Organisational and Structural Drivers of Childhood Immunisation in the European Region

BACKGROUND: Evaluating the immunisation program is vital to identify the inherent factors that impact the achievement of the intended countrywide vaccine coverage rates (VCRs). However, despite the implementation of widespread vaccination programs, the European Health Systems continue to experience care challenges attributable to organizational and structural issues. This study aimed to review the available data on aspects within the organizational and structural domains that might impact vaccination coverage. RESULTS: This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched a comprehensive range of databases from 1 January 2007 to 6 July 2021 for studies that reported quantitative or qualitative research on interventions to raise childhood vaccine coverage. Outcome assessments comprised organizational and structural factors that contribute to vaccine concerns among pediatric parents, as well as data reported influencing the willingness to vaccinate. To analyze the risk of bias, the Ottawa, JBI's (Joanna Briggs Institute) critical appraisal tool, and Amstar quality assessment were used accordingly. The inclusion criteria were met by 205 studies across 21 articles. The majority of the studies were conducted in the United Kingdom (6), the European Union (3), and Italy (3). CONCLUSIONS: A range of interventions studied in primary health care settings have been revealed to improve vaccination coverage rates including parental engagement and personalization, mandatory vaccination policies, vaccine program redesign, vaccine supply chain design, administering multiple/combination vaccines, improved vaccination timing and intervals, parental education and reminders, surveillance tool and Supplemental Immunisation Activity (SIA), and child health information model. KEY MESSAGES: • Maintaining high vaccine uptake rates is critical to the success of any vaccination program and the improvement of children’s health. • Parents and the general public must be actively engaged by health planners and specialists, and process mechanisms must be implemented to guarantee that children receive primary prevention.