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email: secretariat@ineip.org
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Vaccination Equity
Vaccination Equity:
Reaching every child, every community.
Safe and effective vaccines exist, yet significant inequities in vaccination uptake and protection persist across populations and settings. Children and families experiencing poverty, social exclusion and limited access to services are consistently missed by the systems meant to protect them, with consequences that extend across the life course. How can we work together to close these gaps and ensure every child, every community, is protected?
Understanding Barriers
Why Vaccination Inequities Persist in Europe
Vaccination inequity is too often framed as a matter of individual choice or "vaccine hesitancy." Yet, the evidence is clear: inequities are predictable, patterned, and preventable outcomes of how health systems are designed, measured, and experienced. Families are not failing to vaccinate; in many cases, systems are failing families.
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Data Blind Spots
Headline coverage figures can look reassuring while masking deep inequalities between groups and areas. Because systems rarely track timeliness or drop-out, these gaps are often spotted only after an outbreak.
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Structural and Socioeconomic Barriers
Poverty, housing instability, inflexible hours, and complex appointment systems all obstruct vaccination — regardless of whether the vaccine is free. Access has to be designed around how families actually live.
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Trust
Mistrust in vaccination usually reflects a broader mistrust in institutions, shaped by real experiences of inconsistent or unresponsive services. Trust is built through how systems behave over time, not through messaging alone.
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Community Decision-Making
Vaccination choices reflect shared values, relationships, and community norms, not individual knowledge alone. Decisions are often shaped through family and social networks rather than formal authorities.
Key Findings
Evidence for Action
This meeting report from the December 2025 LifeCourse Prevention Summit examines why vaccination inequities persist despite safe, effective vaccines and sets out an evidence-based framework for action.
Download the ReportVaccination inequities are predictable, patterned, and preventable outcomes of system design.
Core Objective
Make equity a core performance priority, embedded in governance, delivery, and accountability — not an aspirational add-on.
Better Data
Disaggregate coverage and track timeliness and drop-out, so inequities become visible early enough to act on.
Equity by Design
Build equity into programs from the outset, especially when introducing new vaccines, rather than retrofitting it later.
Remove Barriers
Free vaccines aren't enough; address the structural obstacles to access and align resources with need.
Rebuild Trust
Strengthen trust through consistency, transparency, and responsive services supporting the professionals who carry it.
Community Partnership
Treat community engagement as core infrastructure: co-designed, locally embedded, and sustained over time.
Resources
Insights, Reports & Expert Perspectives
Explore a collection of policy briefings, expert interviews, reports and newsletters from the LifeCourse Prevention Initiative.
Community Engagement Approaches to Improve Health
Community engagement approaches to improving health, the key barriers to successful engagement and a framework for building trust and equity in underserved communities.
December 5, 2025
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Barriers to Childhood Vaccination in Underserved Communities
The structural and behavioral barriers to vaccination in underserved communities and how health systems must be redesigned around people's lived realities.
December 5, 2025
Social Inequities in Child Health and Vaccine Uptake - Evidence from the UK
Evidence on the widening inequalities in childhood vaccination uptake in the UK, linking the declining coverage to rising child poverty and cuts to preventive services.
December 5, 2025
Inequalities in RSV - Lessons from Barnardo's Public Health Campaign
Barnardo's RSV public health campaign, showing how a culturally competent, community-led approach can reach underserved families and reduce health inequalities.
December 5, 2025
Overcoming System-Level Failures in Vaccination Equity
The three systemic failures that prevent vaccination programs from achieving equity, what overcoming them requires.
December 5, 2025
HTAi for Vaccines - Why It Matters and What Europe Must Get Right
What Health Technology Assessment means for vaccines, and why getting it right matters for new vaccines to reach patients equitably and efficiently across EU.
December 4, 2025
Pediatric RSV Immunisation from Across Europe and Beyond
Review of the available strategies for pediatric RSV prevention, presenting real-world evidence from across Europe and arguing that all infants need protection.
May 12, 2025
Vaccine Trust and Confidence in the Context of Inequality
The drivers of vaccine hesitancy and declining confidence globally, evidence on the role of trust, and institutional credibility in shaping vaccination decisions.
May 12, 2025
A Life Course Approach to Increase Coverage Amongst the Most Vulnerable
Strategies to improve immunization access in underserved communities, addressing social determinants of health and healthcare system barriers.
November 29, 2024
RSV Associated Hospitalizations Across All Age Groups
Data-driven analysis of RSV hospitalization burdens across age groups, seasonal patterns and system-level challenges for healthcare capacity planning.
November 29, 2024
The Essential Role of Pharmacists in Addressing Immunisation Inequity
How pharmacists can transform vaccination accessibility in underserved communities, practical models to integrate pharmacy-based immunization into healthcare systems.
November 29, 2024
Consequences of Inadequate Vaccination on Health Conditions in Late Adulthood
How inadequate vaccination in older adults exacerbates chronic conditions, increases hospitalization risks, and impacts healthcare systems and quality of life.
November 29, 2024
Consequences of Missed Childhood Vaccinations on Individual and Community Health
Lifelong individual and public health impacts of missed childhood immunizations, with insights on preventing outbreaks and protecting community immunity.
November 29, 2024
Leveraging Civil Society and Community Leadership to Bridge Gaps in Vaccine Coverage
How civil society organizations and community leaders can address vaccination gaps, build trust, and implement sustainable immunization programs in diverse communities.
November 29, 2024
The Role of Misinformation in Shaping Vaccine Access and Uptake
How false information limits equitable vaccine access, evidence-based approaches to misinformation and community trust in immunization programs.
