Overcoming Obstacles to Vaccination: an overview of practical and administrative challenges in EU vaccination systems

Overcoming Obstacles to Vaccination is a 3-year project funded by the European Health and Digital Executive Agency (HaDEA) on behalf of the European Commission.

Verian Brussels led this project in partnership with the  European Health Management Association (EHMA), ifok GmbH, European Academy of Paediatrics (EAP) and the European Regional and Local Health Authorities (EUREGHA).

It is one of the few initiatives addressing obstacles to vaccination from a system perspective, with multiple objectives:

• Identify and map obstacles to vaccination of a physical, practical, and administrative nature and the adverse impact these obstacles have on EU Member States and vaccination coverage rates.
• Identify promising practices implemented by EU Member States which can overcome such obstacles.
• Develop recommendations that address the obstacles identified and which are tailored to different actors, including policymakers at EU and national levels, competent health authorities in EU Member States, and EU and national health professionals, patients and citizens.

The mapping identified key steps undertaken by citizens across the EU27 Member States during their vaccination journeys. These steps include outreach methods used by healthcare services and notifications to inform citizens about vaccination; pre-administration requirements; booking procedures; travel distance; and costs. Vaccination programs generally follow similar guidelines across countries and regions but differ in implementation due to governance structures and epidemiological contexts.

System-level factors influencing vaccine uptake across EU Member States—focusing on practical, physical, and administrative determinants—were mainly grouped into three broad categories of barriers, all of which have a measurable impact on vaccination rates:

• Outreach and information barriers
• Geographical and convenience barriers
• Administrative and systemic barriers

As part of the project, health authorities implemented nine pilots inspired by promising practices, organised into three clusters:

• Reminder schemes (Catalonia, Croatia, Murcia, Lithuania, Slovenia)
• Mobile vaccination units (Austria, Sweden)
• School vaccinations (the Netherlands, Estonia)

The experiences from pilot clusters provide blueprints for success. Introducing reminders, expanding vaccination sites, bringing vaccines into communities via mobile offering, integrating vaccines into routine services like schools address multiple barriers such as lack of information on vaccination schedules, physical and logistical barriers, inconvenience of locations and hours.