Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review

Winifred Ekezie; Samy Awwad; Arja Krauchenberg; Nora Karara; Łukasz Dembiński; Zachi Grossman; Stefano Del Torso; Hans Juergen Dornbusch; Ana Neves; Sian Copley; Artur Mazur; Adamos Hadjipanayis; Yevgenii Grechukha; Hanna Nohynek; Kaja Damnjanović; Milica Lazić; Vana Papaevangelou; Fedir Lapii; Chen Stein-Zamir; Barbara Rath

doi:10.3390/vaccines10071038

Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review

Winifred Ekezie
, Samy Awwad
, Arja Krauchenberg
, Nora Karara
, Łukasz Dembiński
, Zachi Grossman
, Stefano Del Torso
, Hans Juergen Dornbusch
, Ana Neves
, Sian Copley
, Artur Mazur
, Adamos Hadjipanayis
, Yevgenii Grechukha
, Hanna Nohynek
, Kaja Damnjanović
, Milica Lazić
, Vana Papaevangelou
, Fedir Lapii
, Chen Stein-Zamir
, Barbara Rath^*

^*Corresponding author for this work

Sociology and Policy

Vienna Vaccine Safety Initiative
Stanford University
European Parents Association
Young European Academy of Paediatrics
Evangelical Hospital Queen Elisabeth Herzberge
European Academy of Paediatrics (EAP/UEMS-SP)
Medical University of Warsaw
Ariel University
Finnish Institute for Health and Welfare
University of Belgrade
Univerzitet u Novom Sadu
Jerusalem District Health Office
University of Nottingham

Research output: Contribution to journal › Review article › peer-review

86 Citations (SciVal)

25 Downloads (Pure)

Abstract

Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

Original language	English
Article number	1038
Number of pages	24
Journal	Vaccines
Volume	10
Issue number	7
Early online date	28 Jun 2022
DOIs	https://doi.org/10.3390/vaccines10071038
Publication status	Published - 1 Jul 2022

Bibliographical note

Copyright © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Funding Information:
The ImmuHubs project is co-funded by European Union’s Health Programme (2014–2020) and coordinated by the Vienna Vaccine Safety Initiative (www.vi-vi.org, accessed on 13 June 2022), in collaboration with academic institutions, NGOs and public health agencies in Europe as well as the European Academy of Paediatrics and the European Parents’ Association.

Funding

The ImmuHubs project is co-funded by European Union’s Health Programme (2014–2020) and coordinated by the Vienna Vaccine Safety Initiative (www.vi-vi.org, accessed on 13 June 2022), in collaboration with academic institutions, NGOs and public health agencies in Europe as well as the European Academy of Paediatrics and the European Parents’ Association. The content of this publication represents the views of the authors and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the European Health and Digital Executive Agency (HaDEA) or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for any use of the information it contains.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

disadvantaged groups
Europe
health services
immunisation programs
inequalities
migration
vaccination

Access to Document

10.3390/vaccines10071038

W Ekezie et al_systemetic review_vaccines-10-01038-v2_Access to Vaccination WHO European Region
Copyright © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)
Final published version, 816 KBLicence: CC BY 4.0

Cite this

Ekezie, W., Awwad, S., Krauchenberg, A., Karara, N., Dembiński, Ł., Grossman, Z., Torso, S. D., Dornbusch, H. J., Neves, A., Copley, S., Mazur, A., Hadjipanayis, A., Grechukha, Y., Nohynek, H., Damnjanović, K., Lazić, M., Papaevangelou, V., Lapii, F., Stein-Zamir, C., & Rath, B. (2022). Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review. Vaccines, 10(7), Article 1038. https://doi.org/10.3390/vaccines10071038

@article{a5fe3e10ab0c42a99bfe56fa1fd25ad8,

title = "Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review",

abstract = "Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.",

keywords = "disadvantaged groups, Europe, health services, immunisation programs, inequalities, migration, vaccination",

author = "Winifred Ekezie and Samy Awwad and Arja Krauchenberg and Nora Karara and {\L}ukasz Dembi{\'n}ski and Zachi Grossman and Torso, \{Stefano Del\} and Dornbusch, \{Hans Juergen\} and Ana Neves and Sian Copley and Artur Mazur and Adamos Hadjipanayis and Yevgenii Grechukha and Hanna Nohynek and Kaja Damnjanovi{\'c} and Milica Lazi{\'c} and Vana Papaevangelou and Fedir Lapii and Chen Stein-Zamir and Barbara Rath",

note = "Copyright {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Funding Information: The ImmuHubs project is co-funded by European Union{\textquoteright}s Health Programme (2014–2020) and coordinated by the Vienna Vaccine Safety Initiative (www.vi-vi.org, accessed on 13 June 2022), in collaboration with academic institutions, NGOs and public health agencies in Europe as well as the European Academy of Paediatrics and the European Parents{\textquoteright} Association. ",

year = "2022",

month = jul,

day = "1",

doi = "10.3390/vaccines10071038",

language = "English",

volume = "10",

journal = "Vaccines",

publisher = "Multidisciplinary Digital Publishing Institute",

number = "7",

}

Ekezie, W, Awwad, S, Krauchenberg, A, Karara, N, Dembiński, Ł, Grossman, Z, Torso, SD, Dornbusch, HJ, Neves, A, Copley, S, Mazur, A, Hadjipanayis, A, Grechukha, Y, Nohynek, H, Damnjanović, K, Lazić, M, Papaevangelou, V, Lapii, F, Stein-Zamir, C & Rath, B 2022, 'Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review', Vaccines, vol. 10, no. 7, 1038. https://doi.org/10.3390/vaccines10071038

TY - JOUR

T1 - Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review

AU - Ekezie, Winifred

AU - Awwad, Samy

AU - Krauchenberg, Arja

AU - Karara, Nora

AU - Dembiński, Łukasz

AU - Grossman, Zachi

AU - Torso, Stefano Del

AU - Dornbusch, Hans Juergen

AU - Neves, Ana

AU - Copley, Sian

AU - Mazur, Artur

AU - Hadjipanayis, Adamos

AU - Grechukha, Yevgenii

AU - Nohynek, Hanna

AU - Damnjanović, Kaja

AU - Lazić, Milica

AU - Papaevangelou, Vana

AU - Lapii, Fedir

AU - Stein-Zamir, Chen

AU - Rath, Barbara

N1 - Copyright © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Funding Information: The ImmuHubs project is co-funded by European Union’s Health Programme (2014–2020) and coordinated by the Vienna Vaccine Safety Initiative (www.vi-vi.org, accessed on 13 June 2022), in collaboration with academic institutions, NGOs and public health agencies in Europe as well as the European Academy of Paediatrics and the European Parents’ Association.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

AB - Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

KW - disadvantaged groups

KW - Europe

KW - health services

KW - immunisation programs

KW - inequalities

KW - migration

KW - vaccination

UR - https://www.scopus.com/pages/publications/85133513251

UR - https://www.mdpi.com/2076-393X/10/7/1038

U2 - 10.3390/vaccines10071038

DO - 10.3390/vaccines10071038

M3 - Review article

AN - SCOPUS:85133513251

VL - 10

JO - Vaccines

JF - Vaccines

IS - 7

M1 - 1038

ER -

Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this