November 29, 2024
The Role Of Civil Society In Promoting Vaccination Across The Life Course
How civil society organizations can advocate for vaccination programs, building community support and influencing policy decisions across age groups.
December 2, 2022
The Importance Of Social Networks And Platforms To Vaccine Confidence
How social networks shape vaccine attitudes, and strategies for leveraging these platforms to counteract misinformation and promote evidence-based vaccine decisions.
December 2, 2022
The Crucial Role Nurses Can Play In Increasing Vaccine Confidence
How nurses can address vaccination hesitancy, featuring evidence-based communication strategies and practical approaches to build patient confidence.
December 2, 2022
Maternal Vaccinations: Building Trust Among Pregnant Women
Aapproaches to increase vaccine confidence among pregnant women, communication strategies to improve maternal and infant protection through immunization.
December 2, 2022
LifeCourse Vaccinations Role In Reducing Hospital Admissions And Burden
Data-driven analysis of how vaccination across all life stages reduces hospital admissions, healthcare resource utilization, and system-wide economic burden.
December 2, 2022
Identifying Factors Driving Vaccination Uptake Amongst Healthcare Workers
The determinants of vaccination acceptance among healthcare professionals, motivational factors, barriers, and effective strategies to improve immunization rates.
December 2, 2022
Disruptions To Routine Childhood Vaccinations During The COVID-19 Pandemic
Disruptions to childhood vaccination programs, coverage declines, contributing factors, and strategies to recover missed immunizations and strengthen systems.
December 2, 2022
Measuring Vaccine Confidence On Twitter
Social media sentiment to gauge public vaccine confidence, with insights on monitoring trends, identifying misinformation, and targeted communication strategies.
December 3, 2021
COVID-19 Vaccine Acceptance/Refusal In Young Children
Predictors of parental acceptance or refusal of COVID-19 vaccines for young children, key demographic, social, and psychological factors influencing vaccination decisions.
December 3, 2021
How Can We React To The Dynamic Shifts in the Three Main Social Groups; the Believers, the Indifferent, and Those Against Vaccines?
Strategic approaches to engage with the three main vaccine attitude segments (believers, indifferent, opposed), changing perceptions and tailoring communication strategies.
December 3, 2021
Co-production With Young People: Educational Resources For Schools
Innovative approach to developing health education materials with student involvement, creating age-appropriate and engaging resources
December 3, 2021
Education About Vaccination And Vaccine Hesitancy Amongst HCPs
Vaccine education needs for healthcare practitioners, hesitancy factors and evidence-based strategies to build vaccine confidence in clinical settings.
December 4, 2020
The Rise Of Online Misinformation, Fuelled by COVID-19
How the COVID-19 pandemic accelerated the spread of health misinformation, information ecosystem changes and effective counter-strategies for public health communicators.
December 4, 2020
Should Influenza Vaccines Be Delivered At The Same Time As A COVID-19 Vaccine?
Scientific evidence for simultaneous administration of COVID-19 and influenza vaccines, safety profiles, immune responses, and practical implementation considerations.
December 4, 2020
Trust Poverty and the System
Sir Terence Stephenson, offers both a systemic diagnosis and a clear prescription: there is no magic bullet — vaccination equity is the product of a more equal society, better systems, and professionals who listen before they speak.
December 4, 2025
The Power of Trusted Communities
Rukshana Kapasi, sets out a clear reality: closing the vaccination gap requires more than clinical delivery. It requires trust — and community-based organizations are essential to building it.
December 4, 2025
The Unseen Children
Prof. Monica Lakhanpaul, shines a light on children who are mobile, marginalized, and invisible to the health system — and what it takes to reach them.
December 4, 2025
Child Poverty & Vaccination Inequalities
Prof. David Taylor-Robinson, presents stark data: the more deprived the area, the lower the vaccination uptake — and the gap is widening.
December 4, 2025
Community Engagement & Vaccination Uptake
Prof. Angela Harden, makes the case that community engagement is not the 'nice to have' of public health — it is the essential. Vaccination confidence can't be lectured into communities. It has to be built from within them.
December 4, 2025
Vaccination Equity Report 2025
The report brings together evidence, policy perspectives, and practical experience from leading experts across public health, clinical practice, social science, civil society, and policy, all focused on a critical question: why do vaccination inequities persist, and what will it take to fix them? The answer that emerged is clear: Vaccination inequities are not accidents. They are predictable, patterned, and preventable outcomes of how systems are designed, measured, and experienced.
May 1, 2026
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Vaccination Equity Report 2024
This report presents findings from a survey of 198 pediatric healthcare professionals that examines why children go unvaccinated in mixed-income communities. It distinguishes outright vaccination refusal driven by mistrust, sociocultural beliefs, and low health literacy from adherence issues such as missed appointments, which stem from logistical and economic barriers. The report closes with targeted recommendations for healthcare systems and practices to improve equity.
April 22, 2025
Volume V - Vaccination Equity - Equitable Access Requires Far More Than Free Vaccines
Free vaccines don't guarantee equal access. Why child poverty drives vaccination inequity, and why reducing it is a prerequisite.
June 8, 2026
Volume III - Vaccination Equity - Vaccination Programs Should Be Designed Around Families - Not Systems
When communities are engaged as partners, vaccination programs work better. Insights from the 2025 LifeCourse Summit on co-design, engagement, and equity.
May 21, 2026
Volume I - Vaccination Equity - When Communities Don’t Trust Vaccination Systems, It’s a System Failure
Why do vaccination systems fail the communities they serve? Insights from the 2025 LifeCourse Prevention Summit on trust, access, and the case for system change
May 7, 2026