The COVID-10 vaccines have arrived very slowly in numerous countries, especially in European Union countries, where the death rates from the pandemic have been high. The supply to none of these nations can compare with the speed in which they were utilized in Israel to protect the population.
The current pandemic has reinforced the central role vaccines play in protecting public health. It is fundamental to improve the responsiveness of health systems to ensure equitable access and uptake of vaccines against all vaccine-preventable diseases.
While there are particular challenges to mass COVID-19 vaccinations, many of the challenges are also common to routine vaccination programs, such as communication, availability of services, and adequate training of health professionals. Many systemic elements of national immunization programs influence vaccination rates. This is particularly true for ethnic, religious and cultural minorities who may face more barriers, such as restricted access to or information about health services, digital exclusion, exclusion from population registers and culturally inappropriate messaging around vaccination.
But there is hope for improvement, with help from Israelis. RIVER-EU (“Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities”) – a new initiative funded by the Horizon 2020 Research Program – is a five-year project that will collect evidence on health system determinants of high and low vaccine uptake in eight specific contexts that will be used to identify and/or develop interventions to reduce barriers in underserved communities and increase trust in the health system.
Horizon 2020 is the financial instrument implementing the Innovation Union, a Europe 2020 flagship initiative aimed at securing Europe’s global competitiveness. Seen as a means to drive economic growth and create jobs, Horizon 2020 has the political backing of Europe’s leaders and the members of the European Parliament. They agreed that research is an investment in our future and so put it at the heart of the EU’s blueprint for smart, sustainable and inclusive growth and jobs.
By combining research and innovation, Horizon 2020 is helping to achieve this with its emphasis on excellent science, industrial leadership and tackling challenges to society. The goal is to ensure that Europe produces world-class science, removes barriers to innovation and makes it easier for the public and private sectors to work together in delivering innovation.
Horizon 2020 is open to everyone, with a simple structure that reduces red tape and time so participants can focus on what is really important. This approach makes sure new projects get off the ground quickly – and achieve results faster
Deputy project leader Prof. Michael Edelstein, associate professor of Public Health at the Azrieli Faculty of Medicine of Bar-Ilan University (BIU) in Ramat Gan (near Tel Aviv) commented: “RIVER-EU will develop interventions specifically designed to ensure that underserved groups receive the vaccines to which they are entitled.”
RIVER-EU will work to improve access to two vaccines – against MMR (measles/mumps/varicella) vaccines and HPV (human papillomavirus virus) – among specific underserved communities in Greece (refugees and migrants), the Netherlands (adolescents of Turkish and Moroccan origins), Poland (Ukrainian economic migrants) and Slovakia (Roma – gypsy – populations). The project will collect evidence what causes low vaccination rates in these five communities, as well as on high vaccine uptake in three underserved communities in the United Kingdom (the Bangladeshi community), Finland (the Somali community) and Israel (the Arab Israeli community).
In Israel, despite socio-economic disparities, the Israeli Arab population achieves very high vaccine vaccination rates. The RIVER-EU consortium is focusing on this population to understand what enables this phenomenon due to the fact that socio-economic deprived groups normally have lower vaccine uptake.
On the basis of the gathered evidence, insight from enabling factors in the UK, Israeli and Finnish contexts will be adapted to provide useful insight to design interventions addressing health system barriers in the five target communities. RIVER-EU will design, implement and evaluate interventions to improve access to vaccination using a co-creative and collaborative approach. The lessons learned will be collected in a set of evidence-based guidelines and implementation recommendations and disseminated to health policy makers and professionals across Europe to improve the performance of vaccine programs and reduce vaccine inequalities.
“Our research focuses on changing healthcare and how we can increase vaccination coverage with targeted interventions,” says researcher and project leader Associate Prof. Danielle Jansen in the department of general practice at Holland’s University Medical Center Groningen
“To do this, we need to identify and remove barriers in the health care system,” she concluded. “We will do this by adapting existing interventions and developing new interventions that are tailor-made with and for disadvantaged communities. Consider, for example, the extra training of professionals in approaching and convincing certain groups or addressing barriers posed by poverty, a different language, limited health skills or social exclusion.”
RIVER-EU’s diverse and highly-experienced consortium includes 13 project partners in addition to BIU and the Dutch medical center – Public Health England, the Institute of Preventive Medicine, Environmental and Occupational Health, EuroHealthNet, Connaxis, Vienna Vaccine Safety Initiative, Maastricht University, the European Academy of Pediatrics, University of Zielona Góra, Pavol Jozef Šafárik University in Košice, the London School of Hygiene and Tropical Medicine, the Finnish Institute for Health and Welfare and the European Public Health Association.