Commission report: EU public trust in vaccines largely positive but gaps remain

At the presentation of the report, EU Health Commissioner Vytenis Andriukaitis commented, “Trust in vaccines is essential for maintaining high coverage rates”. [Shutterstock]

Public perception towards vaccines is largely positive across the EU, with Portugal marking the highest scores, a new report has found. However, mistrust still exists in some member states and four of them are among the top ten vaccine-sceptical countries in the world.

According to the State of vaccine confidence in the EU 2018 report, published on 24 October, the majority of EU citizens “strongly or tend to agree” that vaccines are important (90.0%), safe (82.8%) and effective (87.8%).

The EU Commission report, conducted in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM) and the Vaccine Confidence Project, pointed out that public confidence in vaccination programmes was a crucial factor for maintaining high coverage rates, especially at levels that exceed those required for herd immunity, a term that denotes sufficient resistance within a population.

“Trust in vaccines is essential for maintaining high coverage rates,” EU Health Commissioner Vytenis Andriukaitis commented at the presentation of the report.

Andriukaitis, who recently told EURACTIV that reaching and maintaining a high level of immunity was very important, explained that Europe was becoming one of the regions with the lower confidence in the safety of vaccines

“Four out of ten countries with the lowest vaccine confidence in the world are in the EU,” the EU politician said.

Portugal: best performer

According to the study, the best performer is Portugal, which has the highest percentage of respondents agreeing that vaccines generally are safe (95.1%), effective (96.6%), and important for children to have (98.0%).

Portugal also has the highest percentage of people who consider the trivalent vaccine against measles, rubella, and mumps to be safe and important for children.

Across the 28 EU member states, public perception of vaccines is largely positive, with the majority of the EU public agreeing (strongly or tend to agree) that vaccines are important (90.0%), safe (82.8%) and effective (87.8%).

However, this is not the case for some member states.

The Czech Republic, Finland, Poland, and Sweden display rising levels of mistrust, while respondents from Bulgaria are least likely to agree that vaccines are safe (66.3%), followed by Latvia (68.2%) and France (69.9%).

Conversely, a number of member states, including France, Greece Italy and Slovenia have become more confident in the safety of the vaccines since 2015.

However, overall confidence remains low in France, which was identified as the one with the lowest confidence in the safety of vaccines in 2016 because of a historical context of vaccine controversies and mistrust.

While general practitioners (GP) hold higher levels of vaccine confidence than the public, in the Czech Republic and Slovakia, 36% and 25% of the GP respondents, respectively, do not agree that the vaccine to protect against measles, mumps, and rubella (MMR) is safe, while 29% and 19% respectively do not believe it is important.

Measles and influenza

The report assessed the state of confidence in vaccines in general, with a particular focus on MMR and seasonal flu vaccines.

Globally in the European Union, less than 80% consider measles vaccine to be safe, a percentage that is even lower in relation to the influenza vaccine, with less than 70% of the European population seeing it as safe.

Sweden, Belgium, Bulgaria and Latvia are the countries with the lowest percentage of the population to consider the measles vaccine as safe.

The report emphasised that the recent measles outbreaks underline the immediate impact of declining coverage on diseases outbreaks.

Europe reported 21,315 cases of measles, including 35 deaths, in 2017 – a 400% increase in 2016, according to the data published by the World Health Organisation (WHO) in February.

In 15 of the 53 countries in the WHO European region, the surge of the disease in 2017 was manifested by “major outbreaks” (100 or more cases). “The highest numbers of affected people were reported in Romania (5,562), Italy (5,006) and Ukraine (4,767),” the WHO stated.

In some countries, concerns about the safety of seasonal flu vaccines are more prominent.

In France, for instance, there is a striking difference between the percentage of survey respondents agreeing that the MMR vaccine (77.3%) and the seasonal flu vaccine (51.8%) is safe.

Low confidence in the seasonal flu vaccine is partially due to the 2009 controversies that surrounded the AH1N1 pandemic influenza vaccination campaign in France.

In light of rising anti-vaccination campaigns across the EU, the European Commission has recommended a strengthened cooperation of all stakeholders against vaccine-preventable diseases.

John Ryan, director of public health in the Commission’s DG SANTE, told EURACTIV in October that this recommendation should not remain a “piece of paper” as it needs to bring tangible results for all age groups.

Recommendation on vaccines should not remain a ‘piece of paper’, Commission says

The European Commission’s proposed recommendation on strengthened cooperation of all stakeholders against vaccine-preventable diseases should not remain a “piece of paper” as it needs to bring tangible results for all age groups, Commission officials told

Life-course immunisation

In his 2017 State of the Union speech, European Commission President Jean-Claude Juncker said it was “unacceptable” that children are still dying from diseases that can easily be prevented with vaccines, like measles.

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