Prof Mike Catchpole, ECDC Chief Scientist on 'Vaccination in the EU: benefits and barriers' to the ENVI Committee of the European Parliament.

1. ENVI Committee exchange of view
Vaccination in the EU:
benefits and barriers
Prof Mike Catchpole, Chief Scientist
European Centre for Disease Prevention and Control
ENVI Committee 17 June 2015, European Parliament, Brussels

2. December 2004 October 2012
Why do EU Member States have vaccination programmes?
To protect the health of Europeans

3. Finland - reported measles, mumps, and rubella through November,
2007, since 1915 for measles, 1943 for mumps, and 1957 for rubella*
*Peltola et al Measles, mumps, and rubella in Finland: 25 years of a nationwide elimination programme Lancet 2008; issue 8 vol 12; 796–803
Through MMR vaccination
measles complications averted
Hospitalisations: 1 per 5 cases
Otitis media: 1 per 11 cases
Pneumonia: 1 per 12 cases
Encephalitis: 1 per 1,000 cases
Subacute sclerosing panencephalitis: 1 per
100,000
Deaths: 1 per 1,000 to 5,000 cases
mumps complications averted
Hospitalisations: 1 per 25 cases
Meningitis: 1 per 12 cases
Bilateral orchitis: 1 per 30 cases
Encephalitis: 1 per 300 cases
Pancreatitis: 1 per 500 cases
Hearing impairment: 1 per 300 to 1,000
cases
rubella complications averted
Congenital rubella syndrome: 1 per 400
cases
Post-infectious encephalopathy: 1 per
500,000 cases

4. Vaccines used in EU are highly safe

6. Vaccination policy in Europe is
not achieving its public health goals
Example: elimination of measles in Europe by 2010, 2015, 2020 (?!)
Source: TESSy data on measles cases reported 1 January – 30 April 2015;
Measles vaccine coverage (two doses, 2012 – 2013)

7. EU citizens still die from vaccine
preventable diseases! The threat continues

8. Why vaccination targets are not met (1):
Vaccine hesitancy
• Influenced by issues of confidence (level of trust in vaccine or
provider), complacency (do not perceive need for vaccine) and
convenience (access).
• Hesitant citizens may: i) accept all vaccines but remain concerned; or
ii) refuse or delay some vaccines; or iii) refuse all vaccines
• Results of the ECDC study:
– Main concern/ fear: vaccine safety
– Hesitancy among healthcare professionals
Vaccine safety
concerns
Incidence of disease
Source: Rapid literature review on motivating hesitant population groups in Europe to vaccinate, ECDC, 2015
(under editing).

9. Why vaccination targets are not met (2):
Under-served population groups
Photo credits: www.vam.ac.uk/moc/images/image/36307-popup.html, by Eithne Nighingale
http://www.flickr.com/photos/87563734@N00/ by Henri Weisen

10. Why vaccination targets are not met (3):
Vaccine availability
• Currently, almost one third of Member States have reported
difficulties in procuring vaccines for the vaccination of infants
against pertussis (whooping cough).
• Three out of nine influenza vaccine producers in EU closed
production in the last two years (Baxter, Crucell &
Cantacuzzino).

11. Strengthening prevention and control:
What ECDC is currently doing
2015 will aim at:
 Supporting in responding to the existing and
upcoming Council Conclusions on immunisation
 Providing evidence-based communication tools for
reaching hesitant groups
 Fostering exchange of knowledge to strengthen
vaccination programmes - VENICE project
 Coordinating and supporting EU-wide VPD network
 Supporting Member States with country visits upon
request
ECDC works in a multi-disciplinary approach…
…to support and strengthen prevention and control efforts on
vaccine preventable diseases (VPDs) in the EU/EEA.

12. What more can be done at EU level?
• Support for EU level projects on key issues such as:
– vaccine hesitancy
– under-served populations
– immunity gaps etc.
• EU action to further improve evidence-base for public health
(national and EU level) decisions on vaccination policy
– ECDC guidance
– Robust vaccine monitoring data