine research and trial enrolment of the selected underserved groups. Please fill out the survey (takes only 10 minutes) by the 31st of July.

In case you missed it

Media mentions

Utilising international days to raise awareness of inequalities

Pathways to reduce vaccine inequalities